Possible HIV exposure?

Hi doctor,

I live in Australia.

I've had received unprotected oral sex by a female asian prostitute of unknown risk on the 11th of November 2006. She claims she is from USA. And i also performed oral sex on her but only for a little while. I had no viginal sex with her. I totally regret what i did as it has caused me so much anxiety. That night i had a shower and discovered that i had a small cut on my penis (on the skin, not on the head of the penis). I got HIV tested about 4 weeks after the exposure for HIV, Herpes etc, and all came back negative.

and around the weekend on the 23/24 of December, I noticed some small cuts/openings on the left side of my lips. I have touched them quite a bit and also applied after shave on them because i thought the alcohol in them might help kill bacteria etc. Apart from the alcohol i havn't applied any other medication/cream to it. a week later I have developed yellow crusts that covers the cuts. It has a burning sensation when i lick it, and when i open my mouth wide it sometimes breaks the coverage and bleeds. anyways i think (pretty sure) it is angular cheilitis. It still havn't healed (i've just applied dettol antiseptic cream and blistex cream to it in the past couple of days).

I've read somewhere, alot of places actually, that angular cheilitis is a precursor to HIV. I've had general feeling of unwellness a few days before i got the HIV /STD tests. I felt tired, nausea?(but never vomited) and headaches. The symptoms could have been psychological, i dunno, i'm confused... anyways the initial symptoms are gone after the negative HIV /STD tests which gave me a few weeks of relief, but not for long. I now have this angular cheilitis.

My question is doctor,

1. What is my risk of getting HIV from my encounter? (note the cut on the penis)
2. Is the HIV test conclusive? should i get another test done? What should i do???
3. How do i get rid of this angular cheilitis infection? did my application of aftershave worsen it?

Thank you for your help.

[H. Hunter Handsfield, M.D.]

1) Zero risk for practical purposes.  Oral sex is virtually zero risk, cuts or no cuts--probably because saliva inactivates HIV.  Although there have claims of acquiring HIV from receiving oral sex, there are few if any proved cases.  Performing cunnilingus is no risk.

2) Your negative HIV test is conclusive.

3) Angular cheilitis can be present in advanced immune deficiency, but I'll bet nobody ever had it as the only evidence of HIV infection.  In any casee, it's a common problem and 99.9% of cases have nothing to do with HIV.  The exact cause is often unknown.  I have no particular advice for it.

Bottom line:  You don't have HIV.  Stop trying to figure out the cheilitis yourself and see a health care provider for personal evaluation.

HHH, MD

[duracell123]

Sorry,

Want to clarify the cut on the penis. I saw a very tiny lump of blackish red on the inside skin of my penis, i was able to wash it away and assumed it was a cut? (i think i remember seeing the tiniest of a cut) i can't remember clearly, i'm going crazy.

[nervous_nikki]

Hi there...Your cracked lip issues:

First of all, it is winter and practically everyone has cracked lips.  Just because you have cracked lips doesnt necessarily mean Angular cheilitis. It could just be Cracked lips and cracked lips are not a symptom of HIV and if it were everyone who buys blistex and chapstick would be getting tested.  Oral mucosal (mouth) tissue is very thin and sensitive.  Changes in the weather will cause them to dry out and repeatedly touching them and licking makes it worse. Now for my main point...

"applied after shave on them because i thought the alcohol in them might help kill bacteria etc. Apart from the alcohol i havn't applied any other medication/cream to it. a week later I have developed yellow crusts that covers the cuts. It has a burning sensation when i lick it, and when i open my mouth wide it sometimes breaks the coverage and bleeds."

you put what on your cracked lips??? Alcohol?? mistake number one! Honey...sweetie...no wonder why they are getting worse oh my goodness! Never, never, NEVER, unless you are stranded somewhere for days or weeks, with a bleeding wound that could potentially be infected, become gangrenous, and need amputatuon put ANYTHING with alcohol on open skin. EVER! This is why your lips are now much worse.  1. they are very irritated from the harshness of the alcohol 2. they are very dried out! Angular cheilitis is possible but it is indicated usually from fungal infection, nutritional deficiency...however even if you did have this the alcohol made it worse without a doubt

Treatment for your painful and bleeding lips:
1. If you are concerned that you have AC then you need to see a Dr. so that you can be prescribed antibiotic/anitviral cream

2. In the meantime, buy some bactine or peroxide (to clean and disinfect) and neosporin or bacitracin (antibacterial protective coating)...put the cleanser on the area 2-3 times a day and then coat with the cream. Avoid anything spicy or acidic, and no alcohol. Bactine is the best because it has an analgesic property to it.  This should help if it doesnt then you need cream from the DR.  Good luck! and remember no alcohol! :)

As far as HIV goes, you have virtually no risk but Dr. H will probably tell you that himself.  Unless you have vag or anal sex there is a rediculously low risk. You'll be fine. Relax and enjoy the New Year.

[sweetnss06]

Actually, it's not winter in Australia....but everything else was right on.

[duracell123]

Thank you doctor so much for your advice. and thank you nervous_nikki for your comment.

[nervous_nikki]

whoops, missed the part about you being from Australia...none the less that does not change my opinion.  I still think you'll be A-Ok. Take care ! :)

[DEMCAD]

"Performing cunnilingus is no risk."

I am so glad that you said that. Thanks doc.