Very Concered - Possible HIV Risk

Hi Dr. HHH / Dr. Hook:

I think it is wonderful this forum is on here to provide insight on possible HIV risk exposures.  Thank you very much for taking the time to analyze my situation and answer my questions.  I greatly appreciate it.

Ok, here is my situation.  Five days ago (Sunday, January 29th.) I had oral sex with a guy (I am a male as well).  We did not ejaculate in each other's mouths.  I am concerned to the fact that a.) there may have been a sore on his penis and b.) we mutually masturbated after the oral sex.  Some of his semen may have gotten on a scratch on my finger.  My finger was not bleeding at the time, and the wound was not open.  It was just a minor scratch.  This guy's HIV status was unknown, but he seemed to think he was negative.

Starting on Monday (maybe Tuesday) I develop swollen lymph nodes in my neck and a sore throat.  I go to a clinic to see if it is strep and it is not (tested negative on strep test).  Now it is Friday, and I still have a very minor sore throat with swollen lymph nodes in my neck.  Last night, I noticed white bumps (spots) on my tonsils.  There were only a few, not many at all.

Please keep in mind this is my only symptom.  I have no fever, no rash.

Do you think I put myself at risk to acquiring HIV?  I am very worried :-(.  What about other STDs like gonorrhea?  Please keep in mind I have minor OCD / General Anxiety Disorder.  I tend to be a "cybercondriac".  I spend hours searching Google aimlessly for ailments and their possible symptoms.  

I know oral sex is very low risk for HIV.  Some would argue there is zero / negligible risk when it comes to oral sex.  Why is there a disparity in  the risk guidance with different websites? (i.e. some websites say oral sex is a risk for HIV, while others say there is practically zero risk).

Thank you for taking the time to answer my questions, doctor.  I really appreciate it.

All the best,

Mike

[Edward W Hook, MD]

Welcome to our Forum.  I'll be happy to try to help.  I have a number of suggestions.  Before I get to your exposure, let me comment on your internet surfing. This is not a good idea.  Your situation, like that of many of our clients represents a great example of the power of the internet not only to inform but also to mislead.  While there is much useful information available on the internet, much of it is also taken out of context or a bit unbalanced and some of it is just plain wrong.  Please stay off the internet.  Particularly if you have a touch of OCD, this is not good for you.

As for your exposure.  This was a no risk exposure.  We answer questions such as this at least once or twice a day so if you search the site for the topic, you will find literally thousands of similar answers.  In most cases, unknown status means HIV negative.  Most people, even men who have sex with other men, do not have HIV.  Further, The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex and we have come to agree.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  This includes by all of the people who had sores on their penis or in their mouths, blood in their mouths, gum disease, etc.

There is no risk of HIV if you got some of your partner’s genital secretions on you, even if it was on a sore or recent scratch.

As for other STDs, oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea is transmitted through giving oral sex and only gonorrhea and NGU are acquired from receiving oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU from receipt of oral sex you would have most likely developed symptoms of urethritis (penile infection).  Even if your partner had an STD (any STD and it is likely he did not), most exposures do not lead to infection.  In your case, your exposure was brief; I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time.  I suspect the tests will be negative and in my opinion.

I hope these comments are helpful.   EWH

[clemsonmike]

One last thing.  After the oral sex encounter, I immediately washed my mouth out with listerine at the guy's house.  I then drove home 30 minutes to an hour later and washed my mouth out with listerine again.  I then flossed and brushed my teeth.  I had some minor bleeding with flossing...... Did this put me at risk of acquirint HIV?

Thank you.

[clemsonmike]

Very helpful.  Thank you Dr. Hook

[Edward W Hook, MD]

Gald to help.  EWH

[clemsonmike]

If I could ask you one last thing lol.  I promise this will be the last.

I seem to have a "rash" (maybe a rash, not sure) on my upper chest and neck.  However, I think i've always had this quote on quote "rash", and it is especially evident during the winter season when the air is dry and cold.  The rash resembles the dry skin or rash I get on my hands in wrist every winter (my hands get so dry that my skin cracks and bleeds).

There are no raised bumps or dark red spots or brown spots.  It is just a light bright red patch or patches of skin that tend to encompass parts of the upper chest and neck.  

The rash is very evident after running for 30 minutes, as my whole face is red as well as chest/neck.  

Could this be an HIV rash?  I know I worry too much......  I'll get a rapid HIV test in 2-3 months after the exposure, and i'm sure i'll test negative since my only risk factors have been unprotected oral sex and protected anal sex.

Thank you for putting up with me Dr. Hook.  I tend to be a hypochondriac at times.  I plan on seeing a psychologist sometime soon.

-Mike

[Edward W Hook, MD]

I think you have answered your own question but let me confirm that-an isolated skin rash without oterh symptoms is not ARS.  You need not worry, really.  EWH

[clemsonmike]

ok thank you again