Risk and ARS symtoms

[NoCalGuy]

Hi, I am a bit worried. I had a one time encounter with a male massage therapist about a month ago. It led to both of us giving oral sex for a minute or two with no ejaculation. I got him off by hand and then rubbed my on his belly until I came, about another minute.

10 days later I had a bout of the chills but showed no fever when I took my temp. It lasted for a few hors in the afternoon and I felt fine in the morning. A week later I had a bad bout of diahrea right after I awoke and it lasted about 4 hours, after which I had pain in the prostate region all day.

Two days after that I had stinging urination and some irritation on the tip of my penis.  I went into the doctor this past Tuesday and got tested for Chlamydia and Gonorrhea which I have not yet seen the results.  They did give me the Zthromax and a shot and sent me on my way.  The stinging has gone away three days later. I feel pretty good now but am worried about Hiv exposure from what I have done.

[NoCalGuy]

Thanks on that!  I am not really worried but feel more guilt over letting my guard down. I was a bit worried that his ejaculate touched my urethra and that would be a route of transmission.

[H. Hunter Handsfield, M.D.]

There is a slight chance you caught gonorrhea or nongonococcal urethritis (NGU) from the oral sex event.  Most cases have discharge as the main or only symptom, not urethral pain, so most likely not and I expect your gonorrhea test to be negative.  Chlamydia isn't acquired by oral sex, so that will be negative for sure, unless you were infected previously.  But treatment for all those things, which you had, was the right thing to do to be safe.  And the resolution of symptoms a couple days after treatment suggests you might have been infected; most likely you'll never know for sure.

As far as HIV goes, the risk from receieving oral sex is so low that many experts believe it doesn't occur at all; for giving oral sex, the risk also is extremely low, estimated at 1 chance in 10,000 if your partner was infected--and that's with ejaculation.  Of course hand-genital contact is risk-free.

Diarrhea and "pain the prostate region" are not symptoms of new HIV infection, and numerous things other than HIV are statistically far more likely as a cause of your chills.  And if you had it, the presumed fever would have continued for at least a week or two.

From a medical or risk assessment perspective, you don't need HIV testing.  But feel free to do it if you remain concerned.

Regards---  HHH, MD