You are seriously overthinking all this. You were not at any any significant risk of HIV or other STDs from this event and there is no information you can provide that will change that judgment. If you can't accept this advice and move on with your life, visit your primary care provider or your local GUM clinic and get tested for additional reassuarnce. I disagree with your characterization of the UK GUM clinics. And unfortunately, I do not provide personal care of the type you suggest or any other referalls from MedHelp. However, if you remain leery of the GUM clinics, consider contacting Freedom Health of London; see MedHelp's' HIV International forum for more information about it.
If I were in your situation, knowing what I know, I would not have stopped having unprotected sex with my wife, with no concern for her health.
That will end this thread. Take care.
Dear Doctor, Thank you and am so sorry to trouble you again. Anxiety is a terrible thing. -These are my final questions.
1, I refer your saying that the skin having to be massaged to introduce the herpes virus HSV2. Yes, there was only fleeting kissing on the lips, but she had ingested semen and 'tounged' my scrotum and perhaps the skin is a little thin there because of steroid use? Does this change anything for transmission in that region?
2. I am a married man, but not have had sexual relations with my wife for in excess of 9 years, BUT, if I weer in a happy marriage, would it be OK to be engaging in full sexual contact given all of this informtion?
3. GUM clinics in the uK are less able to discuss in terms of probability of risks that you are able to. Is there some way that I may have a telephone consultation with you ( and pay by credit card?) I could e-mail you at the hospital to set that up. I do apologise if this is not appropriate.
Thank you so much again.
1) As you correctly predict from the comment by Dr. Hook, your psoriasis makes no difference.
2) In general, it is believed that HSV transmission requires the virus to be massaged into the tissues (which is why initial herpes outbreaks typically involve the sites of maximum friction during sex, e.g. penis in men, vaginal opening and labia in women). I cannot say there was no risk from semen exposure during the fleeting kisses you had, but it was exceedingly low and probably zero.
3) I see no need for testing in this situation, but you are free to do it if you will find the test results (which almost certainly will be negative) reassuring.
Thank you doctor. As with all anxious patients, I do have some follow up questions and I would like to apologise for taking more of your time.
1. I do have psoriasis in the groin area, but it is kept under control with topical steroids. Normally when there is a lesion, I know, because of the itching or burning sensation when soaping during bathing. Neither symptom was present on the said date of the incident - so I presume the skin was intact. Even if it was not, reading a post answered by Dr Hook, psoriasis lesions are not deep enough to be of HIV risk - so I should not worry?
2. As for herpes, I think you do mean transmission from her lips rather than the semen? I am positive to HSV 1 IgG, probably acquired in childhood and not symptomatic for as long as I can remember ( I am 50). As you say, I hope that I probably did not acquire HSV 2 this time. If I am not symptomatic in 4 weeks or so, I intend to carry on with my life. Is that OK?
3. With regard to the semen related risk, I probably will do a health check for Gonorrhoea and syphillis in about 2 weeks to be sure? .
I trust this is all OK doctor. Thank you very much.
Welcome to the HIV forum.
The mouth, throat etc are not highly susceptible to HIV. According to one estimate from CDC (the US national public health agency, similar to UK's Health Protection Agency), performing oral sex on an HIV infected man carries an average risk of transmission of 1 in 10,000. That's equivalent to performing B-Js on HIV infected men once daily for 27 years before getting infected. Furhter, I would point out that most of the men participating in the activities you describe probably were heterosexual, meaning there is a pretty low risk any of them had HIV. To your specific questions:
1) HIV has never been known to be transmitted by kissing. In addition to the mouth not being very susceptible, saliva inactivates HIV, so exposure to infected persons' oral fluids carries little or no risk.
2) Contact of HIV or body secretions with intact skin never carries any HIV transmission risk. The scrotum skin is no more susceptible to that on the arm or anywhere else.
3) With deeper kissing, there could have been some risk of oral gonorrhea, syphilis, or herpes -- not because the stripper is infected, but from other men's semen. But with the superficial, fleeting kisses you describe, I would say the risk is nil. There is no STD risk from contact of her lips with any other part of your body, including scrotum.
4) Chapped lips or dry/cracking lips should not make any difference.
Bottom line: No risk for HIV or other STDs and no need for testing on account of the events you describe.
Regards-- HHH, MD