Starting to Worry

[tucson22]

Doctors:

I am starting to worry about a particular incident that happened on Monday night.  I a male uncircumcised.  I met up with another male whose status I am unsure of.  I am also not sure if he was circumcised or uncircumcised.  We engaged in deep kissing and he also gave me hickies on my neck and I have some prior lesions from shaving as well.  We also gave each other oral sex.  Neither of us ejaculated in each others mouths but I'm worried about the state of my mouth as had I a hot cup of coffee from a few hours before our encounter that may have had led to some abrasions.  Additionally, we also engaged in mutual masturbation until each of us ejaculated.  I am particularly worried because he inserted quite a bit of his hand into my rectum as he had his fluids on his hand.  

While I did some searching on the topic and thought that this scenario is a risk too low to worry about, I'm starting to have some extra worries all of a sudden because of having some symptoms.  These symptoms include diarreha in addition to have red bumps which look like a rash on my feet, legs, thighs, lower back, and an even a few on my arms.  While the red bumps are itchy on my feet and legs, they are not itchy on my lower back, thighs, arms.  I'm unsure if this could be from insects given that I went to the beach recently, but obviously my mind is racing.

Do you feel doctors that I need HIV/STD testing given this info provided above? This is my only possible encounter to HIV/STDs since my last negative test a few months ago.  

[Edward W Hook, MD]

Your concerns are not founded in fact and do not alter my assessment in any way.  As said before, coffee burns, canker sores, gum diseases, etc do not modify the virtually no risk circumstance of your exposure.  This will be the final answer.  Further repetitive, anxiety-driven questions will be deleted without comment.  EWH

[tucson22]

And of course the oral sex with coffee burns in the mouth and the possibility of cuts and a canker sore in the mouth was unprotected...but I mentioned that earlier.  

[tucson22]

Also, I noticed a small canker sore behind my bottom lip as well.

Please take into account on your final statement that you recognize that I did have burns from the coffee, in addition to the likely hood of a canker sore and some cuts as I performed the oral sex and if this changes your assessment.

That is all.  

[tucson22]

Dear Dr. Hook:

I want to bring this to your attention.  I know I said yesterday that it was my last statement, however I am particularly worried because my mouth may have had more than a few abrasions then the cup of hot coffee a few hours before I performed oral sex.  I think there were actual burns in my mouth from the coffee and perhaps some cuts in my mouth as well as I performed oral sex.  

Please confirm to me that this does or does not change your advice.  I suffer from anxiety/OCD and this last bit of assurance will be all I need to let this episode go.

[Edward W Hook, MD]

Correct.  EWH

[tucson22]

Thank you Dr. Hook.  This is my last comment, I just want to double check this.

I can assume from your statement above therefore that my use of mouthwash immediately after engaging in the activities makes no change to your original assessment from yesterday.

[Edward W Hook, MD]

Mouthwash following oral sex is of no known benefit for HIV/STD prevention.  It is unstudied.  I doubt that it does any harm however.  EWH

[tucson22]

Dear Dr. Hook:

Thank you for the answer.  My last question is regarding the use of mouthwash after oral sex activity.  

I rinsed my mouth out with Scope mouth wash after performing oral, and I'm curious if there is any reason to believe that mouth wash after oral sex could either increase or decrease the risk of HIV transmission as I have read online both arguments so I'm curious to get an opinion from someone like yourself.

Thank you

[tucson22]

Dear Dr. Hook:

Thank you for the answer.  My last question is regarding the use of mouthwash after oral sex activity.  

I rinsed my mouth out with Scope mouth wash after performing oral, and I'm curious if there is any reason to believe that mouth wash after oral sex could either increase or decrease the risk of HIV transmission as I have read online both arguments so I'm curious to get an opinion from someone like yourself.

Thank you

[Edward W Hook, MD]

I hope that I can help to reduce your concern.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to sensations and symptoms than in periods when they are not concerned.  Perhaps this was a contributor to your situation.  

The exposures you describe are no risk and do not require testing at all.  There is no risk for mutual masturbation.  As for oral sex, 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.  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 burns in their mouths, gum disease, etc.

I don't doubt that you have a rash and diarrhea. These two symptoms may or may not be related to each other but they are NOT related to HIV, of that I can assure you.  If your symptoms continue to trouble you, I would suggest you see your own physician for evaluation.  You do  not need to be concerned about HIV however.  I hope this helps.  EWH