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Avatar universal

HIV risk

Dear Doctor

Thank you so much for reading my questions:

I am a 28 year old man who went to Shanghai China in May and visited a gay sauna there 4 weeks ago. I had mutual masturbation with 2 Chinese guys (with unknown HIV status and one of them looks pretty weird with a tattoo!) in the sauna. We also have brief insertive and receptive oral sex (for couple of minutes but NO ejaculation) with them and I also rub my penis with one of them's penis. I find my penis a bit painful with some swelling of foreskin afterwards possibly due to too rough masturbation (not sure whether there is abrasion or not).

I start to feel quite nauseous and dizzy right after the exposure and start to have headache and stomachache the next day. I also find some tiny itchy skin rash sometimes over my limbs and trunk and some peeling of feet skin. I check for any swelling of neck lymph nodes about 20 times every day and recently find them to be transiently more obvious than before. I also have one episode of diarrhoea.

Here are my questions (sorry for asking so many):

1. I am really worried that they are the symptoms of acute HIV seroconversion syndrome. I am so so so scared that I might catch HIV from this exposure! I have never been so worried! When should I go for a HIV test?

2. I had some clear discharge from my penis few days ago and I went to a doctor and he thinks it is likely to be Chlamydia. As I heard that chlamydia is rare to be transmited by oral sex, what is the likely route of transmission in my case? (I 've never had sex before this exposure) Can it be due to rubbing of penises? If yes, will it be more likely that I will get HIV by rubbing my penis with a guy's with chlamydia?


Really thanks for your help!!!
5 Responses
300980 tn?1194933000
MEDICAL PROFESSIONAL
Welcome to our Forum. the activities you describe, mutual masturbation, receiving and giving oral sex and rubbing do not put you at risk for HIV.  You have no reason to worry about HIV and should look for other explanations for your symptoms.  Furthermore, there are no STDs, including HIV for which symptoms begin so quickly after exposure.  For most STDs it takes at least 3 days for symptoms to occur and for HIV the symptoms of early HIV infection do not appear until about 3 weeks following exposure.  Thus, in addition to the fact that your exposures did not put you at risk for HIV, the symptoms and their time course are not suggestive.  

In answer to your specific questions:
1.  You have no medical reason for testing.  If you choose to seek testing, please understand that you are doing it to relieve anxiety and promise yourself that you will believe the results.   At this time, 4 weeks since your exposure, if had gotten HIV about 90% of infections would be detectable,  At 8 weeks virtually all infections can be detected using standard tests.  If your symptoms had been due to HIV seroconversion, blood tests taken a week after they began would typically be positive.

2.   If you were not tested for chlamydia it is inaccurate to say that you have chlamydia.  The discharge you had may have resembled the discharge of NGU and thus could be misidentified as chlamydia.  You may have gotten from receipt of oral sex but it would be most unusual to get chlamydia in this way.  Chlamydia is transmitted through anogenital sexual contact.  Fortunately NGU and chlamydial infections are typically treated in the same way.  Here in the U.S. that treatment is with doxycycline or azithromycin.

If you have NGU it still does not put you at risk for HIV.

I hope my comments are helpful to you. There is no risk of HIV.  Take care.  EWH
Avatar universal
Thank you so much for your enlightening answers!
Just one follow up question: What if my sex partner produces lots of pre-cum in my mouth or the tip of his penis hits on the back of my throat? Does these increase risk of having HIV? Much thanks!
300980 tn?1194933000
MEDICAL PROFESSIONAL
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 gum disease, etc. Furthermore this does not change when people are exposed to pre-ejaculatory fluid or ejaculate on if the oral sex is vigorous.  EWH
Avatar universal
Sorry for bothering you again. I experience some urethral discomfort and scanty scanty clear urethral discharge again for ~5 days. I am worried that it might be a recurrent urethritis after the one 2 months ago (but I didn't have sex since then). I actually had blood tests for chlamydia, gonorrhea, herpes and syphilis at 1 month post-exposure (but it was done after I took 2 shots of cephalosporin injections, 1g of azithromycin, 7 days of augmentin and 10 days of pyridium) and all of them are negative.
Did you think my recurrent urethritis is likely due to mycoplasma genitalium? What kind of treatment should I have : another course of azithromycin or else? Thank you so much for your help!
300980 tn?1194933000
MEDICAL PROFESSIONAL
Obviously there is no way to determine this. Azithromycin is the favored therapy for treatment of M. genitalium infection, if it really warrants therapy (there is debate).   You should first not assume that you have urethritis but should find out if indeed you have urethritis by seeking evaluation from a trained clinican.,  

If there are further questions, it is time to start an new thread.  EWH
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