oral on women; taste lots of vaginal fluid

[concerned_to]

On March 20th, 2008 I met up with a female friend for drinks. I had one too many and we ended up at her place and I performed unprotected oral (+fingering) on her and protected (condom) vaginal sex. I am not concerned about the protected vaginal because I checked the condom after to see if my liquids were leaking and it appeared that the condom was fully intact. I have also read on this forum about the risks of oral on a women but I would like to emphasis that I did taste a good amount of her fluids. While performing oral I recall inserting my tongue inside her vagina (very stupid I know) for about 30-60 seconds. My oral hygiene isnt the best and my tonsils are frequently inflamed. Lets say I had inflammation in the throat when I swallowed her vaginal fluids when I inserted my tongue inside her vagina.

2 days later, March 22, 2008 I developed a throat infection which consisted of swollen tonsils with white matter covered all over the tonsils. On March 26, 2008 I went to the doctor (in NYC as I was on a business trip) and the doc took a throat swab (still waiting for results - dont know why its taking so long). I came back home on friday and went to my home doctor Saturday March 29 where he also took a swab (negative for strep). During this visit to the doctor he said my glands in my neck were swollen and my right ear had fluid. I'm not sure if my glans in my inner thigh are swollen but I do feel tender there. The white matter on my throat cleared April 1, 2008 but my ears hurt (crackling sound when I swallow as well) and I've been feeling very tired - flu like symptoms the last two days (today is April the 2,2008). I came home early from the office and slept. So today is 14 days since the oral episode and I am freaking out that I am experiencing ARS as a result of contracting HIV through her fluids in my mouth.

I have aches and pains in my muscles in my thighs and triceps and a sore throat that began during the infection. Can this be any other STD if not HIV?

[Edward W Hook, MD]

Regarding your oral exposures and both STD and HIV risk, you have little to worry about.   Why? for the following reasons:

1.  Most people don't have STDs (or HIV), thus the odds are in your favor that you were not exposed.
2.  Infection does not occur with most exposures, even if the partner is infected.
3.  Oral sex is an "inefficient" way to transmit STDs.  Most are not transmitted this way.
4.  Same for HIV.  the quoted odds of getting HIV from oral sex, if your partner was infected (and your was probably not) are less than 1 in 10,000.
5.  As for your symptoms, you got a viral sore throat and it caused your ears to get stopped up and let to your other symptoms.  Symptoms are a terrible way to ascertain risk for HIV and most oral STDs are asymptomatic

Bottom line, you do not have HIV and your risk for STD is minimal.  It was just bad luck that your sore throat occurred after your exposure.  I would not even get tested.  Time to move on.  EWH  

[concerned_to]

I did a rapid test at the http://www.hasslefreeclinic.org/HIVTestUpdate.html in Toronto. Tested negative at 5 weeks and 2 days after exposure. I know that its not conclusive until 3 months (or 6 weeks in your and doctor HHH's opinion) but I think as you would say for my level of exposure its pretty much conclusive. No more testing and no more thinking about HIV. Thank you for all of your support and help. You guys really do an exceptional job providing insight on the subject of STDs and HIV. Thank you once again.

[Edward W Hook, MD]

No, this is not suggestive of herpes and one last time, you do not have ARS.  I have nothing more to say.  REad earlier comments for the answers to your repetitive questions.  Further questions will be deleted.  EWH

[concerned_to]

Hi Dr. Hook - I am still axiously waiting to move on but my mouth is still on fire and my leg muscles really ache. Could I have contracted oral herpes on my tonsils and if so could that have increased my chances of contracting HIV? I have read that occassionally oral herpes can present on the tonsils. And since I noticed them 3 days after my encounter it falls into the time line of experiencing herpes symptoms. And now that my leg muscles are really sore this could be ARS from the increased likelyhood of getting HIV from the double wammy. I appreciate your feedback. Kind Regards.

[Edward W Hook, MD]

This is not ARS.  If you are in this much pain you need to see your health care provider.  EWH

[concerned_to]

I almost feel like I need to be hospitalized because the pain is so severe. Have you ever seen ARS muscle/joint pains like this?

[concerned_to]

The sore throat is better today doc. Will update you on the gonorreha tests. Was wondering though would ARS related muscle pains be generally all over or isolated muscles. The muscle pains in the left thigh is really deep, the back of the left knee is hurting as is the left hip. I am also experiencing fasciculation (twitching) in these muscles. Could I please get some expert feedback on these pains as its really killing. I'm popping so many advils.

[Edward W Hook, MD]

No, some sore throats last 3 weeks.  Chances that this is gonorrhea are tiny  EWH

[concerned_to]

THanks doc. Any feedback on gonorrhea and does 3 weeks sound unusual for a viral sore throat? Thank you kindly.

[Edward W Hook, MD]

Yes, viral sore throats often effect the ear as well.  EWH

[concerned_to]

Hi Doctor - Thank you for the feedback. Its been almost 3 weeks and I still have that feeling where my ears are full and cracking sound when I swallow (not to mention tenderness in and around the ear). The sore throat is present but not as bad and I have muscle pain in my calf muscles. No fever through out this time (knock on wood).

Do viral sore throats cause your ears to feel like this and why would liquid get in the ear? Is 3 weeks a long time to experience these symptoms? Do you think gonorrhea could present itself like this with the white pustule tonsils, fluid behind the ears etc...? I'm waiting for my throat swab result for gonorrhea which was done this past saturday (that and clamidia). I apologize for the questions but it does feel like I have no where to turn and I respect your expertise. Thank you very much doctor.

[Edward W Hook, MD]

No means no.  Average figures include people with gum disease, cavities, bad breath, pizza burns, etc.  Whether she was menstuating or not issimilaqrly irrelevant.  

Viral sore throats vary.  If it continues to trouble you, see your doctor but forget about HIV.  You do not have it.  EWH

[concerned_to]

Thank you doctor for the feedback. I do have some follow-ups.

I know you say symptoms are a terrible way to ascertain risk for HIV. But was wondering if ARS could come on 2 days after exposure as I noticed the white spots on my tonsils then. Though I realize that it’s been 2 weeks and I am still feeling the effects – they are actually more pronounced now i.e. sore throat and ear and am very gassy the last week (hopefully its not signs of diarrhea coming on). You say that its less than 1 in 10,000 for a normal oral but what about with inflammation in the mouth. I don’t know if she was menstruating or had recently (I didn’t notice it) but by how much would that increase the risk of exposure.

Also doctor how long would it normally take to recover from a viral sore throat. If you count the white spots as the start then I’ve had this for 12 days now. The white spots are gone but the throat is killing. I am freaking out.

Appreciate the feedback doctor.