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Test Valdity
Hello.
I am writing to see if I have any need for further testing. I was tested for HIV at 7 weeks after an episode of unprotected oral sex and mutual masturbation with another man. We both performed oral sex on each other but we did not ejaculate in each other's mouths. We also engaged in deep kissing/making out. Additionally, we engaged in mutual masturbation with fluids present. He had his fluids on his hands and his hands made contact with my rectum, my penis head, my foreskin as I am not circumcised, my penis and potentially my mouth. I also massaged his penis/rectum with my hands with both of our fluids on my hand. I can't remember if he was circumcised. Furthermore, I was particularly worried about this because of the state of my mouth during that evening. I had coffee burns in my mouth, in addition to a canker sore, and I believe cuts and possibly a cold sore as well. Additionally, I suffer from gum disease. After the episode for the 24 hours following it, I felt very badly about it so I engaged in aggressive and excessive use of mouthwash and teethbrushing which led to irritation all over my mouth. After the incident Furthermore, I engaged in aggressive washing with a bar of soap of my penis (including the foreskin) and my rectum which may have led to irritation there.
The HIV test turned back a negative result. I have the following questions doctors.
1. Can I move on with my life given this incidence and negative test result at 7 weeks or do I need further HIV-1 tests?
2. What about HIV-2?
3. This is more general but can excessive mouthwash use in the hours and days following oral sex increase risk? I read that teeth brushing isn't recommend, but I'm concerned more about mouthwash use as I've read very different things on it.
4. Is it possible that one's activities after potential exposure with cleaning off their genitals, rectum, and mouth could actually increase risk even after the sexual act has occured?
Thank you.
I am writing to see if I have any need for further testing. I was tested for HIV at 7 weeks after an episode of unprotected oral sex and mutual masturbation with another man. We both performed oral sex on each other but we did not ejaculate in each other's mouths. We also engaged in deep kissing/making out. Additionally, we engaged in mutual masturbation with fluids present. He had his fluids on his hands and his hands made contact with my rectum, my penis head, my foreskin as I am not circumcised, my penis and potentially my mouth. I also massaged his penis/rectum with my hands with both of our fluids on my hand. I can't remember if he was circumcised. Furthermore, I was particularly worried about this because of the state of my mouth during that evening. I had coffee burns in my mouth, in addition to a canker sore, and I believe cuts and possibly a cold sore as well. Additionally, I suffer from gum disease. After the episode for the 24 hours following it, I felt very badly about it so I engaged in aggressive and excessive use of mouthwash and teethbrushing which led to irritation all over my mouth. After the incident Furthermore, I engaged in aggressive washing with a bar of soap of my penis (including the foreskin) and my rectum which may have led to irritation there.
The HIV test turned back a negative result. I have the following questions doctors.
1. Can I move on with my life given this incidence and negative test result at 7 weeks or do I need further HIV-1 tests?
2. What about HIV-2?
3. This is more general but can excessive mouthwash use in the hours and days following oral sex increase risk? I read that teeth brushing isn't recommend, but I'm concerned more about mouthwash use as I've read very different things on it.
4. Is it possible that one's activities after potential exposure with cleaning off their genitals, rectum, and mouth could actually increase risk even after the sexual act has occured?
Thank you.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
HIV is rarely acquired by oral sex (regardless of coffee burns or other mouth problems) and never by hand job. You really didn't need HIV testing at all after such an exposure. Also, a negative HIV test 7 weeks after exposure is nearly 100% reliable. Given the combination of low risk of transmission plus test performance, you can be sure you were not infected.
Symptoms almost never are useful indicators for or against new a HIV infection; test results always are more reliable. That is certainly the case here. In addition, symptoms and positive blood tests almost always go hand in hand. For these reasons, it is not possible to have HIV symptoms with a negative other words, your test result shows your symptoms are not due to HIV. And they don't sound like HIV symptoms anyway. That applies to all the symptoms you mention, including those in the follow-up comments below.
So the direct answers to your questions are:
1) Since some experts recommend final testing at 3 months, you might want to do that for peace of mind. In my opinion, it is unnecessary, however. You do not need further testing.
2) Standard antibody tests in industrialized countries cover HIV-2 as well as HIV-1.
3,4) There are no data that heavy use of mouthwash or other hygienic measures like you describe have any effect on HIV risk.
Final comment: You don't mention your partner's HIV status. You should never have sex with another man -- including safe sex, like oral sex or condom-protected anal sex -- without first asking about his HIV status and discussing your own, and avoiding sex (or being especially careful about safe practices) with those who are positive, don't know, or who are evasive in their replies. I call it "do ask, do tell". It isn't foolproof, but in the long run it is just as important in avoiding HIV among gay/bi men as are other safe sex strategies. Please get in the habit of doing this.
But for now you're home free. Stay safe--
HHH, MD
HIV is rarely acquired by oral sex (regardless of coffee burns or other mouth problems) and never by hand job. You really didn't need HIV testing at all after such an exposure. Also, a negative HIV test 7 weeks after exposure is nearly 100% reliable. Given the combination of low risk of transmission plus test performance, you can be sure you were not infected.
Symptoms almost never are useful indicators for or against new a HIV infection; test results always are more reliable. That is certainly the case here. In addition, symptoms and positive blood tests almost always go hand in hand. For these reasons, it is not possible to have HIV symptoms with a negative other words, your test result shows your symptoms are not due to HIV. And they don't sound like HIV symptoms anyway. That applies to all the symptoms you mention, including those in the follow-up comments below.
So the direct answers to your questions are:
1) Since some experts recommend final testing at 3 months, you might want to do that for peace of mind. In my opinion, it is unnecessary, however. You do not need further testing.
2) Standard antibody tests in industrialized countries cover HIV-2 as well as HIV-1.
3,4) There are no data that heavy use of mouthwash or other hygienic measures like you describe have any effect on HIV risk.
Final comment: You don't mention your partner's HIV status. You should never have sex with another man -- including safe sex, like oral sex or condom-protected anal sex -- without first asking about his HIV status and discussing your own, and avoiding sex (or being especially careful about safe practices) with those who are positive, don't know, or who are evasive in their replies. I call it "do ask, do tell". It isn't foolproof, but in the long run it is just as important in avoiding HIV among gay/bi men as are other safe sex strategies. Please get in the habit of doing this.
But for now you're home free. Stay safe--
HHH, MD
MEDICAL PROFESSIONAL
Good grief. No change. Read all my replies and pay attention. Do not post anything more.
Dr:
You may have misunderstood me in the comments that I made. I had a canker sore while performing the oral sex, which I mentioned above. Then I had another canker sore that formed somewhere in the 7 days following the event.
Therefore, is any of your advice changed? This is my final comment, I promise.
You may have misunderstood me in the comments that I made. I had a canker sore while performing the oral sex, which I mentioned above. Then I had another canker sore that formed somewhere in the 7 days following the event.
Therefore, is any of your advice changed? This is my final comment, I promise.
MEDICAL PROFESSIONAL
My original reply started with "HIV is rarely acquired by oral sex (regardless of coffee burns or other mouth problems)". Even if a canker sore might increase risk, yours developed later. I see no reason for concern.
Please no more anxiety-driven "yes but" or "what if" questions that come to mind. Accept the reassurance you have been given and move on.
Please no more anxiety-driven "yes but" or "what if" questions that come to mind. Accept the reassurance you have been given and move on.
Correction
The canker sore that I am referring to formed in the days following the exposure, believe somewhere in the 7 day period following the exposure.
Does this impact your statement that there is no further need for testing?
The canker sore that I am referring to formed in the days following the exposure, believe somewhere in the 7 day period following the exposure.
Does this impact your statement that there is no further need for testing?
And by soon afterwards, I mean in the days that follow.
Hi Doctor. I apologize for this but one thing that occured to me as I was asleep last night was that after my risk encounter, I also had a canker sore that formed soon afterwards. I'm curious if a canker sore forming in my mouth soon after the exposure would change your advice that that my 7 week test after the exposure I detailled above has no further need for testing.
MEDICAL PROFESSIONAL
Yes, I agree HIV-2 testing isn't necessary. Last I heard, there has not been a single documented case of HIV-2 transmission in the US; the very few cases diagnosed were in people who were immigrants or travelers from HIV-2-endemic countries.
Thanks for the thanks about the forum. Take care.
Thanks for the thanks about the forum. Take care.
Thank you doctor for your reply.
Actually, my HIV test didn't include HIV-2 testing. I did it via labcorp and ordered it through an online site and it was just HIV-1 testing. To get HIV-1/2 testing is actually $100 more. I know the CDC says HIV-2 testing isn't recommended for the general population with the exception of those having a connection with the few countries its in. So would you agree that an HIV-2 testing isn't needed for me in this case?
Thank you. I feel better all ready. This is a great service.
Actually, my HIV test didn't include HIV-2 testing. I did it via labcorp and ordered it through an online site and it was just HIV-1 testing. To get HIV-1/2 testing is actually $100 more. I know the CDC says HIV-2 testing isn't recommended for the general population with the exception of those having a connection with the few countries its in. So would you agree that an HIV-2 testing isn't needed for me in this case?
Thank you. I feel better all ready. This is a great service.
Oh, and also I felt joint pain as well-mainly in my fingers in addition to the syptoms noted in my most previous post.
Thank you. I apologize for the repeated posts.
Thank you. I apologize for the repeated posts.
Doctors:
Please make sure address this issue as well either in the original or as a follow-up:
I had some symtpoms - some red lumps appearing as a rash on my legs, lower back, feet, and arms. It was itchy in some parts, not itchy in others and occured soon after the exposure. I've also experienced fatigue and some diarehha over the past few weeks as well.
Please make sure address this issue as well either in the original or as a follow-up:
I had some symtpoms - some red lumps appearing as a rash on my legs, lower back, feet, and arms. It was itchy in some parts, not itchy in others and occured soon after the exposure. I've also experienced fatigue and some diarehha over the past few weeks as well.
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