Wondering about risk level

[john_m]

I recently had two encounters with women that have me concerned. The first was 2 months ago - I performed unprotected oral sex on a stripper in Vegas. I later realized that I had a cut on my finger during this (the finger was inserted, but my understanding is that that shouldn't be a risk). I also found out that this girl does coke, though she claimed not to use injected drugs). About 2.5 weeks ago, I again performed unprotected oral sex on a different girl. Afterwards, I noticed a sore in my mouth. We also had protected intercourse.

From what I've read, this seems like it would be a low risk situation, but I am still worried. A week ago, I got two red spots on my arm (looked like bug bites). I then noticed a rash on my back and two blisters on my foot. I also thought I might have oral thrush. I went to my doctor and he dismissed my concerns about thrush, but said he thought the rash was likely to be herpes zoster (shingles). From what I've read, this is a common indicator of HIV.  I've seen conflicting things on whether it can occur in the early stages of infection, but it does seem like a pretty big coincidence for it to occur now. If it makes a difference, the rash does look like shingles from the pictures I've seen, but is pretty small and doesn't cause much pain or itching.

I am going to get tested, but any thoughts on this would be appreciated.

[H. Hunter Handsfield, M.D.]

Your first impression was correct--your exposures were zero risk for HIV, for all practical purposes.  If HIV transmission occurs from mouth to penis, it is very rare, and may not occur at all--even without a condom.  With protected oral sex it is impossible.  Genital-to-hand transmission is too rare to think about, even with a supposed cut on the finger.

Therefore, your symptoms cannot be due to HIV, unless you caught it somewhere else.  And they don't even hint at HIV anyway.  The sorts of skin spots you describe do not sound at all like herpes zoster, which does not occur simultaneously in several areas of the body (arm, back, foot).  And lots of things other than oral yeast infection (thrush) can occur in the mouth--and anyway, oral thrush occurs often in people with perfectly normal immune systems.

Whatever is going on indeed is only a coincidence.  See a health care provider if you remain concerned.  But you have no HIV worries.

Good luck--  HHH, MD

[john_m]

Thanks for your response.  I think I've read too much stuff on the internet that has made me paranoid...

If it makes a difference, my doctor was focused only on the rash on my back that looked like shingles (smallish red area with a few slightly raised bumps on it), not the other spots that had appeared.  One point of clarification though - your response seemed to be referring to fellatio.  My situation is regarding cunnilingus.  I assume your advice is the same though.  

It's encouraging to see your comments on my risk level.  Thanks.