Trouble?

[jimjames123456]

Hi,

I recently had a vacation in Thailand and had some sexual encounters that I am a little concerned over whether I may have contracted HIV. On one occasion I received masturbation from a Thai girl who had given me a massage in a massage parlour.  She masturbated me she also inserted her fingers in my anus after the massage.  Later that day after visiting the toilet I notice a reasonable amount of blood on the tissue.  At the time I didn’t really check her hands to see if she had any cuts but from what I saw they seemed OK.  

The second occasion was an encounter with a Sudanese girl. We had intercourse and I wore a condom and no oral sex was had.  However in the morning I noticed a reasonable amount of blood on the sheets.  I ask her about this and she advised that maybe her period had started.  I also asked her HIV status and she said that she was negative.  The main worry I have here is that I noticed in the morning that I had a very tiny cut above my nail.  This was not bleeding and actually was really just where the skin had come away a tiny amount. It was a little sore and later a tiny scab the size of a pin head appeared and went within a day or so. Unfortunately for me I did masturbate her clitoris a little with this finger and placed it inside her vagina maybe once or twice whilst we had sex that night.

I have contacted a UK doc who also a specialist in STDs and has dealt with me and my antics before.  He advised that the risk was minimal and that I should have a 4th generation test in four weeks which should be near conclusive.  If I was still worried I then should have a final one in three months after exposure to be 100%

I am in a relationship in the UK but we will not see each other for at least 5 weeks. which gives me time to take the 4th generation test before I see her again.  My question are. 1)How much risk do you feel I have encountered? 2)How conclusive would a 4th generation test be after 4 weeks?

Thanks

James

[Edward W Hook, MD]

There is still no medical reason for testing an my advice has not changed.  If your persisting anxiety would be helped by a negative test, I would suggest you get tested but ONLY if you will be able to use the negative test results to control your anxiety.  If your symtoms were due to HIV, the test would be positve (BTW, nothing about the rash you describe raises concerns about HIV for me).  EWH

[jimjames123456]

Hi Dr Hook,

Tried to follow your advice and not worry too much however strange illness is still with me. The one other thing that has occurrd that has freaked me out a bit is a strange itchy rash on the top of my feet has appeared.  I know that rashes in this area are often significant of something going on in the body.  Is this a reason to be concerned, would you still advise no need for testing?

James

[Edward W Hook, MD]

The lack of a spleen can impair antibody production but this is more of a problem for antibodies to bacterial infections than to viruses.  Antibodies are however the response to infection, not a mechanisim of resistance.  Your lack of a spleen should not alter your susceptibility to infection,  I would not worry. EWH

[jimjames123456]

Thanks for the responce Dr Hook.  I hope you are right!  Just one last question and then I will leave you guys alone.  I am Asplenic, as in I had my spleen removed 10 years ago after a motorcycle crash.  Would the lack of a spleen make me more susceptible to contracting HIV either after the events above or in the future?

Thanks again

James

[Edward W Hook, MD]

Of course ARS symptoms can be mild but your exposures are still not risk and the chances of your symptoms being due to HIV remain at far less than 1%. EWH

[jimjames123456]

Hi Dr Hook,

I took your advice onboard and have felt pretty much OK over the past few weeks.  I need to wait another 2 weeks until I can take a P24 (generation 4 test) just for my own peace of mind.  However yesterday I noticed a small maculopapular rash on my stomach, maybe 10 or 12 spots. I have also been suffering from a cough and slight sore throat.  Usually issues such as these I probably would not give a second thought.  My question is can early symptoms of HIV be on the mild side?  Like the ones I have described.  I am probably just requiring a little more reassurance however my worry nerve has started to tingle.

Thanks,

James

[Edward W Hook, MD]

the blood from your anus was stil the result of masturbation.  This can be traumatic but hand to genital or to anal sites has not be described.  I would not worry.  EWH

[jimjames123456]

Hi Thanks for the welcome and advice.  For the first instance I was not at all worried about the masturbation but more from the possibilty of infection from blood from my anus and any potentual sores or cuts on the girls fingers.  But can I take it from what you have said for the second insident that you believe there is no risk form this, or at least very minimal risk.  Thanks agian for the advice  

James

[Edward W Hook, MD]

Welcome to our Forum.  I agree with the advice your doctor has already given you. there is no appreciable risk of HIV from either of the encounters you describe.  To break things down:

First encounter. All of what you describe is masturbation. Masturbation is safe sex and HIV is not spread through mutual masturbation.  No risk at all.

Second encounter.  Condom protected sex is likewise safe sex, even if your partner did have HIV and irrespective of whether or not she was having her period. That you may have had contact with her and gotten genital secretions on a finger with a sore/irritated cuticle does not change this either.

Bottom line- these exposures did not put you at risk for HIV.  There is no medical need for testing.  If you choose to test using a 4th generation test at 4 weeks, the results will be conclusive and will confirm what I've just said - that you did not get HIV from the encounters you have described.   EWH