At risk?

[DR79]

Doc...thank you for your tireless efforts on this forum. I will try to keep it brief. I have 2 exposures that I would value your opinion on.

1. I wear braces on the lingual side (tongue side) of my teeth. Last night I was out at a bar and part of the braces caught my tongue, causing it to bleed. I tried to stop the bleeding as best I could in the bathroom, but it didn't stop right away... it did slow down. When I came out of the bathroom a girl I had been dancing with (and met that night) came up to me and we started deep kissing. There had to have been some blood still present in my mouth and tongue...she had no open sores or anything on her mouth. Did I put myself at greater risk for oral herpes or anything else because of the blood?
2. This girl did come home with me, and we did fool around. My penis never fully entered her, but i did use it to rub on her clitoris and there was a bunch of rubbing around the opening to her vagina. It's possible the top of the head could have slipped inside for a moment. All of this was without a condom. What have I put myself at risk for? Anything? I am worried since I don't know this girl or her history.

Thank you for your time.

[H. Hunter Handsfield, M.D.]

Dr. Hook is away from the forum for a while.

On quick review of this thead, my view is that you do not need to be tested for HIV on account of these events.  You can be sure Dr. Hook would agree.

It is time to end this thread.  No more comments, please.  Happy holidays.

[DR79]

Doctors - do you think HIV testing is warranted for this experience? Should I be concerned about herpes?

[DR79]

So do you think I need to go for an HIV test in 6 weeks? Would males always have symptoms of the other STDs? Herpes is not a concern?

thanks.

[Edward W Hook, MD]

Specific answers:

1. The risk, I emphasize, is theoretical but there are smal aounts of HIV in saliva of infected persons.  Your wound could serve as a portal of entry.
2.  These infections may be asymptomatic and while symptoms typically start at around 3-5 days, in some they can take longer.  That is the reason we suggest screening which can be done at any time 3 days or beyond after exposure.
3.  These are borad questions the answers to which can be found on this or other web sites such as those hosted by the CDC or the Amercan Social Health Association (ASHA).  Warts typically appear weeks after exposure.  I would not worry about HPV. EWH

[DR79]

Thanks for your answers, doctor. A followup, if I may:

1. For HIV to enter the wound on my tongue, wouldn't she have to be bleeding in her mouth as well? I don't believe I was exposed to anything from her  mouth except for saliva.
2. If I were to have contracted non-gonococcal urethritis, gonorrhea or chlamydia from this exposure how soon would I know it? How soon could I have a reliable test to confirm? I shouldn't monitor myself for the appearance of a herpes lesion?
3. As for HPV, I have no idea of the timeframe of her infection. How soon would I see a wart on my penis, if I were to have one? What are the consequences of HPV in males? I don't read too much about that anywhere and the info seems spotty. Is this something I should be very concerned about?

Thanks.

[Edward W Hook, MD]

thanks for keeping your questions succinct and to the point.  I hope you will find my answers helpful.

1.  The blood in your mouth means that you had an "open" wound on your tongue.  It is theoretically possible that something like HIV could enter your blood stream and cause infection of you through such a wound but it is unheard of, even when persons are exposed to partners with known HIV infection.  As for the "run of the mill" STDs, including herpes, no change in your risk of infection.  I personally wound not worry one bit about this exposure and urge you to do the same.
2.  The real question here is penetration yes or no.  I think you should consider that the answer is effectively yes and as such, in the absence of symptoms, you qualify for screening - (testing in the absence of symptoms) because you have had a least one new partner over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).   In your case the STDs I would suggest screening for are non-gonococcal urethritis, gonorrhea and chlamydia.  I would not worry about other STDs, including herpes.
3.  If here warts were removed and have not recurred in the past 3-6 moths, you have nothing to worry about.  If it is more recent, there is still a chance but it is modest and, if you do have HPV, you have just joined the majority of sexually acitve adults.  Over 85% of adults will have genital warts and/or HPV at some time in their lives.

Hope this helps  EWH

[DR79]

Sorry---forgot to mention that a friend told me he knows this girl and knows she has had HPV downstairs in the past that has been surgically removed. Am I now at risk for HPV?!