Aa
symptoms and testing
Dear doctor,
I had an insertive anal sex with a condom (not sure if it failed or if it was a latex condom at all) and oral without condom). Small chance to get HIV, but still I am worried. It has been 18 days since then and there is only one change on my body so far: I have an itchy skin (the last 2 days). Not a particular part, but every minute another location: head, nose, arm, leg, foot,... I found on this forum that HIV can create an itchy skin, but I am not sure if that can happen in the early stage. Can that be a symptom for HIV? I was negative 3 weeks ago. I also had a diarrhea that did not last too long (just enough to bring worries).
Another question is related to HIV testing. I know I should wait 3 months for antibody test, but http://www.requestatest.com offers HIV PCR test at 28 days for about $200. How reliable is this test and can I completely rule out HIV at 28 days with this test? It would definitely help relax.
Third question is about herpes. I asked my doctor to be tested for common sexually transmitted diseases. The doctor recommended syphilis and gonorrhea, but not herpes. He told me if there are no symptoms of herpes after 18 days, there is no chance there is herpes. Is that true?
Thanks a million,
I had an insertive anal sex with a condom (not sure if it failed or if it was a latex condom at all) and oral without condom). Small chance to get HIV, but still I am worried. It has been 18 days since then and there is only one change on my body so far: I have an itchy skin (the last 2 days). Not a particular part, but every minute another location: head, nose, arm, leg, foot,... I found on this forum that HIV can create an itchy skin, but I am not sure if that can happen in the early stage. Can that be a symptom for HIV? I was negative 3 weeks ago. I also had a diarrhea that did not last too long (just enough to bring worries).
Another question is related to HIV testing. I know I should wait 3 months for antibody test, but http://www.requestatest.com offers HIV PCR test at 28 days for about $200. How reliable is this test and can I completely rule out HIV at 28 days with this test? It would definitely help relax.
Third question is about herpes. I asked my doctor to be tested for common sexually transmitted diseases. The doctor recommended syphilis and gonorrhea, but not herpes. He told me if there are no symptoms of herpes after 18 days, there is no chance there is herpes. Is that true?
Thanks a million,
Hello,
I'd just throw in a little caveat about "straight" and "gay" risks and how they differ. I don't think the women on this forum should assume that if a man is sleeping with her, he has always been "straight" and therefore poses no HIV risk. When I was part of the "down low" scene a few years ago, I saw the truth about what Dr. H said in his response here -- men with female partners would start a gay sexual encounter with the intention of not doing anything risky, but in the heat of it, they would end up performing oral sex and swallowing semen, or even wanting to have anal sex without a condom. (This is one of those scenes that you won't know anything about if you're not part of it, sort of like those massage parlors that I find so bewildering.) The CDC figures seem to support my angle on it, because a third of new infections (if I remember correctly) were women, most of whom were infected by sex with men. And a lot of those infectious men had been infected by other men.
By the grace of some higher power, I never got infected with HIV or any other STD; but this also had a lot to do with the fact that I accepted my bisexuality and had the presence of mind to be responsible about it. Other men, in denial, couldn't deal emotionally with what they were doing so they didn't carry condoms around and lost control of their behavior in the face of temptation. Now that my female partner is pregnant, I've gone through too much soul-searching to seek out male partners again; but I still carry condoms around in case I "slip."
Some people believe everyone's either gay or straight. My response to that is: fine, if you say so. But gay men still sometimes sleep with women, and straight men still sometimes sleep with men -- so as far as HIV is concerned, we're back at the same problem. Straight and gay are easier categories, but they don't protect anyone from a virus.
J
I'd just throw in a little caveat about "straight" and "gay" risks and how they differ. I don't think the women on this forum should assume that if a man is sleeping with her, he has always been "straight" and therefore poses no HIV risk. When I was part of the "down low" scene a few years ago, I saw the truth about what Dr. H said in his response here -- men with female partners would start a gay sexual encounter with the intention of not doing anything risky, but in the heat of it, they would end up performing oral sex and swallowing semen, or even wanting to have anal sex without a condom. (This is one of those scenes that you won't know anything about if you're not part of it, sort of like those massage parlors that I find so bewildering.) The CDC figures seem to support my angle on it, because a third of new infections (if I remember correctly) were women, most of whom were infected by sex with men. And a lot of those infectious men had been infected by other men.
By the grace of some higher power, I never got infected with HIV or any other STD; but this also had a lot to do with the fact that I accepted my bisexuality and had the presence of mind to be responsible about it. Other men, in denial, couldn't deal emotionally with what they were doing so they didn't carry condoms around and lost control of their behavior in the face of temptation. Now that my female partner is pregnant, I've gone through too much soul-searching to seek out male partners again; but I still carry condoms around in case I "slip."
Some people believe everyone's either gay or straight. My response to that is: fine, if you say so. But gay men still sometimes sleep with women, and straight men still sometimes sleep with men -- so as far as HIV is concerned, we're back at the same problem. Straight and gay are easier categories, but they don't protect anyone from a virus.
J
MEDICAL PROFESSIONAL
artma: Everyone should disclose their HIV status if positive, for any sexual exposure--including oral, despite the low risk. At a human level, it simply isn't fair or ethical to take any risk at all of infecting someone without that person's knowledge and consent. Also, intended safe practices (oral, condom) often don't stay safe in the heat of the moment.
The specific advice to gay men is logically more assertive, simply because the risks are greater. Some men argue that they needn't disclose, because all gay men should be aware that all encounters are potentially risky. That's wacko reasoning, in my book. The fact is that most HIV negative men will defer sex if they know a potential partner is HIV positive, or will be especially likely to avoid the highest risk practices (anal sex, non-condom use, etc); and most HIV positive men will also take greater precautions if they know a partner is HIV negative. (Yes, there are exceptions--gift givers, bug chasers, barebackers, etc--but the generalization holds.) In my view, nobody has a right to knowingly put another person at risk for a deadly disease without that person's knowledge and consent. Also, in my view nobody has the right to put HIMSELF at risk knowingly; in this, there is an ethical parellel with motorcycle helmet laws.
Having said all that, some behaviors indeed are riskier than others. My personal perspective--with which many well-meaning and thoughtful people will disagree--is that there is no duty to inform for hand-to-genital contact or frottage; there is an absolute obligation to know and disclose HIV status for anal sex (with or without condom); and oral-genital sex is somehere in between.
MF: Yes, being uncircumcised increases the risk of getting HIV if exposed (and probably also of herpes and other STDs), for exactly the reason you suggest: partner's genital secretions trapped under the foreskin, prolonging exposure. It's the same reason women are at higher risk, in general, than men, if exposred; women have continued exposure to their partners' genital secretions long after sex is over. But don't over-interpret the circumcision risk; for most straight men in industrialized countries, the overall risk of HIV is low, and even doubling that risk probably wouldn't make much difference in overall HIV incidence and risk. However, in sub-Saharan Africa, circumcision may prove to be an important HIV prevention strategy (the results of 2 major research studies on this question are anticipated in the next few weeks).
HHH, MD
The specific advice to gay men is logically more assertive, simply because the risks are greater. Some men argue that they needn't disclose, because all gay men should be aware that all encounters are potentially risky. That's wacko reasoning, in my book. The fact is that most HIV negative men will defer sex if they know a potential partner is HIV positive, or will be especially likely to avoid the highest risk practices (anal sex, non-condom use, etc); and most HIV positive men will also take greater precautions if they know a partner is HIV negative. (Yes, there are exceptions--gift givers, bug chasers, barebackers, etc--but the generalization holds.) In my view, nobody has a right to knowingly put another person at risk for a deadly disease without that person's knowledge and consent. Also, in my view nobody has the right to put HIMSELF at risk knowingly; in this, there is an ethical parellel with motorcycle helmet laws.
Having said all that, some behaviors indeed are riskier than others. My personal perspective--with which many well-meaning and thoughtful people will disagree--is that there is no duty to inform for hand-to-genital contact or frottage; there is an absolute obligation to know and disclose HIV status for anal sex (with or without condom); and oral-genital sex is somehere in between.
MF: Yes, being uncircumcised increases the risk of getting HIV if exposed (and probably also of herpes and other STDs), for exactly the reason you suggest: partner's genital secretions trapped under the foreskin, prolonging exposure. It's the same reason women are at higher risk, in general, than men, if exposred; women have continued exposure to their partners' genital secretions long after sex is over. But don't over-interpret the circumcision risk; for most straight men in industrialized countries, the overall risk of HIV is low, and even doubling that risk probably wouldn't make much difference in overall HIV incidence and risk. However, in sub-Saharan Africa, circumcision may prove to be an important HIV prevention strategy (the results of 2 major research studies on this question are anticipated in the next few weeks).
HHH, MD
I don't think it matters whether you're getting a blowjob from a gay guy or a woman, it's all the same.
As for the other issue, I recently read that a South African HIV specialist is recommending circumcision as a preventative measure. Is this really true? I could see a slight difference, but I think he said the chances were reduced by like 60% or so. If it really is that high, is it because fluid gets trapped and held longer under the foreskin?
As for the other issue, I recently read that a South African HIV specialist is recommending circumcision as a preventative measure. Is this really true? I could see a slight difference, but I think he said the chances were reduced by like 60% or so. If it really is that high, is it because fluid gets trapped and held longer under the foreskin?
Dear Doctor,
You mention to never have sex with another guy without finding out this status. I can certainly appreciate anal sex. But what would be the different between getting a blow from a gay guy versus a woman, such as someone promiscuous.
Also, I've been on this Forum on-and-off. And I notice that there are a few guys conerned b/c they are not circumsized. Does your advice apply to those guys as well?
You mention to never have sex with another guy without finding out this status. I can certainly appreciate anal sex. But what would be the different between getting a blow from a gay guy versus a woman, such as someone promiscuous.
Also, I've been on this Forum on-and-off. And I notice that there are a few guys conerned b/c they are not circumsized. Does your advice apply to those guys as well?
MEDICAL PROFESSIONAL
The risk of catching HIV from any particular exposure, even if you didn't use a condom, is low. Itching is not usually a symptom of HIV. Don't get an HIV PCR test; waste of money. Have a standard HIV antibody test 6 weeks after exposure; you don't need to wait 3 months. (See many other threads on this forum; search for "Time to positive HIV test".)
Your doctor is wong about herpes; many cases are asymptomatic. But once again, the risk is low after any single exposure, unless you have specific reason to believe your partner is infected. Your doctor is right, however, that syphilis and gonorrhea likely are higher risks (also chlamydia). (This assumes your partner is another man; if not, syphilis is unlikely to be a concern.)
As I have said many times on this forum, it is a foolhardy strategy to get tested for HIV after every potential high risk exposure. People at substantial risk for HIV, such as gay men, should just get a routine antibody test every year; or perhaps every 3-6 months if at particularly high risk, such as frequent unprotected anal sex.
By far the most important things you can do to prevent HIV are 1) never have sex with another guy without first asking about his HIV status and telling him yours, regardless of what sexual practices you plan (oral vs rectal, condom or no condom); and 2) outside a committed, monogamous relationship, never have anal sex without a condom.
Good luck-- HHH, MD
Your doctor is wong about herpes; many cases are asymptomatic. But once again, the risk is low after any single exposure, unless you have specific reason to believe your partner is infected. Your doctor is right, however, that syphilis and gonorrhea likely are higher risks (also chlamydia). (This assumes your partner is another man; if not, syphilis is unlikely to be a concern.)
As I have said many times on this forum, it is a foolhardy strategy to get tested for HIV after every potential high risk exposure. People at substantial risk for HIV, such as gay men, should just get a routine antibody test every year; or perhaps every 3-6 months if at particularly high risk, such as frequent unprotected anal sex.
By far the most important things you can do to prevent HIV are 1) never have sex with another guy without first asking about his HIV status and telling him yours, regardless of what sexual practices you plan (oral vs rectal, condom or no condom); and 2) outside a committed, monogamous relationship, never have anal sex without a condom.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
