Can oral or protected anal sex lead to HIV infection?

Question

Hello doctor,

I met a man who was a foreigner. During the winter, one night, we went to a restaurant, and after that, we went to a bar for some drinks and then to a food store. I had not dressed appropriately for the cold weather, and I had no hat or scarf, and it was very cold. We ended up going to his place. Next thing, I was fingering him, and we had oral sex. I started to masturbate, but I am circumcised, so it hurt without moisture. He gave me Jerkins, and I was behind him. I slipped inside him, and he came off. Then we put on a condom and did anal sex. We did mostly cuddling. Then I pulled out the condom with no ejaculation. The next day, I developed a severe headache, so I assumed it was from the alcohol. I was not drunk. The next day, I started to get bursts of muscle and joint pains throughout my body, mainly when I was indoors. I was caught up with my final examinations, so I ignored the pain.

When the pain continued for some days, I went to a sexual health clinic and did a full sexually transmitted disease (STD) test. I tested negative for human immunodeficiency virus (HIV), but for acute HIV, I had to wait ten days for all the results. I still had the pains and took no pills. The very next day, I experienced night sweats and chills. I became so worried that I went at 11:00 p.m. to a 24-hour pharmacy to buy painkillers. My fever reached 104 degrees Fahrenheit. I took Tylenol, then got a cab at 3:00 a.m. to go to the emergency room (ER). The fever went down, and I did not see the doctor until 8:00 a.m., when I only received a painkiller. The following day, I noticed that my right leg looked slightly swollen. Since then, my fever has remained low, and the muscle and joint pain continued. I rushed to other emergency rooms (ERs) for help as the pain intensified, especially at night when I tried to sleep. My arms, armpits, neck, collarbone, groin, and legs were all painted.

I had another human immunodeficiency virus (HIV) antibody/antigen blood test just two weeks after possible exposure, and it came back negative. I have been taking Ibuprofen every five hours to reduce the pain, but I started to experience breathing problems, and my bladder area feels tender with pain in the upper right abdomen. I explained all my experiences to my friend, but he was firm that he was HIV-negative. We did not have bareback sex, and we used a condom. I have no diarrhea, cough, fatigue, or rash. Is it possible that I have contracted the human immunodeficiency virus (HIV)? I only have sex two times per year without ejaculation. My friend tends to be more active.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Protected anal sex and fingering are considered safe and carry no risk of human immunodeficiency virus (HIV) transmission. However, receiving unprotected oral sex carries a very low risk, even though saliva is not considered infectious, provided the person does not have oral sores or bleeding gums. You may wait for another four weeks to repeat the HIV-1 and HIV-2 antigen/antibody test. At six weeks, the result is considered conclusive according to the recommendation of the Centers for Disease Control and Prevention (CDC). Although your symptoms may feel like a flu-like illness, I believe they are more likely due to the flu itself. You may continue with symptomatic treatment in the meantime.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

If there was unprotected anal penetration, then it does present a high risk of transmission of human immunodeficiency virus (HIV). You may undergo either an HIV polymerase chain reaction (PCR) test, a ribonucleic acid (RNA) test, or a p24 antigen test even now, as they are highly sensitive at two weeks following a high-risk exposure. The PCR and RNA tests have a short window period of nine to thirteen days, and the p24 antigen test has a window period of one to two weeks. However, these tests must be followed up by a more specific HIV test, such as the HIV Duo test—also known as the HIV antigen/antibody combination test—at four weeks and again at six weeks for a conclusive result. Alternatively, a rapid human immunodeficiency virus (HIV) screening antibody test can be done at four weeks and repeated at three months for a conclusive result.

I think the best option for you would be to take a PCR ribonucleic acid (RNA) test now, followed by an HIV Duo test at four weeks and a repeat test at six weeks for a conclusive result. The HIV Duo test has a window period of two to three weeks and is highly accurate at four weeks, detecting 95 percent of those infected. However, it is considered conclusive at six weeks with 99.9 percent accuracy.

I hope this helps.

Thank you and take care.

Regards.

Answer 3

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

The fourth-generation human immunodeficiency virus (HIV) antigen/antibody screening test is not reliable within the first two to three weeks after possible exposure. Therefore, it can be repeated at four weeks, as almost 95% of individuals with HIV will test positive at that point, and at six weeks, it is considered conclusive. You may instead consider undergoing a ribonucleic acid (RNA) polymerase chain reaction (PCR) test. The RNA PCR test may be relied upon early after possible exposure, as it has a shorter window period of nine to thirteen days. Other tests, including the third-generation and fourth-generation human immunodeficiency virus (HIV) screening tests, usually have a longer window period.

I hope this helps.

Thank you and take care.

Regards.

Answer 4

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

Flu-like symptoms, also known as seroconversion illness, usually happen two to four weeks after infection with human immunodeficiency virus (HIV).

I hope this helps.

Thank you and take care.

Regards.