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How many days after HIV do rashes appear?

How many days after HIV do rashes appear?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At April 12, 2018
Reviewed AtApril 12, 2018

Patient's Query

Hello doctor,

15 days back, I met a girl and we got talking and I was really into her. During the course of sex (I had a condom but before I could use it), she started rubbing my penis on her vagina and clitoris. There was a definite presence of vaginal fluid on the head of the penis. I freaked out but was assured by her that she is not HIV positive and I have nothing to worry about. I later looked up symptoms of HIV on the net and one of the symptoms mentioned was rashes. About a week later I found red bumps on the arm. I started to apply a normal cream on the spots (the ones you apply in the winters to keep your lips and cheeks from cracking) and the redness of the bumps went away after two to three days and the bumps also started to fall. The bumps are all much smaller than when started and have started to merge back into the skin. I have had no fever in this period. So I was really freaked out and want to post some questions as follows:

  1. How many days after HIV do rashes appear?
  2. How many days do they last?
  3. Can the rashes appear without other symptoms such as fever?
  4. Can the rashes go away without specific treatment, and by applying just any winter cream?

Currently, I am on medications for blood pressure.

Hello,

Welcome to icliniq.com.

  1. A rash is a very vague term and rashes are not specific for HIV. There is no definite time range for the appearance of HIV and we do not suspect HIV after the appearance of general rashes. I do not see any need to worry about HIV because of this rash you had.
  2. I said about there is no defined period appearance or duration of the rash.
  3. This rash seems to be due to local allergic causes. Yes, the rash can appear without other symptoms.
  4. Rashes due to HIV generally do not go away on their own.

For more information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist

Patient's Query

Hi doctor,

Thank you for the reply. It does put me a lot at ease. I had been worried sick since the red rash showed up. Just wanted to point out that I had attached the link to the picture of the rash on the original post. Two days before that rash appeared I had moved to another home which had been locked down for months and the mattress and all was not fully cleaned when I started to use the bed. I did use new sheets, but the mattress was dusted not as thoroughly as it perhaps should have been. I spend a lot of my time on the bed resting sideways, as I use my right arm to perk me up to use the laptop. The red rashes in the picture appeared on the right arm which was in contact with the mattress more than perhaps any other part of the body. Could those rashes have been because of dirt or dust? I thank you once again for having put me at ease about that rashes in the previous reply.

Hi,

Welcome back to icliniq.com.

I have read your query and looked at the picture attached (attachment removed to protect patient identity). Yes, this rash could be due to local allergic or irritant reaction caused by the mattress. Glad to have helped you.

For more information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist

Patient's Query

Thank you doctor,

I wanted to confirm that you had looked at the pictures of the rash before your first reply, right? If not, then in light of seeing the picture your opinion in your first reply, remains unchanged?

Hi,

Welcome back to icliniq.com.

The answer remains unchanged after looking at the picture (attachment removed to protect patient identity). This rash is not due to HIV and rashes are not a specific symptom of HIV.

For more information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist

Patient's Query

Hi Doctor, I am getting more and more hypochondriac and should really see a psychiatrist about it. However after your answer in the previous post I had relaxed for a while, but then the anxiety has returned. Also it struck me that there was some (perhaps) relevant info that I had not given in the previous posts. The info is that the red bumps (which btw have become normal by now, did so in around a week), never itched. They just stayed like that till they became normal Also I am sending some more pictures of the rash that I had taken back when it had happened - https://ibb.co/fAgk7H https://ibb.co/gPNE1c https://ibb.co/i901gc https://ibb.co/dv23ux Its been over a month since the said sexual encounter and I have had no issues such as fever etc upto now. Request you to kindly reassure me and put my mind to rest on this issue once more, that these rashes seem to have been caused by local allergies and as you said in your previous reply that (and I quote) "this rash is not due to HIV". I assure you this is the last I will bother you regarding this issue. Regards
Dear Ravi, I have read your query and looked at the picture. The rash is not related TO HIV. Regards

Patient's Query

Hi, I am sorry to disturb you over this again, but since you already know the history and the context of HIV, I thought you would be the best person to put this to. I noticed two red patches on the left arm biceps on the 15th night. I don't know how long they had been there, but 15th is when I noticed them. I applied some dettol and boro plus and they have noticeably reduced a great deal. They never itchced or anything. I felt it was best to show them to you. Pics - On the 15th night - https://ibb.co/hfDv47 On the 18th night - https://ibb.co/mdFKWn The redness has greatly reduced and they are on the way out. Is this anything to worry over. There were just these two red 'spots' on the left bicep and no where else on the body, as far as I could tell and I have looked. Also additionally tomorrow is the 19th which is 6 weeks since the day of the incident. I have read that symptoms such as fever, flu, rashes, etc. show up within 2 to 6 weeks of the incident. I do know that net is full of medical misinformation. However I have checked multiple sites and all of them stick more or less to 2-6 week range. I have spent the past 6 weeks in a great deal of panic and worry and have been on constant what I could only describe as symptom watch, and have stayed awake all night worrying at the slightest sneeze or the slightest of red bumps even due to mosquito bite. In this 6 week period I have not had fever or flu or rashes besides the one that you have already said I needn't worry about in the earlier posts or the two red spots whose pics I have sent you in this post. I understand that only way to be completely accurate about this is to do a test done. However seeing that I didn't have any symptoms for 6 weeks now should I stop worrying about the whole thing. I understand that one can't be completely sure in this till one is tested but I simply don't have the courage to be tested, but seeing as I have had no symptoms should I atleast consider that on balance I probably don't have HIV. I am not saying to confirm definitely I don't have HIV, but on balance of probability in the absence of symptoms is it fair to say that I in all likelihood don't have it. This will be surely be the last I bother you about this. Kind Regards
Hello Mr Ravi The absence of flu like symptoms in initial 6 weeks is a good sign but not a strong Marker for presence or absence of HIV. Probability of acquiring HIV by Single unprotected intercourse is 1 in 1000, so yours is even less. Regards

Patient's Query

Hi, Thank you for you reply. 1 in a 1000 for full unprotected intercourse. That is a good hear. In this case there wasn't even any unprotected penetration. Just rubbing of the penis on the vagina opening and clitoris. So I am thinking the chances further reduce. Also doctor those two red spots whose pictures I sent you are nothing to worry about in this context right? I am guessing they aren't or you would have raised a flag in your reply. However just seeking full clarification to as not to leave any ambiguity in mind. Regards
Yes your chances are further less. And yes, your rashes are not related to HIV. Good luck

Patient's Query

I ABSOLUTELY hate bothering you again and again and again over this. However just for FULL clarity I am seeking to confirm that when you say 'rashes' you mean the ones in these two pics. On 15th Night - https://ibb.co/hfDv47 On 18th Night - https://ibb.co/mdFKWn I needn't worry about them right? You do not know what a big help you have been during this whole very troublesome phase. I really truly appreciate you help. Regards
Yes, I mean the lesions in these 2 pics.

Patient's Query

Oh you don't know what a tremendous help you have been. Could barely express in words who grateful I am for your help. I am now going to let this issue go from today, it being the completion of the 6th week from the incident. These past 6 weeks have been worrying but you were a great help in getting through it. Regards
I'm glad I could help. Regards

Patient's Query

Hi Doctor, I am very sorry to have to bother you again, but the thing is on the 30th of April I noticed an ulcer in my mouth on the inside of the lower gum. The night before that I had accidentally eaten piping hot soup. However I wasn't in agony or felt any burning sensation. I didn't think much of the blister that showed up the morning the next day. I (wrongly perhaps) applied dettol on the blister without diluting it with water or anything. Then a few hours applying dettol a whole bunch of blisters formed on the gum. Photograph here - https://ibb.co/kWAzM7 I have had ulcers in the mouth before but never in a cluster like this. I showed it to out local medical compounder who comes home to check BP and stuff, while also giving the backstory of the hot soup drinking. He looked at it and said that they do appear to be burn type blisters and applying dettol was a mistake as the inside of the gum is very sensitive. He prescribed some vitamin tablets and an ointment, this afternoon. I have to say I do feel very slight relief. Those blisters were painful to touch even with the tongue and that seems a little more bearable. However after he left, I suddenly wondered about the HIV connection to the blisters. Since you already know the backstory I am writing to you the whole story of the ulcer/blister and have sent a photograph. I am getting a little worried again (I had been very relaxed after out last conversation till the ulcers showed up). I have not had any fever or flu yet or any set of rashes on the body. When the ulcer showed up it was 7 weeks and 3 days since the initial sexual incident. I request you to please help me puy my mind to rest regarding the ulcer/blisters. Regards
Hello Mr Ravi These blisters appear to be herpes labia listed, which is a very commonly occurring viral infection of the lips. usually tablet acyclovir 800 milligram is prescribed thrice a day for 7 days for this infection in the first episode. you can continue taking multivitamins. again herpes labialis is very common infection and should not be linked to HIV in your case. Regards

Patient's Query

Dear Doctor, Thank you for the reply. However I would like to once again ask that are you sure the result of dettol on a 'burnt' area like inside of gums won't cause this. Also I did some research and Herpes it is said forms on the mouth or lips unlike ulcers which form inside the mouth. This is clearly inside the mouth. Additionally not all of them showed up together. Only one ulcer showed up first, the rest happened with a few hours of applying dettol. Till I applied dettol there was no sensation on the rest of the gum. It was only after applying dettol that I started to feel a sort of well I don't know what to call it besides sensation/slight pain, in the rest of the gum/flap of the mouth. Also thank you for the medicine suggestion. Right now eating though manageable is painful. I will just be on the watch for a few days, to see how it heals. If it doesnt then I will take the meds you said I should. At the very least thank you for reassuring me that this is not linked to HIV. I don't know what I would have done had I not contacted you and had your counsel in this period.
Herpes mostly forms on the outside of lips but CAN occur inside. It can't be due to dettol burn. Not all vesicles appear together as in your case. Regards

Patient's Query

Dear Doctor, I am starting to get very worried. The ulcers/blisters got unbearable in the few days since I last contacted you. They made it impossible to eat anything and were very painful to touch even with my own tongue. However since yesterday things have improved. The ulcers are still there but they have started to lose their 'sting'. I can touch them with my tongue with almost no discomfort and even eating is a lot more bearable. I have just had the vitamin tablet so far and applied that gel. This is their picture taken today - https://ibb.co/bT3qjS Hopefully the ulcers will fade out like this in a few days. However what has got me very worried is that in the past 2-4 days a group of red lesions has appeared on the back. They seemed similar to the ones that appeared on the left bicep earlier whose photographs I sent you. However they disappeared in a few days, the ones on the back are not showing much signs of disappearing and if anything have gotten darker. The lesion on the left side of the back on the 2nd of May - https://ibb.co/kAovJn Lesion on the left side of the back today - https://ibb.co/e94wPS Lesion on the right side of the back today - https://ibb.co/dKv9dn Naturally I am very freaked out and worried about these lesions. I have not had any fever or flu as yet. Please help.
dear Mr Ravi., since you are very worried about HIV and 8 weeks have passed since the episode, I would suggest that you have your HIV 4th generation combo test done. HIV Rash usually appears months to years after aquiring HIV infection. It can appear very early but in that case it is accompanied by fever and flu like symptoms. the present Rash also seems to be allergic and not due to HIV. your oral blisters will get better with time. meanwhile, you can apply Kanacort orabase twice daily over these. Good luck

Patient's Query

Dear Doctor, I just dont have the courage to get a test done. Its just too scary a prospect for me right now. Just this worry over HIV is a big source of tension for me. Following one of our earlier chats I had let it go but then the mouth ulcer/blister happened and around that time was when I noticed the red lesions on the back and completely freaked out. I hoped they would go away in a few days but when they didn't I thought it was best to seek help from you. Having seen the picture of the blister/ulcer as on today - would you maintain your original hypothesis that it was Herpes Labia or do you think it could be something else. Also doctor it was very re-assuring to hear that you say that the lesions on the back are not due to HIV. However is it okay to ask if you feel so because it didn't come along with a fever or flu, or is it because this is not what HIV rash looks like. You have been an immense source of comfort for me and I will continue to seek your help should some doubts arise. (Of course if no doubts arise after this, that will be great). Regards
Lesions on lips: Differential diagnosis of stress ulcers (aphthous ulcers) can be added. These are the regular ulcers that appear in mouth. Stress aggravates them. Again, Nothing to worry. Since you asked, Lesions on back don't look like HIV Rash. Hope this clarifies your doubts. Feel free to consult if you have any further issues. Good luck

Patient's Query

Dear Doctor, Thank you for the clarification. For a second after reading your earlier reply I was worried that the lesions looked like HIV rashes and the only reason that you had not called them HIV rashes was because they had not come with fever or flu, but still you had doubts and that is why you had asked me to get tested. That was scary. However if they don't even look like what HIV rashes look like, then that is a lot lot more reassuring and comforting. Additionally doctor with the mouth ulcers would you still categorically deny the dettol burn reasoning. I am continuing to take the multivitamins and applying a a gel called Zytee Gel, and there has been some improvement. Regards
Possibility of dettol burn is almost negligible. I told you to test because you are quite stressed. Regards

Patient's Query

I was rather stressed I will admit, however having spoken to you I am a lot more relaxed. So within the bounds of reasonable probability, you would rule out any link between the HIV and the Mouth Ulcers and Rashes? I assure you this is the last time that I am bothering you today. :D You have been a big help. Regards
Ya, I would mostly rule out any link between Hiv and ulcers or rashes.

Patient's Query

Hi, Thx for the reply. However I am burdened by being a lawyer and don't like the slightest room for ambiguity hence I seek precise clarifications. You must pardon me for that. Just to be absolutely clear - when you say you would mostly rule out any link between HIV and Ulcers or rashes, you mean the ulcers and rashes whose photographs that I have sent you right? and not rashes and ulcers in general. In other words, you mean that the rashes/lesions on the back and the ulcers/blisters in the mouth whose photographs I have sent you, are unrelated to HIV. Is that correct? (You must be tired of my endless questions/clarifications by now, I duly apologise if that is that case).
Dear Mr Ravi, Medical science is not as absolute as law is. It is based on probabilities. Yes I meant ulcers and rashes whose photos you sent to me, their possibility of being due to HIV is Negligible.

Patient's Query

Dear Doctor, I understand medicine is not law. All I meant was that when you just say rashes it could mean rashes in general, or the specific lesions who photos I sent you. To any normal person there would be no ambiguity at all and they would assume you were referring to their rashes. However being a lawyers is quite a handicap and therefore I have developed a tendency of 'make sure that is what they meant' in nearly everything. I annoys people a great deal. I say all this in a little bit of a tone of jest, please don't mind me. Thank you for the clarification and putting my mind at ease again. Also just one last point - You had initially suggested that the lip blisters were herpes labia and suggested a medicine for it. However I have not tak3en the medicine and the blisters have started to ge muct better and there ish improvement since the first day. So is it possible for Herpes to heal on its own within a week? If not then is it likely that the ulcers were normal ulcers and not herpes labia if they healed without a specialist medicine. Kindest regards
Ya, I understand. Yes herpes usually does get better by itself. Medicine is given to shorten the duration and pain associated with the disease, and prevent the complications. Good luck

Patient's Query

Dear Doctor, Its been nearly a month since I last contacted you. Today is the completion of the 12th week from the date of the incident and I have not had fever or flu nor would I say I am covered head to toe in rashes. There were some lesions and red spots on a very limited part of the body, which I have already shown to you (in this rather long thread) and you have ruled out any link between them to HIV. That makes me very optimistic about the HIV situation, and in any case the odds of me having got it from the said encounter was very low as you explained, even less than 1 in 1000. The lesions in the last photographs that I sent you disappeared in a week. They formed a thin soft crust and that peeled off and the red spots underneath had become normal. The mouth ulcers also disappeared around may 10th and I have been able to eat normally since then. I just took Vitamin tablets for that. The reason I contacted you today was simply to give you a brief summary of the whole thing and let you know that its been 12 weeks and I have remained more or less symptom free, and to thank you for your help in these troubling past weeks. Also I have noticed two boils/pimples (could be mosquito bites that I scratched in my sleep) on my right hand, which I just thought I will run them past you as a precaution. I know its nothing, but being the hypochondriac that I am, I would feel a lot better if I showed it to you. Photograph of the pimple - https://ibb.co/kj41ay Close up of the pimple - https://ibb.co/cmHMay 2nd close up of the pimple - https://ibb.co/j2KOoJ Please take a look and put my mind at ease again about HIV and those pimples. After this now that its been 12 weeks and I have had no fever or flu, I will just let this whole thing go for good. Kind regards
Hello Mr Ravi These lesions seem to be simple folliculitis (bacterial infection) and should settle down in a week even without medication. Not having any flu signs is a positive sign. Wish you good luck

Patient's Query

Great to hear that doctor. Would it be fair to say that in a reasonable scenario, knowing that no one could give me a 100% definite answer without tests, but in a reasonable estimate, I can rule out HIV right? Not asking you to say 100% sure I don't have HIV, I know that can't be done without tests, but in a reasonable estimation, I can now rule out HIV right after 12 weeks of no real symptoms like flu and fever etc.
Well, I would say the chances are less without symptoms like fever, flu etc. How much less, the answer is not absolute though. Different studies have shown 10-50% of persons may be asymptomatic. Regards

Patient's Query

Dear Doctor, You suddenly have me worried again. However in this specific case given the nature the act (not being a full penetration) and chances of contraction being 1 in 1000 (even less as there was no penetration), that is assuming the partner was infected to begin with, and the subsequent absence of symptoms, would it be reasonable, again not asking you to say with 100% certainty, but on a reasonable basis to rule out HIV? At least to lean on the side of no HIV than HIV. Regards
Definitely we are leaning towards no HIV side, your having no symptoms is still better, but still, clinically, "ruling out" HIV can't be done without the test. Yes considering the whole scenario, your chances are like 1 in 3000.

Patient's Query

Thank you doctor. That is much better to hear. I had got worried for a second. I understand that your opinion is being given here as a professional and you cannot as a professional tell me that I don't have HIV, without tests. Being a lawyer I understand that line that exists as a professional. No matter how unlikely you think something is one still has to stick to the formal line. Even if you think I in all likelihood don't have HIV, you still have to err on the side of caution and I understand the official 'doctor' line is always going to be, can't say without tests. With that knowledge, you telling me that I in all likelihood don't have HIV is very encouraging. I understand you cannot say I definitely don't have HIV without tests. However you telling me that there is a very low probability of me having HIV is very encouraging. Also I have asked the partner in question multiple times (I had taken her number but never met her again, just texts) if she has HIV and she has repeatedly told me she doesn't and that she gets tested regularly. I know her 'word' counts for almost nothing, but atleast she has said she doesn't have HIV, which would be the greatest scenario. Thx for you help during this period.
What all you have said is correct. My pleasure Mr Ravi, Healthy regards!

Patient's Query

Dear Doctor, I know I keep bothering you about this, but you are the only person who I have spoken to about this, and talking to you helps relieve the worries. Besides you are an expert in the field so your words carry even more relief. In regard to all that we have discussed in this thread, if I were to sum up the whole situation in the following words - Based on what you know (this whole thread basically), I have a very minuscule chance of having HIV [atleast 1 in 1000, more likely 1 in 3000] from the said sexual encounter, however the possibility cannot be 100% ruled out without tests. Would you agree with this summing up of the whole thing? If you agree with this, then that will really put me at ease about the whole incident. Regards
Agree

Patient's Query

Thx so much doctor, it was truly a relief to see you agree. That really puts me at a lot of ease. I hope that the summary of the while situation in the above post was fair and accurate? I mean you agree so it must have been. You being in agreement with it, is a great relief. Wish you the best and you have been a big big help. Kind regards
Yes your summary is accurate. Good luck

Patient's Query

Dear Doctor, I am writing to you in relation to this thread again. Things are good and I had nearly forgotten all about this HIV thing and was doing well. However yesterday I started to feel a little unwell. The weather where I am has been changing a lot, sometimes it rains, then its hot and then it rains, and often on the same day. Everyone in the household is under some form of flu, not fever, but lots of coughs and stuff. I too have cough (no cold though and nose is not clogged/blocked either), but slight pain in the neck when I cough. Also yesterday, I felt my body was warm to touch, for about an hour or two in the afternoon, but felt normal cold to touch in an hour or two. I haven't had full blown fever, and ever since I woke up this morning I have been feeling fine, body is cold like normal, although the cough is still there. However since fever is one of the things to watch out for, I thought of writing to you. Yesterday was 175 or 176 days (nearly 6 months) since the incident. I am treating this as just seasonal cough, especially as everyone in the household has it. However thought it best to run past you. Regards.
Hello Mr Ravi, As many people in your household have flu like symptoms, you are most likely having viral flu which is very easily communicable and generally involves all people who stay together . prolonged or recurrent fever or Febrile episodes, upcoming without any obvious cause (like flu in your home) should be an indication for investigations. you can just take Paracetamol or anti cold tablets for this seasonal cough and flu. Regards

Patient's Query

Thx for the prompt feedback doctor. As always you have been a great help. Also I am feeling better now, only yesterday felt a little dull and for a brief period body felt a little warm upon touching (once in the afternoon and once in the night). Even that lasted barely an hour and after some sweating (got in a blanket) the body temperature was back to normal upon touch. I usually don't have fever much, in the past 8 years or so, I remember having fever lasting multiple days only 3 times. Things have improved in only day and I have not had any medicine so far. Just thought it best to inform you. It could hardly be said to be prolonged as I am better after 1 day. The appetite has been normal. There are three people in the house all three of us starting coughing within a few days of each other, me the last one to start. I am treating it like flu, and only thought it best to discuss with you. Good to know that you too think it is seasonal flu. Regards
Dear Mr Ravi, Its great you recovered fast. Glad to know I could help and reassure you . Healthy regards.

Patient's Query

Hi Doctor, I don't know how well you remember this thread, since its been a while and you must get many questions like this everyday. Its been more than a year now since the potentially dangerous encounter. I have in this period been healthy. I did have fever twice (1st time was nearly six months after the encouter), but in both instances it sort of went away in a few days and I have not had any real issues since then However since 1 year of the incident only recently went by, I have once again started having anxiety of what ifs. I therefore opened this thread to calm down. Then I thought why not write to you. Naturally I keep going back to the said incident and try to recall what happened (frottage or rubbing of penis tip on her labia). Being anxious has meant that I once again started reading up stuff on google. I have read that HIV is not present in the fluids that lubricate the vagina which come from Bartholin Glands, which was the fluid that I was most likely to have come in contact with during that night. The HIV is present far deeper in the vagina and would require deeper and prolonged penetration to reach the areas likely to infect with HIV. Is this true or partly true? I dont have the courage to get tested, although that would put an end to all the anxiety for good. Anyway I just thought of writing to you again, I dont know why. You are still the only person who knows of this whole incident. I guess I wanted to talk and be comforted again. Regards
Hello Mr Ravi As per my knowledge, there is no cent percent demarcation in the presence of HIV in various vaginal fluids. Please share with me your source of information so that I can check its reliability and give you better information. Thanks

Patient's Query

I dont remember where I read that exactly, but it had something to do with how if the fluid is exposed to air, it kills the virus and so the penetration would have to be deep and prolonged to contain hiv transmission risk, and why frottage (which is basically what I did), contains little risk. Additionally I found this question answered which was a near carbon copy of the situation I found myself in. http://www.thebody.com/Forums/AIDS/SafeSex/Q219751.html, where in the situation was described as a no risk. I think the person who answered it was perhaps over-stating a little, but even so it was comforting to read. Anyway even besides that point, its been more than a year and I feel fit or atleast no unhealthier than the previous year. I guess that is something. I dont know how advisable it is but I am trying to retrace the said woman, not to have sex with her again of course, but to sit and have a frank chat with her about her status. She had assured me she was HIV free when I spoke to her about it back then. If she is then nothing to worry. I dont even know what I am meeting her, perhaps to be re-assured again that she doesn't have HIV. Its all these anxieties that have come rushing back all of a sudden that I am having a hard time dealing with. I was fine for so long and had almost even forgotten that such a thing happened. But the passing of the 1 year point has brought all these things rushing back. Regards
Thanks for the link. Please read this too http://helpline.aidsvancouver.org/question/hiv-risk-if-there-no-penetration So what I want to emphasize again is that : 1.Risk is negligible 2.There is no confirmed report of HIV with above method of sexual engagement and the negligible risk i'm talking about is only theoretical. 3. HIV transmission is possible in your case only if there is some contact of vaginal fluid with an open wound on your penis or contact with the urethra. 4. If point 3 is surely negative, you can assume your risk of HIV transmission with the encounter you had to be zero. Hope it helps. Regards

Patient's Query

What is the Urethra and I am confused about what it means by all contact being external? If the head of the penis, which has the opening on top used to urinate, came in contact with vaginal fluid, is that the equivalent of vaginal fluid coming in contact with the urethra? Secondly there was no deep penetration, but the penis head did touch the vaginal fluids around the clitoris and vulva and labia lips. Is that the equivalent of penetration? Even this contact was very brief, barely seconds at most. Even if there had been proper intercourse, I would still only have 1 in 1000 chance of having got HIV from her, assuming she had HIV to begin with. Surely the lack of deep penetration and the brief nature of the exposure would greatly reduce the chances even further. Right?
1. Yes you are right, the opening on the head of the penis is the opening of the urethra. However, Vaginal fluids could have been exposed to air before touching the urethra and even a few seconds of exposure to air inactivates HIV virus. 2. No it is not equivalent to penetration. 3. Right. Longer exposure is required for HIV transmission. 4. Surely. Chances are negligible and that too, theoretical.

Patient's Query

Wow point no. 4 is very encouraging to read. That after knowing all you do about the nature of the act I was involved in, you would say that the chances are negligible and merely theoretical, (thereby not practical), makes me feel very relaxed. Very relaxed indeed. Thx for the help. Also regarding point 3, when you say longer exposure is required, I am sure there is no scientifically defined threshold for how long an exposure is required for transmission, but even so, it would have to be in minutes rather than seconds, right? and that too from deep penetration. You have been a big help doctor through this ordeal. Point no. 4 felt very good to read. Regards
Yes you are right time is not defined, but seconds is way too short. Good to know that you feel better . Good day.

Patient's Query

Yes Doctor as always you have helped a lot. However I had this query going forward. On the off chance that I do have it, what should I be on the lookout for going forward. I know you said that falling ill frequently is not good, but what is frequently at this point. Once every week, once every ten days, once every 15 days, once every 3 months? Additionally even people without HIV do fall ill, and some more frequently than others. So exactly how to differentiate. Suppose I start to feel feverish and two days later I feel normal again without taking medicines or taking 1 crocin or something, does that indicate that the immune system is working fine and hence no HIV issues so far. What exactly do I need to be on the lookout for going forward. Additionally while I know that HIV can't be cured, but I have read that people with HIV can live a normal span if they take medicines. However upto what point does taking medicines help. If someone starts getting opportunistic infections and then is found to have HIV, what is his expected life expectancy at that point. How many years further can he expect to live from that point on?
Hello Mr Ravi, All these things vary highly from person to person. while one person carrying hiv virus may not have any constitutional symptoms at all, other person maybe frequently falling ill. frequently is not defined and again varies a lot. medicines is taken properly and started early, one may expect a normal lifespan if proper diet and healthy lifestyle is maintained. In the last case scenario, lifespan may be shortened and a lot of damage may have already been done

Patient's Query

Yeah its a scary thought and yet I dont have the guts to get tested. I don't. There is no way to explain around it. Anyway, I have heard that hiv causes thrush on tongue and stuff and that could be one way to tell. So here is a photograph of my tongue, (after I have brushed this morning mind you), but here it is - https://ibb.co/y5q7Sff Do you see any cause for worry based on the pic? Regards
Your tongue seems normal to me. Regards

Patient's Query

Actually doctor I thought there is no point sending you only a picture of the tongue after it has been cleaned. So I am sending you pics of tongue before cleaning (https://ibb.co/XXDpJdW) and after cleaning. (https://ibb.co/9ghyFtx) Now obviously the one after cleaning looks cleaner, but in either pic do you see any reason to worry. Additionally how is HIV related fungus different from general unfreshness one feels everyday before brushing? Does HIV fungus not go away even after brushing or comes back quickly after brushing and remain all through the day?
Hello Both the pictures look normal to me. Oral fungus is usually distinct, is not cleaned by brushing and is persistent till treated.

Patient's Query

Hi Doctor, I am sorry to disturb you again on this but please understand that you are the only person I have ever opened up to on this, and when anxiety hits you are the only person I turn to. I was reading up more stuff about HIV and I learned that oral thrush is usually the first indication that something is up. Roughly on avg, how long after HIV infection does oral thrush start to form. Additionally I have read that HIV infection leads to weight loss. How much weight loss and over what period of time is considered alarming. Also for weight loss on avg how long after HIV infection does this kind of weight loss happen? Regards.
Hello Mr Ravi, I understand your concern. Oral thrush may or may not be the first symptom of HIV. There is no fixed or probable time for oral thrush. May be after months to years. Similarly, about weight loss. 10% weight loss is considered significant. Regards

Patient's Query

Thx doctor for the clarifications in the hotline thread. I do need one more clarification. What about the case that the female touches her vagina and gets vaginal fluids on her fingers and with the same hand which has vaginal fluids on it touches a cut or wound on the male. Is there any risk of transmission in such a scenario.
Exposure of virus containing vaginal fluids to air, even for a few seconds will inactivate the virus, that's why no such case has been reported. Hope it clarifies your doubt. Regards

Patient's Query

So in other words in the scenario in the aforementioned post of a woman getting vaginal fluids on her hands and then touching an open wound on the male with those same hands containing vaginal fluids, the risk of hiv transmission would be zero because the virus would have been deactivated after exposure to air for even a few seconds?
Yes the risk is zero in the above scenario

Patient's Query

Sry to bother you on this again and again doctor, but going forward, I am trying to be as learned and thus as safe as possible. I think I forgot to add a relevant point in the above question - Suppose a female (who we presume to be HIV positive) touches her vagina, gets vaginal fluids on her hands and with the same hands touches a cut on the male, such that (the part I forgot to add above) the vaginal fluids on the hand of the female made contact with the cut. The risk assessment would still be zero in this situation? Because the air should have still inactivated the virus? Secondly doctor what if the male is giving pleasure to the female by inserting his finger in her vagina and there is a cut on his finger. Will this be considered a high-risk activity for HIV?
In the first case, yes the risk assessment will be zero as exposure to air outside the human body will inactivate the virus. In second case, risk of transmission of HIV from female to male is there.

Patient's Query

Thx doctor for the replies. I am sorry to keep throwing "what if" scenarios for you to answer. But to further explore the first scenario, suppose the female with vaginal fluids on her hand or nails touched the cut or wound in such a way that it started bleeding again or aggravated the cut, and the vaginal fluids on her hand or nails came in touch with the blood from the cut. The assessment would still be zero because the virus would have long been inactivated by being exposed to air?
Yes as per literature, the risk assessment should still be zero

Patient's Query

That is good to know doctor. Actually the reason I asked is for a friend. After I told him of the HIV test I had got done, he shared his HIV anxiety with me. Once he had gone for a massage in Thailand which was one of those typical Thai massage places which offered erotic massages. He had a deep shaving cut which was fresh and still red. Not bleeding out but the wound was still fresh and red. He went for a massage and during the erotic massage the masseuse touched his face several times, and her hands on multiple occasions made contact with the wound, and the hands may have had vaginal fluids on them, thereby making it very likely that the vaginal fluids made contact with the fresh wound through the hand. He didn't think much of it at that point, but once he realised the possibility of vaginal fluids touching the wound through the hands, he got worried. Anyway he told me of this incident so I said I will ask. However, as I understand from the query above that this activity (this hand with vaginal fluid touching the wound part) would carry no HIV risk whatsoever, correct? So should I tell him to relax and forget about it, and that there is no reason to get tested for this?
Yes there is no need to get tested for the above exposure. Regards

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Jyotisterna Mittal
Dr. Jyotisterna Mittal

Dermatology

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