Am I at risk of HIV after having unprotected oral sex?

Question

Hello doctor,

I am a 26-year-old male. I only received unprotected oral sex for roughly two minutes around 46 days ago from a commercial sex worker. I did not have any intercourse. I do not know her HIV (human immunodeficiency virus) status. I had an episode of diarrhea immediately after, within the next five days, and it resolved after taking Levofloxacin and Lomotil (which I guess was food poisoning, as it occurred the very next day). I tested for all STIs (chlamydia, gonorrhea, hepatitis, and HIV) 14 days after exposure, and all came back negative. It is an early test for HIV. I traveled abroad for vacation in the meantime, and I took Azithromycin 500 milligrams for three days as I had a throat ache and mild fever 20 days after my potential low-risk exposure. I developed a sore on my upper gum, and it has been there for 16 days. It is painless now. Also applied Orasore ointment. Recently, 40 days after exposure, I developed small red bumps only in my hand and behind my ear, with a sore throat and mild fever. The doctor has prescribed me an Amoxicillin antibiotic for five days and Vizylac once for five days. My throat is feeling better now.

My questions are:

Am I at risk of HIV?
Are these recurring mild fever and sore throat acute HIV symptoms?
Is the sore in my mouth a concern?
As I have had an eye transplant and my immune system is weak, would I have contracted HIV from my exposure?

Kindly guide.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern and will try to help you with it.

Unprotected oral sex with an HIV-positive woman has a negligible/non-existent risk of transmission of HIV for the male partner unless she has oral sores, blood-mixed saliva or bleeding gums, which might increase the risk. You have had two episodes of a sore throat after this sexual encounter, which can be because of seasonal flu and changes in the weather.

I have a few questions.

What was the HIV test done in 14 days?
You told me that you are on immunosuppressants. I would like to know what immunosuppressive medication you were or have been taking.

The sore on your gum could be more of a dental problem rather than an STD. I suggest you take oral Metronidazole 400 mg, thrice daily, in addition to the Amoxicillin that you are already taking. Also apply Metrogyl DG gel (Metronidazole), twice daily.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

You may take a 4th-generation HIV screening test (antigen/antibody test) even now. It is considered conclusive at six weeks (45 days) from a risk contact. This is a recommendation of the CDC (Center for Disease Control and Prevention), whereas the HIV antibody test has a longer window period of three months. You may upload images of the skin lesions on your hand/back of your ear so that I can have a look at them and guide you better.

I hope this helps.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

I have viewed the images (attachment removed to protect patient identity). These lesions seem like those of folliculitis, bacterial skin and soft tissue infection. Amoxicillin is an oral antibiotic and would definitely help. In addition, I suggest you apply a topical antibiotic, either Mupirocin 2 % cream (T-Bact Cream) or Fusidic acid 2 % cream (Fucidin cream), twice daily. Bacterial folliculitis is not a specific symptom of HIV. There is a negligible risk of HIV with oral sex, but of course, you may get it documented when you return, or you may take a 4th-generation HIV screening test here itself.

I hope this helps.

Thank you.