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

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

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

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Published At February 1, 2018
Reviewed AtApril 18, 2024

Patient's Query

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 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 STI’s (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 g for three days as I had throat ache and mild fever in 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 after 40 days after exposure, I developed small red bumps only in my hand and behind the 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:

  1. Am I at risk of HIV?
  2. Are these recurring mild fever and sore throat acute HIV symptoms?
  3. Is the sore in my mouth a concern?
  4. As I have had an eye transplant and my immune system is weak would I have contracted HIV from my exposure?
Answered by Dr. Sushil Kakkar

Hello,

Welcome to icliniq.com.

I have noted your concern. Unprotected insertive oral sex with an HIV-positive woman has a negligible/non-existent risk of transmission of HIV for the male partner unless she had oral sores or 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 change in weather. I have a few questions.

  1. What was the HIV test done in 14 days?
  2. You told me that you are on immunosuppressives. 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. Regards.

Patient's Query

Hello doctor,

Thank you for your response. I had been on Prednisolone tablet one year back after the transplant. But now I am only applying Prednisolone eye drops once a day. Last known, I took Prednisolone three months ago for wheezing for three days. I took the test in an STD clinic. I am not sure which test that was. I presume it should be an antibody test. I will be taking the test in another 14 days. That will be a total of 63 days after exposure. I knew it was a negligible risk but since these sorts of symptoms appeared I panicked. As my fever, sore throat, and red lumps (only in my right hand and behind my ear total of six or seven scattered) are going away they got nothing to do with HIV. Please let me know your advice. Am I overthinking myself?

Answered by Dr. Sushil Kakkar

Hello,

Welcome back to icliniq.com.

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 CDC recommendation, whereas HIV antibody test has a longer window period of three months. You may upload images of the skin lesions on your hand/back of ear so that I am able to have a look at and guide you better. Regards.

Patient's Query

Thank you doctor,

I will be taking the HIV test once I am back home in two weeks. I can say that there was no visible bleeding In her mouth when this happened. I have attached the photos of the skin lesion that I have. The ones in the ears have gone already. It has actually reduced after Amoxicillin and Vizylac and few are gone already. Should I still be worried about HIV risk?

Answered by Dr. Sushil Kakkar

Hello,

Welcome back to icliniq.com.

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 insertive oral sex but of course, you may get it documented when you return back or you may take a 4th generation HIV screening test here itself. Regards.

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

Dr. Sushil Kakkar
Dr. Sushil Kakkar

Dermatology

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