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hiv+ blood in mouth

Nov 26, 2008

Hi Dr Frascino,

My partner is HIV+, and we were kissing quite passionately when I noticed blood smear covering three of his teeth.

It turns out he had some gingivitis and the tips of his gums (where they point) were bleeding a little and i guess at one point quite a bit of blood came out. I assume it got into my mouth.

We checked my mouth and I did not have any visible cuts or sores.

Its four weeks on now, and i got a sore a throat at week three, but no fever. a few days ago (now end of week 4) I got some small reddish spots about 15-20 on each side of my torso. The spots were not on the chest, but the side of the torso, like where the arms touch the torso when you put them along your body. And also maybe a few on the back.

My armpits, and upper arms also felt a little wierd, sore and wonder if this was the lymph nodes swelling, as I am not sure.

They are not big, about like a pencil spot, but some a little bigger. They are red, and can have 4 or five in an area, and then a ways away a few more. So they are not evenly spread.

I appreciate you are in a magnetic relationship and value your insight.

The last time we had sex was months ago, and it was safe, used condoms, and very brief. There was no condom failure. We are always very careful. I tested Neg in September. We did not have sex, I did not give him a bj or anything, and we havent kissed since the incident.

1) Can HIV get in through the tonsils? Or other mucuos membrane in the mouth?

2) Could you please provide some insight on the rash?

3) Could you please provide some insight on what you would have done with your partner if the same thing had happened?

4) Has that happened before with you?

5) Has your partner ever had a rash like that?

I appreciate I may be asking some personal questions, but appreciate your input. Thanks for your help.

Two appreciative guys in London.

Response from Dr. Frascino

Hello Magnetic Couple-Guy,

1. HIV can permeate mucous membranes, including those in the mouth.

2. Symptoms, including rash, are unreliable in predicting who is or is not HIV infected.

3. What we would do might not be applicable to what you should do! If a significant amount of HIV-infected blood comes into contact with mucous membranes, there is an HIV-transmission risk. Consequently, a course of PEP may be warranted.

4. No.

5. No.

I would suggest you and your partner read through the chapter on magnetic couples in the archives. You may wish to consider several of the harm-reduction strategies discussed there, including 1) driving your partner's viral load down to undetectable levels with antiretroviral drugs to significantly decrease the risk of transmission, 2) having an emergency starter pack of PEP always available and 3) PrEP (Pre-Exposure Prophylaxis).

Good luck to you both.

Dr. Bob

Pregnant wife - window period

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