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Aussie Jake again - think you misread my question can you have another look? Please please?
Jun 5, 2011

Hi doc,

I think you misread my question. I had anal sex not oral sex - I've pasted the original question below with your answer if you could have anoter loom and let me know??

Cheers mate

Jake

You do great work here, if you ever find yourself in Perth Australia I'll be sure to shout you a cold one (beer).

My question is - are mouth ulcers (small - maybe two of them) 14 days after exposure worrisome or suggestive of HIV ARS?

I had proected sex with a positivly charged dude (he was top gun) but now I'm worried that the rubber might have burst - even though I dont think it did and I'm experiencing ars through the mouth ulcers. No other symptoms to date which makes me think its unlikely but I could sure do with a reassuring answer from you.

If there was a risk - would mouth ulcers at 14 days post event be worrisome or suggestive of ARS?

Thanks

Jake

Response from Dr. Frascino

Hey, Downunder Jake.

Isolated mouth ulcers are not worrisome for HIV acute retroviral syndrome (ARS). Protected oral sex carries essentially no risk for HIV transmission. Even if the condom broke and you didn't notice (extremely unlikely mate!), your HIV-acquisition risk would remain remarkably low.

I'm hoping to get to Perth one of these days. I'm headed back to Sydney in October.

Cheers mate!

Dr. Bob

Response from Dr. Frascino

Hey Jake,

Oops. Sorry about that. You didn't state exactly where your top gun decided to shoot and apparently because of the mouth ulcer question, I (wrongly) assumed it was your mouth! That's why I was a bit surprised by your not knowing if the condom broke or not. Now, in retrospect, your question makes much more sense to me.

Protected sex, no matter which orifice is used, continues to have an essentially nonexistent HIV-transmission/acquisition risk if the latex condom is used properly and doesn't fail (break). If the condom did break, your risk would be the same as unprotected receptive anal sex. The CDC here in The States puts the estimated per-act statistical risk for acquiring HIV from unprotected receptive anal sex with a partner confirmed to be "virally enhanced" at 5 per 1,000 exposures. HIV testing for this type of exposure is recommended at both the three- and six-month marks.

As indicated in my initial response, isolated mouth ulcers are not worrisome for HIV ARS.

Sorry again about the misread, but I hope this now clears up any confusion.

Be well mate.

Dr. Bob



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