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Oral Sex (Cunnilingis) with Cold Sores
Dec 17, 2012

Hi Shannon - I am a 30 year old male and my exposure was performing oral sex on a female of unknown status for 5-10 minutes (very intoxicated) who I met late at a bar and hooked up with on vacation. I had dead skin cells in both cheeks, three cold sores near tip of my tongue, very dry mouth, she was very wet, and after inserting my finger very deep into her vagina, I did put my index finger into my mouth.

Starting at exactly 14 days, right up until I had my tests at 40 days, I have had (with no crazy online poster-like exaggeration): facial flushing (but no fever over 100), terrible headaches, sore throat, rashes (hives on stomach, back arms and legs; red blotches looking like eczema/seborric dermatitis on my face; and little pimply rashes on legs and buttocks; bumpy red rash on legs that when I itched it bled and scabbed over like petechiae looking), persistent canker sores on tongue, super itchy skin, dry mouth, diarrea, nausea, vomitting and have lost 12 lbs. I'm very concerned as I've made the biggest mistake of my life and at the worst time possible - my wife is 8 months pregnant. She is yet to be tested but her symptoms have been macupapular rash on back of both legs (started 3 days, lasted 5 days post exposure), and at 12 days developed sore throat, nasal congestion, muscle aches, severe coughing, lot of mucous, vomitting and still after 8 weeks now, has the cough and sore throat. She hasn't been tested but is planning to very soon.

My 40 day PCR RNA test (20c/ml - 10million c/ml range) came back negative, as did my antibody test for HIV 1 & 2. Can you please tell me based on your expertise, how conclusive these results are? Also - do you recommend another such combo test (or just antibody test) at 3 months? 6 months?

Thanks in advance for your time and help.

Response from Ms. Southall

Hi Oral sex carries the lowest risk of HIV transmission, even with your sores it does increase the risk some but not very much. Fingering as well carries very low risk.

This is not to say that it is not a way for transmission to occur, but with your PCR test at 40 days this is very reassuring that you are HIV free. The guidelines for HIV testing are to be initially tested at 3 weeks then again at 90 days, if both of these tests are negative then so are you, as long as there were no other types of exposure during that 3 month period, if so then the timing starts over again.

If your symptoms continue I would definitely follow up with your health care provider. Other sexually transmitted infections can occur through what you experienced as well as just picking up a bacteria or viral infection such as the flu. With your wife being pregnant and experiencing symptoms I would recommend the same for her as well.

Be well, Shannon



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