HIV Risks: Oral Sex and Symptoms Explained

HIV issues

Hello, doctor.
On March 6th of this year, I had unprotected oral sex with a sex worker.
About 20 seconds later, she rinsed her mouth and then continued to provide service for another 20 seconds.
Because I was concerned, I stopped the activity immediately.
In the end, my glans was covered with her saliva.
Doctor, am I at risk of infection? I made many phone calls, including to the Lu Der Clinic, the Red Ribbon Foundation, and the AIDS Rights Promotion Association, as well as inquiries to Taipei Veterans General Hospital and Taipei City Hospital.
They all said that while there is a risk, there have been no documented cases of infection solely from oral sex, unless there is significant bleeding in the mouth.

About two weeks later, I experienced a sore throat and mild diarrhea, so I went to see a doctor.
The doctor said I had mild throat inflammation and mentioned that many patients have similar symptoms of sore throat and diarrhea lately.
After taking medication for a few days, my diarrhea decreased, but my sore throat has persisted for 16 days.
I wake up in the morning with white phlegm.
I am unsure if this is caused by HIV or if it is because my roommate also has a cold and has been blowing his nose in the dormitory.

I watched Dr.
Luo Yi-jun's "Heart Valley," and he mentioned that acute HIV symptoms usually appear in 3 to 4 symptoms together and that there is always a fever.
Although I do not have a fever or other acute symptoms like a rash, I only have a sore throat and diarrhea.
However, I am uncertain if my persistent sore throat is caused by HIV.
I kindly ask for your advice, doctor.

Nìmíng, 20~29 year old female. Ask Date: 2017/04/02

Dr. Hong Yuanbin reply Internal Medicine

Hello, from your question, I can sense your concern and fear regarding oral sex without a condom.
Indeed, if there is no blood contact and only saliva is involved, the risk of transmission is very low.
As for your symptoms, they are likely caused by a cold or gastroenteritis.
Although some symptoms of HIV may resemble those of a cold, your symptoms do not align with typical HIV symptoms.
If you are still very worried, you can consider getting tested for HIV every 3-6 months, or if you are concerned about potential exposure, you might want to consider anonymous testing.
If you test negative for HIV throughout the entire year, you should be able to feel reassured.
Thank you for your question.

Reply Date: 2017/04/02

More Info

When it comes to understanding the risks associated with HIV transmission, particularly through oral sex, it is essential to consider several factors, including the nature of the sexual activity, the presence of any cuts or sores, and the health status of both partners.

In your case, you engaged in unprotected oral sex for a brief period, followed by the partner rinsing her mouth. While oral sex is generally considered a lower-risk activity for HIV transmission compared to anal or vaginal sex, it is not entirely without risk. The primary concern arises if there are open sores or bleeding gums in either partner, as these can facilitate the entry of the virus into the bloodstream. However, as you mentioned, the likelihood of contracting HIV solely through oral sex, especially in the absence of visible blood, is relatively low.

Regarding your symptoms, it is important to note that many conditions can cause a sore throat and gastrointestinal issues, including viral infections, bacterial infections, and even allergies. The symptoms you described—persistent sore throat and diarrhea—could be attributed to a common viral infection, especially since you noted that your roommate was also experiencing cold-like symptoms.
HIV acute infection symptoms, often referred to as acute retroviral syndrome (ARS), typically appear 2 to 4 weeks after exposure and can include fever, fatigue, swollen lymph nodes, sore throat, rash, and muscle aches. However, not everyone experiences these symptoms, and they can vary significantly in presentation. The absence of fever and a rash in your case makes it less likely that you are experiencing ARS.
It is also crucial to understand the concept of the "window period" for HIV testing. The window period is the time after exposure during which HIV tests may not detect the virus, even if a person is infected. For most HIV tests, including the fourth-generation tests (which detect both HIV antibodies and antigens), the window period is typically around 18 to 45 days. Therefore, if you are concerned about potential exposure, it is advisable to get tested after this period for a more accurate result.

In summary, while there is a theoretical risk of HIV transmission through oral sex, the actual risk is low, especially in the absence of blood. Your symptoms are more likely related to a viral infection rather than HIV. However, if you remain concerned about your health or potential HIV exposure, it is wise to consult a healthcare professional for testing and further evaluation. Regular testing and open communication with sexual partners about health status are vital components of maintaining sexual health and preventing the spread of sexually transmitted infections.

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