Concerns About HIV Infection After Risky Encounter: What You Need to Know

Concerns about HIV/AIDS

Hello, Dr.
Lee.
About four weeks ago, I had my wisdom teeth removed, and the dentist mentioned that I have periodontal disease.
Three days after the extraction, I had a tongue kiss with a guy at a nightclub that lasted intermittently for about one to two hours.
I can't be sure if he had any wounds in his mouth.
I am not gay, but I tend to do crazy things when I drink.
That day, the guy asked if I wanted to go to the restroom, and we went together.
Then he asked if I had ever tried giving oral sex to a guy.
I said, of course not! He then asked if I wanted to try it.
I was drunk and surprisingly agreed! However, I only performed oral sex for about 10-20 seconds before stopping.
I thought about it; he had just come from the restroom, and although I wiped his glans slightly with my hand, urine could still be present.
Plus, I know that during oral sex, some bodily fluids are secreted, and there might have been some fluid released due to the tongue kissing.
Although the amount of fluid is really small, I am very worried about infection because I have periodontal disease and just had my wisdom teeth removed.
I am especially concerned because after I finished giving him oral sex, I stood up and accidentally bumped his mouth, causing it to bleed! He suddenly said, "I can't kiss you anymore!" I asked why, and he said, "I don't want to infect you!" I was stunned when I heard that! Recently, I read some articles, and I have some symptoms that seem to align with the window period of infection, such as elevated body temperature.
My sublingual temperature is around 37.5 degrees Celsius.
I have back pain, excessive sleepiness, poor mental state, diarrhea, and rashes on my face! But I am also confused because I have always been very sleepy, sometimes needing up to 13 hours of sleep a day! My mental state has also been poor for a long time, but it has worsened slightly recently.
However, compared to the worst times in the past, it is about the same.
Additionally, I used to get some rashes on my face during seasonal changes, usually around the sides of my nose! I also have a long-standing habit of drinking alcohol, and I have always experienced either constipation or diarrhea.
Especially after drinking, I often have diarrhea the next day, sometimes lasting two to three days! Back pain has also been a common issue for me in the past! Recently, I have experienced joint pain, which has occurred before but not frequently.
However, it is not a constant pain; it just occasionally feels like a sharp pain! I really want to know if I have been infected.
What is the likelihood of being infected with HIV based on the situation I described above? I hope to get some reassurance.

Niming, 20~29 year old female. Ask Date: 2015/12/14

Dr. Li Yilun reply Urology

Your symptoms primarily indicate an upper respiratory infection, so it is advisable to drink plenty of water and get ample rest.
It is not possible to determine if you have a specific infection based solely on this information.
Many sexually transmitted infections, such as HIV, can indeed have a window period of 3 to 12 weeks, so you may still be within that window.
However, HIV typically does not cause an immediate drop in immunity after infection.
If you continue to experience symptoms of infection without recovery, please seek medical attention from an infectious disease specialist.
When you seek care, inform the healthcare providers that the sexual partner may be a high-risk individual, and request an HIV screening.
Reducing contact with complex partners' bodily fluids can help decrease the risk of infection, and prevention is better than treatment.
It is essential to clarify that a simple description cannot determine your condition, so if you have any concerns, it is still recommended to consult a nearby infectious disease or HIV specialist for evaluation and testing.

Reply Date: 2015/12/14

More Info

It's understandable to have concerns about potential HIV infection after engaging in risky behaviors, especially given your recent dental procedure and the nature of your encounter. Let's break down your situation and address your concerns based on current medical knowledge regarding HIV transmission and symptoms.

Understanding HIV Transmission
HIV (Human Immunodeficiency Virus) is primarily transmitted through specific bodily fluids such as blood, semen, vaginal fluids, rectal fluids, and breast milk. The main routes of transmission include:
1. Unprotected Sexual Contact: This includes vaginal, anal, and oral sex without the use of condoms or dental dams.

2. Blood Exposure: Sharing needles or exposure to infected blood.

3. Mother-to-Child Transmission: During childbirth or breastfeeding.

In your case, the encounter involved kissing and oral sex. While oral sex is generally considered to be a lower-risk activity compared to anal or vaginal intercourse, it is not without risk, especially if there are open sores or bleeding gums involved.

Risk Factors in Your Situation
1. Recent Dental Procedure: Since you mentioned having just had a tooth extraction and having periodontal disease, your mouth may have been more susceptible to bleeding. If the other individual had HIV and there were any cuts or sores in your mouth, this could potentially increase the risk of transmission.

2. Kissing: Kissing, especially deep kissing (French kissing), can pose a risk if either party has open sores or bleeding gums. However, the risk of HIV transmission through saliva is extremely low.

3. Oral Sex: Performing oral sex on a male partner can carry some risk, particularly if there are cuts or sores in your mouth. The risk is higher if the partner is HIV-positive and has a detectable viral load.

Symptoms and the Window Period
You mentioned experiencing symptoms such as fever, fatigue, back pain, diarrhea, and rashes. These can be indicative of many conditions, including but not limited to HIV. The acute HIV infection phase typically occurs 2-4 weeks after exposure and can present with flu-like symptoms. However, these symptoms are not exclusive to HIV and can be caused by various other infections or conditions.

Assessing Your Risk
Given the details you've provided:
- Kissing and Oral Sex: While there is a risk, it is generally lower compared to anal or vaginal intercourse. The presence of bleeding gums or recent dental work does elevate the risk somewhat.

- Partner's Statement: The fact that the individual expressed concern about infecting you could indicate they are aware of their own health status, but it does not provide definitive information about their HIV status.

Recommendations
1. Testing: The most reliable way to determine your HIV status is to get tested. Testing is recommended at least 2-4 weeks after potential exposure, with follow-up testing at 3 months for conclusive results. Many clinics offer rapid testing, which can provide results within minutes.

2. Monitor Symptoms: While it's important to be aware of symptoms, many of them can be attributed to various other factors, including stress, anxiety, or other infections. If symptoms persist or worsen, seeking medical attention is advisable.

3. Reduce Anxiety: It's natural to feel anxious after a risky encounter, but focusing on getting tested can help alleviate some of that anxiety. Additionally, consider discussing your feelings with a healthcare provider or counselor, especially if you find that anxiety is affecting your daily life.

4. Safe Practices: Moving forward, consider adopting safer sexual practices, such as using condoms or dental dams, to reduce the risk of sexually transmitted infections (STIs), including HIV.

In conclusion, while there is a potential risk based on your encounter, the best course of action is to get tested and consult with a healthcare professional who can provide personalized advice and support. Remember, early detection and treatment are key in managing HIV and maintaining overall health.

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