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Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV?

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HIV AIDS Specialist
Practicing since : 1974
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Hi Doctor,
I recently had protected sex with a prostitute. we had sex in missionary and woman on top position. As far as I can recall, the condom was intact.
After sex, I took out my condom with my right hand. I felt something sticky on the condom. I rinsed my hand in water for 2 seconds. I did not see any blood on the condom. I dont know if she was menstruating.
I used water from the same hand to clean my penis.
Then I cupped the palm of the same hand, took some water on it and rinsed my mouth and gargled with the water. Then I spit the water out. Assuming there was some vaginal fluid on the condom and it stuck to my hand when I removed the condom. Although I rinsed my hand in running water for two second, I am not sure it it washed away all the vaginal fluid.
I am afraid now. I think I might have been at risk for HIV. I know that the mouth is inhospitable for the HIV virus. But I am worried that some water might have gone to the back of my throat, or I might have ingested some water.

I am extremely afraid. two weeks after the episode i have a canker sore in my mouth. Also I have a very mild sore throat. I felt feverish but when I took temperature it turned to be 98 F.

Do you think I am at risk? I am extremely afraid
Please answer.
Posted Mon, 16 Sep 2013 in HIV and AIDS
 
 
Answered by Dr. S. Murugan 3 hours later
Brief Answer:
Negligible risk for HIV, symptoms not due to HIV

Detailed Answer:
Hi XXXXXXX
Welcome to XXXXXXX
Thanks for posting your query.

There is nothing to worry.
You had protected sex and the condom was intact.
The vaginal fluid outside the condom outer surface had been contacted with your fingers and after a wash, you cleaned your penis with the same hands and gargle your mouth using same hands, is almost common to many who had protected intercourse, not it happened to you alone.
The HIV risk by a touch of infected fluid is negligible. Then mouth gargling with the same hand also never caused a HIV infection to anybody so far. Even swallowing a little bit of infected material also won't cause an infection unless there is an obvious injury in the mouth or throat. Gastric acidity and juice are also have inhibiting power over HIV. So nothing will happen. You need not worry.
The symptoms of a oral ulcer and sore throat is a very common illness for anybody, especially following any close intimacy with someone. It could unlikely to be due to HIV.
Relax and ease yourself and have your blood test with HIV DNA PCR or P24 Antigen test after another week and confirm yourself that you are free from HIV.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 10 minutes later
Hi Doctor,
Thanks you so much I have researched a lot over the possible ways HIV infection can occur. I am just wondering if some vaginal fluid stayed at the back of my throat. I gargled and rinsed at least 5-6 times immediately afterwards to eliminate whatever chances there were.
I am sure you understand that I am extremely scared now and do not have the courage to go and test.
1. Doctor, I just wanted to ask, why do you say that oral ulcers and mild sore throat is common after intimacy? any specific reason.
2. Its been two 12 days since my exposure and I developed an ulcer under my tongue. Since, I am extremely stressed can that might be the reason for the sore throat and canker sore?
3. I am sure the condom was intact. Does an unbroken condom protect 100%. I have read on CDC that condom has holes that can allow HIV to pass through? Doctor XXXXXXX on WWW.WWWW.WW says that HIV cannot pass through condoms if used correctly

4. Lastly, what is my probability that I am not infected. I do not have fever or rashes? How common are these with ARS? I just hope that I do not have ARS.

Thanks.
 
 
Answered by Dr. S. Murugan 33 minutes later
Brief Answer:
HIV risk is negligible for you.

Detailed Answer:
Hi,
Welcome back.

1.Sore throat can be an air born infection and also intimate kissing also can produce some sort of nonspecific throat infection by virus and bacteria other than HIV.
2.It is possible that a stress can cause canker sore.
3. Millions of people who are using condoms are not getting HIV as we are coming across practically. Spouses of HIV positive individuals who are not having HIV (Sero-Discordant couple) remain sero-negative for years together when they are using condoms consistently. I am having a lot of living examples rather than mere statements.
4. Your chances of getting HIV is negligible. Your symptoms are not consistent with that of acute HIV infection (earliest HIV manifestation). ARS is different and will occur after years.
DR S.Murugan
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 10 minutes later
thanks doctor. you have been very helpful
Final questions
1. i had an ulcer in the mouth at the time of the incident. it was very superficial though? does that increase my risk in your assessment? does that count as an obvious injury in the mouth? I also had slightly sore throat at the time. Would having slightly sore throat count as obvious injury of the throat?
2. I did not see any blood on the condom. If a microscopic amount of blood was present and it came in touch with my mouth and throat, would that change your assessment?
3. The woman was on top for a while? I hope that does not increase the risk?
4. Even if some amount of vaginal fluid/ blood was present, water would have diluted it, right? I believe in diluted form virus would be unlikely to infect?
5. what would you count as obvious injury of the mouth or throat?
6. I kissed her, some saliva might have been exchanged? Does that change your assessment?

Thank you so much for your time and patience.
 
 
Answered by Dr. S. Murugan 8 hours later
Brief Answer:
It is not altering your HIV risk.Still negligible.

Detailed Answer:
Hi,
Welcome back.
Very interesting to answer your intelligent queries.

1. Presence of an ulcer in the throat and a sore throat will likely to increase the risk for HIV if you had oral sex with another man and not for the mouth washing or gargling.
2. Even if we assume that there was a microscopic blood in the outer surface of condom along with vaginal secretions, the risk of HIV on touching the same and carrying to mouth to cause an infection, it would not be adequate. Such situations are happening in day to day activities with health care personnel and in a home where there caring of HIV positive individuals. But not got infected.
3.Women on the top does not carry any extra risk for HIV.
4. You are absolutely correct that it would not be adequate to cause an infection.
5. A gum infection or a bite XXXXXXX or other traumatic injuries.
6. The concentration of HIV in saliva is not adequate to cause an infection. It did not increase your risk towards HIV.
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 1 hour later
Hi Doctor,
1. I was worried about the woman in top position because then the cervical fluids can directly come in contact with the tip of the condom, directly above the urethera. Since the cervical fluid has a high concentration, I was worried that even if a small amount passed through, I would be at risk.


2. If I am not mistaken Doctor, condoms are designed to burst, if there is even a small tear in the condom, right? since there was no obvious tear can I safely assume that the condom was intact?

3. Also while removing condom, on other occasions also, I have felt something sticky on my penis. Is there some lubricant in the condom, that causes the stickiness after removing it.


Thanks. You have been extremely patient.

 
 
Answered by Dr. S. Murugan 1 hour later
Brief Answer:
Woman on top has no extra risk for HIV

Detailed Answer:
Hi,
You are welcome.
1.Cervical fluid will not dribble. Its consistency is very thick and very little in quantity. The vaginal fluid is more than cervical fluid and the quantity varies with persons and in situations.Whether it is woman on top or man on top does not mater any difference as far as the infection point of view.
2. Correct method of usage of condom will not lead to breakage. If the terminal air space of the condom is hold properly during insertion, then the chances of condom breakage is very much less.
3.While removing condom, your semen and pre-ejaculatory fluid are likely to be there over your penile shaft is quite expected.
So remove your obsession and relax.
DR S.Murugan
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 12 hours later
Hi Doctor,
I have got a rash or something similar on the upper part of my left leg. Please find the photograph attached.
I showed it to a general physician and told him about my exposure. He said it looks like a fungal infection.

You have been very reassuring but I am a bot worried as the timing of the rash or fungal infection and the ulcer in the mouth both developed around 2 weeks after exposure.

Please have a look at the photograph and suggest if its anything to be worried about.

Thanks.
 
 
Answered by Dr. S. Murugan 37 minutes later
Brief Answer:
Pictures are received

Detailed Answer:
Dear XXXXXXX
Your photographs are not reaching me. Try to upload once again I will tell my opinion about the same in the morning.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 9 hours later
Hi Doctor,
I have uploaded the photograph once again.
Also I just wanted to ask, absence of fever is a very strong symptom against acute infection, right. From what I have read, anyone who tends to show any other sympt the other symptoms like rashes, sore throat or ulcer generally also has fever and all symptoms come at the same time.
Please correct me if I am wrong.

Thanks.
 
 
Answered by Dr. S. Murugan 1 hour later
Brief Answer:
Picture not received, symptoms appear together

Detailed Answer:
Dear XXXXXXX
Once I am sorry to say that the photograph was not found in my Dashboard.
If you are not able to upload the same you can also send the same as an attachment to WWW.WWWW.WW

Usually only 40-70% of the people had HIV infection only will manifest the symptoms of Acute infection and not all. They will manifest usually 3-4 weeks following an infection or entry of virus into one's body. As you said the individual will manifest a FLU like syndrome with fever, body pain, throat pain and sometimes even with diarrhea and rashes along with lymph node enlargement.
They will occur simultaneously or at a sequence and not in part by part.
Anyhow there is nothing to worry on your part about your encounter.
Dr S XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Had protected sex, contacted with vaginal fluid outside condom with penis. Have canker sore in mouth. HIV? 32 hours later
Doctor, I have sent mailed the photographs to YYYY@YYYY and asked them to ensure that they reach you.

Also 14 days after exposure I had a mouth ulcer. I still continue to have it.
I dont know if what I had on my skin on the same day is a rash or dermatitis. Anyway, the photographs will reach you.


Doctor, have you come across even one case in which inspite of using a condom effectively a person contracted HIV?

I know my questions are repetitive, but I cant gather the courage to have a test.

If my rash(or whatever it is) and mouth ulcer are not anything to be worried about, I will move on.

Please advise.
 
 
Answered by Dr. S. Murugan 3 hours later
Brief Answer:
No one of my patient got HIV with protected sex

Detailed Answer:
Hi,
Welcome back.
I received the photographs sent by you. But the clarity of the photographs are not enough to give any specific diagnosis. But I am sure, this rash is not at all indicative of HIV.
Oral ulcer can occur recurrently for some people for various reasons other than HIV.

In my 25 years of experience in the field of HIV practice, I had not come across a single case to be established to acquire HIV in spite of using condom. Especially nearly thousand HIV sero- discordant couple are using condoms regularly and they remain free from HIV. Only those had used inconsistently got HIV. Similarly all my HIV positive patients got this disease when having unprotected sex.
By touching condoms also nobody got HIV so far.
So you need not worry and have HIV test to find yourself free from HIV.
Dr S.Murugan
Above answer was peer-reviewed by
 
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