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What are the chances of HIV transmission through non penetrative sex?

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Posted on Fri, 1 Aug 2014
Question: Hi,

I received UNPROTECTED ORAL SEX 30 days before with a sex worker who claimed HIV Negative. After I got the oral sex, within 72 hours I visited a Physician in my country and he said saliva alone would never pass HIV. I also did not see any blood while she was giving the oral sex. I did NOT give her oral sex. I did NOT touch her genital. Did NOT kiss lip to lip as well. But, my pubic area had slight razor cuts due to shaving around 40 minute BEFORE the oral sex session. The physician here recommended me Aciclovir and another pill for 2 weeks to prevent other STDs except HIV. Now from the 24th day of this incident, I experience just unwell, mild fever and a feeling of something being stuck in my throat and mild headache. In some websites, I read that these are sereconversion symptoms and afraid. Really scaring to death. As far as I'm aware, I do NOT have swollen lymph nodes or rashes (for the time being) in my body. A general doctor gave me some pills and the feeling of something stuck in throat has decreased, but it still exists. I see some white coating in my tongue as well (however I just checked my mother and she too had similar color tongue). Is this Oral Thrush developing ??? Can the feeling of something stuck in throat be Esophagitis caused by HIV ? Really scared and waiting for your clarification. I have not tested myself yet. Please note that I received unprotected oral sex for about 40 minutes and I feel it's a fairly long time. Does this time duration make saliva capable of transmitting the virus ? Thank you for your time.
doctor
Answered by Dr. S. Murugan (31 hours later)
Brief Answer:
Allswallowing difficulty arenot due to esophagitis

Detailed Answer:
Hi,
Once again I welcome you to HCM.
Saliva is not infectious even in the presence of abrasions of shaving. So nothing to worry.I would like to know how long you had Tablet Acyclovir and in what dose as a preventive one, and what was the another pill you had to prevent STD. As I had told you already, the symptoms started by 24 th day after the oral sex could not be due to sero-conversion illness of HIV. Feeling of something stuck in throat is very common with any throat infection and not necessarily due to esophagitis in which the difficulty is more behind the chest and not in throat and is one of the very late manifestation in HIV disease. So this possibility is simply ruled out. All the white coating of tongue are not due to oral thrush. It would be easily diagnosed by your Physician.
However much the time your penis exposed to her saliva, that did not make much difference in the HIV risk.
So forget about these things at present and your HIV test would clear everything and you will get a non reactive result.
DR S.Murugan
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. S. Murugan (3 hours later)
Thank you once again sir.

In some websites, they say sero-conversion illness might start from 2-6 weeks after the exposure. Isn't this true sir ?

I used Aciclovir 400mg for 2 weeks at 6 hourly doses (4 times a day) and Doxycycline 100mg for 2 weeks at twice daily dose. Yes of course the white coating seems went out now and I didn't have a true red color tongue ever. My only concern now is, just after the exposure I'm having a red throat and still the mild feeling of something being stuck. Tongue feels bit differently which makes eating food not that needy (but not lost of appetite). The general doctor (MBBS educated. Not an specialist doctor) saw my throat and told me it seems a viral infection (HIV ???). I'm totally down. Sir, can't it be Pharyngitis which is described in many medical websites as one of the symptoms of sero-conversion illness ? Kindly help me sir. Many thanks for your kindness and time.
doctor
Answered by Dr. S. Murugan (4 hours later)
Brief Answer:
Close intimacy cause to ordinary throat infection

Detailed Answer:
Hi,
Welcome back.

Sero-conversion (Antibody formation) in HIV usually starts from 6-8 weeks. Some sites mentioned as 4- 6 weeks. This primary infection in HIV is otherwise called as Sero-conversion illness as it corresponds with the antibody formation or immunological response of the body to the virus. So also the symptoms of sero-conversion illness appears only after 4 weeks and not earlier as some sites described.

Throat infection can occur due to either bacteria or virus (Other than HIV also). Common cold is viral origin. There are hundreds viral diseases are there, other than HIV like pox, herpes, polio, bird flu, Chikunguniya, rabies, Hepatitis and so on...... Close intimacy during sexual act can produce a throat infection with anybody other than HIV (Air born).

So it is an ordinary infection only. Nothing to worry.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. S. Murugan (53 minutes later)
Sir,
Many many thanks for your time with me.

I just had an HIV test and the result is NEGATIVE. "Thanks and Praise to almighty God".
But I have something to clarify with you sir. I hope you would help me in this.

1. I live in XXXXXXX Lanka. Although the lab is a prestigious lab with ISO Accreditation, I just visited its branch nearby. Being a small town, the staff there might not have handled a lot of HIV patients. Thus, although they could perform the testing, they are unable to tell me much details. They told it was an STRIP test. I asked which kind of strip (I've read about "Hema Strip tests). They again said this is Strip test. Meanwhile, I read in XXXXXXX Love website which is managed by Thai Red Cross AIDS Research Centre that currently used antibody tests are more sensitive than those used in the past. 
Most people will develop detectable antibodies by 30 days after infection with HIV. Could you kindly guess, whether the strip test performed on me today also might be an advanced one here in XXXXXXX Lanka ? Or still, those old day strip tests are performed in countries which are not able to detect anti bodies in 30 days ? I ask this because I have tested today which is just the 33rd day after exposure. Will this test be reliable ?

2. I still have the red color throat & tonsils - for the 5th or 6th day. But it never pains. No special feeling other than MILD feeling of something been stuck in throat (Yes it might be due to REALLY REALLY EXTREME FEAR as well!). In earlier (ARS) stages of sore throat, is this the characteristic that PAINLESS RED THROAT or painFUL throat ? I did have some high temperature and it got reduced after taking paracetamol. Will ARS fever be MILD and reduce for PARACETAMOL sir ?

3. I have also asked for an ELISA test from the same lab which would be done at its head office. They said they need around 36 hours of time to deliver the results. But they are not aware whether it's an ELISA 2nd Generation or 3rd Generation test. If in case it was 2nd generation, would 33 days enough to detect anti bodies sir ?

4. The lady at the lab told, POSITIVE results came by STRIP method had become NEGATIVE when done with ELISA. But, they don't know any case when a NEGATIVE result came by STRIP became POSITIVE with ELISA. Is this the usual occurrence sir ?

5. I have also asked for a Full Blood Count (FBC) which the results would be given to me in 1 hour time. Sir, can we find any clue in FBC report about any possible HIV Sero-conversion illness sir ? Such as low white blood cells etc etc ?

I am sorry for too many questions. But simply, I have no specialist doctor nearby to assist me on this sir. Further to add, in future, I would NEVER do any such activities if the God wishes, whether with protection or without protection. I grew up in a good family and never did these things. The above case was my 1st ever in life. I only called a massage therapist and surprized to see a lady into the hotel room. I was expecting a male (I am NOT a XXXXXXX I simply needed some massage only!). At 7:00 PM, seeing a female foreign massage therapist (ie: Tall, white skin lady from Russia!) in my room for the 1st time in my life, my concentration really slipped as I'm a human being. Still, I controlled myself. She asked me to bend over and I did so. Then I experienced some unusual body parts touching my back and shoulders during massage (Those body parts were her breasts!) and turned my face to see her. Then I found she was nake without dress and then my mind went insane. Except RECEIVING ORAL SEX - I did NOT KISS her; did NOT touch her vagina by my hands or by mouth (Yes please believe me sir. True); did NOT touch her back & anus. Nothing !! Almost, except she was taking my organ into her mouth, I did NOT do anything actively there (just was bit shocked to see what was happening!). So all it happened and now scared to death as the oral session lasted for 40 minutes - whole 40 min time my organ was in her saliva / mouth WITHOUT any protection (did not notice any blood. But cant be sure!). Many many thanks again for taking time to read my reply and taking time to answer my query. May almighty God bless you !
doctor
Answered by Dr. S. Murugan (1 hour later)
Brief Answer:
Repeat the test after 12 weeks to get a conclusive

Detailed Answer:
Hi,
Welcome back.
I am happy to know that you got a HIV negative test

1.First of all I am a clinician, not a lab specialist or a virologist or microbiologist. As far I know all the antibody Rapid tests, marketed, are reliable up to 98% or more. I don't have experience with strip test.
Antibodies against HIV started appearing after 6 weeks (some says 4 weeks). But more conclusive after 12 weeks as the antibody formation may be delayed in some individuals. So all the antibody test will become more conclusive only after 12 weeks.

2.Your throat infection is getting better. Painful or painless nature of sore throat can occur in all infection according to the severity either in HIV or without HIV.

3. Complete blood count can predict an infection, but never confirms HIV or any other infection.

Dr S.Murugan

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2948 Questions

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What are the chances of HIV transmission through non penetrative sex?

Brief Answer: Allswallowing difficulty arenot due to esophagitis Detailed Answer: Hi, Once again I welcome you to HCM. Saliva is not infectious even in the presence of abrasions of shaving. So nothing to worry.I would like to know how long you had Tablet Acyclovir and in what dose as a preventive one, and what was the another pill you had to prevent STD. As I had told you already, the symptoms started by 24 th day after the oral sex could not be due to sero-conversion illness of HIV. Feeling of something stuck in throat is very common with any throat infection and not necessarily due to esophagitis in which the difficulty is more behind the chest and not in throat and is one of the very late manifestation in HIV disease. So this possibility is simply ruled out. All the white coating of tongue are not due to oral thrush. It would be easily diagnosed by your Physician. However much the time your penis exposed to her saliva, that did not make much difference in the HIV risk. So forget about these things at present and your HIV test would clear everything and you will get a non reactive result. DR S.Murugan