What are the chances of getting HIV after genital rubbing?

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Posted on Fri, 19 Jun 2015 in Sexually Transmitted Diseases
Question: I went to a strip club last week and had a naked lap dance. I was wet and so was she, we rubbed our genitals together. There was mutual wetness and I had my pants down. She then gave me a blowjob. The day after I went to Planned Parenthood and told them about my situation. They did not got me a PEP HIV medication which was supposed to be take within 72 hrs of possible exposure. They had never heard of it.

It is now 8 days from that day, I am feeling a sore throat with flu like symptoms. I am very worried I may have exposed myself to HIV, I am not worried about STI's as much since I am not having any symptoms in my genitals.
doctor
Answered by Dr. Kakkar S. 2 hours later
Brief Answer:
I suggest screening for all STDs including HIV

Detailed Answer:
Hello. Thank you for writing to us.

I have gone through your query in detail and i have understood it.

Genital rubbing is a risk factor for transmission of Hiv.
The risk with genital rubbjng is less as compared to the act of actual penetration but it is not Zero.

I suggest tbat you get yourself screened for Hiv with an HiV DUO test at 4 weeks.

You should also get screened for other STDs like gonorrhea, chlamydia, genital herpes, syphilis. The reason being that STDs may not present with symptoms/ signs soon after sexual contact and therefore it is important to do lab tests to rule out the possibility.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 7 hours later
Hi Dr. Kakkar,

I have heard on other forums that naked rubbing or naked frottage is a no risk situation for HIV. I have also heard that Male receiving oral sex from a female is a no risk situation for HIV.

From your experience have you had patients who received the virus from either of these methods?

I am very stressed at the moment as I am in a long term relationship and made this big mistake.

Thanks
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
I suggest screening tests for all STD's

Detailed Answer:
Hi.

Vaginal secretions, blood, semen are considered to be infectious as far as HIV is concerned.
The risk of infection with HIV would depend on the amount of wear and tear involved during sexual act.
HIV enters through minute tears sustained during sexual act.
Also longer the act lasts the higher the risk because would be more chances for the virus to gain an entry through minute mucosal tears.

Risk of HIV is greatest with anal sex, followed by vaginal and oral sex because anal sex is by far the most traumatic i.e involves a lot of wear and tear.

Genital rubbing specially if did involved exchange of fluids is a risk factor though it is less of a risk as compared to anal and vaginal sex because genital rubbing would cause less wear and tear.
It is hard to estimate the risk solely from an act of genital rubbing because most people who practice genital rubbing also practice other forms of sexual contacts e.g oral, vaginal Or anal during the same sexual encounter.

As far as myself is concerned I am yet to encounter a case of HIV whom I can attribute purely to genital rubbing, because most of these patients also practice other forms of sex during the same sexual encounter.

Receptive Oral sex is a low risk for Hiv, provided the person giving oral sex did'nt had any oral sores/ breaks in oral mucosa.

As I already said the risk is low with genital rubbing but still you would want to rule it out by appropriate testing.
Flu like symptoms are not diagnostic of HIV and this could be a normal viral flu.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 1 hour later
Hi Dr. Kakkar,

I took a home test for HIV called Oraquick, its a saliva swab test that gives results in 20 minutes. That came back negative, but it has only been 8-9 days since the incident. The test stated its most accurate after 3 months. That seems like a long time for me to wait in this anxious state. Is there any test I can take sooner that would be more accurate.

When should I get tested again? When should I test for STDs.

Thanks
doctor
Answered by Dr. Kakkar S. 8 hours later
Brief Answer:
STD testing at appropriate intervals

Detailed Answer:
Hi.

The test which you did is purely an antibody based test. Testing just 8-9 days after sexual contact is too soon for an antibody based test.

Though in most of the infected individuals circulating antibodies against HIV appear by 1 month, however, in a few they may be delayed for as long as 12 weeks, therefore, testing at 3 months (also known as the window period for detection of Hiv) is the upper limit for a purely antibody based test to be taken as conclusive.

For HIV i would suggest you to take an HIV DUO test at 1 month. It is a blood test.
It is highly specific and sensitive. It would test for both circulating antibodies as well as HIV antigens (P 24)
It has a short window period of detection i.e 4 weeks as compared to a test which is purely antibody based.

For syphilis an RPR test can be done at 1 month.
Result at 1 month for syphilis is very suggestive but testing Syphilis should be repeated at 3 months for a conclusive diagnosis.
This is because the incubation period of syphilis is 9-90 days. Therefore if a 90 day test is negative that conclusively rules out syphilis.

For genital herpes I would suggest an ELISA for Hsv type 1 and type 2 (IgG and IgM). This can be done at 4 weeks and then repeated again at 12 weeks for a conclusive result.

A swab test for gonorrhea and chlamydia would be advisable earliest at 2 weeks.

In the mean time if you develop any signs or symptoms of an STD you should consult a venereologist.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 49 minutes later
Hi Dr. Kakkar,

I went to a local family doctor today after taking the Oraquick test. He also said that it was a very low risk event for HIV, but higher for chlamydia and gonorrhea which are more common.

So he had me take a urine test for chlamydia and gonnorrhea. When we get the test results I will let you know.

He also told me to take a "HIV-1/2 AB BY XXXXXXX W RFLX HIV-1 AB" blood serum test in about 1 month from now which would be much more accurate. He said that this test in 1 month is about 99.9% accurate, what do you think?

I'm still nervous until all testing is done, but with your help and his I feel a little better about the situation. Any other advice for me?

Thanks
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
I agree with your doctor

Detailed Answer:
Hi.

I completely agree with your doctor and you can take this test at 4 weeks, however, the HIV-1/2 AB BY XXXXXXX W REFLX HIV-1 AB confirmation by Western Blot, is a 3rd generation test.
If this test is negative at 4 weeks that almost certainly rules out HIV.

However, I had suggested you an HIV DUO test in my reply earlier, which is 4th generation test i.e Human Immunodeficiency Virus (HIV) Combo Antigen/Antibody (HIV-1/O/2) by ELISA, with Reflex to HIV-1/HIV-2 Antibody Differentiation by Multispot.
You may take this test if available. This test is appropriate if acute HIV infection is suspected i.e those with flu like symptoms.

Hope for the best

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 19 minutes later
Hi Dr.

What is the time recommended for taking the HIV Duo test? My family doctor did not mention the HIV Duo test, but I could ask if he has it available if you strongly recommend it over the Western Blot test.

He also said that my flu like symptoms are most likely resulting from a respitory/sinus viral infection. He did not think they were HIV like symptoms. What is your opinion? I am having a sore throat, losing my voice, sinus pain, and a little coughing, with minor chills/aches. He did a Rapid Strep throat test and it came back negative.

Thanks
doctor
Answered by Dr. Kakkar S. 20 minutes later
Brief Answer:
Flu is not diagnostic of HIV

Detailed Answer:
Hi.

HIV DUO is a 4th generation test. It is ideally done at 4 weeks.
HIV DUO is automated for both HIV antibody as well as Antigen detection (P 24 antigen) therefore it is more sensitive and specific unlike a 3rd generation test which tests only for anti-HIV antibodies. You can go for this test if he can do that.

However, i would be more than happy even if you test by what your doctor suggested at 4 weeks even though it is purely an antibody based test because most of the infected individuals develop circulating antibodies by 4 weeks which can be detected by HIV-1/2 AB BY XXXXXXX W REFLX HIV-1 AB confirmation by Western Blot.

Therefore a negative result by HIV-1/2 AB BY XXXXXXX W REFLX HIV-1 AB confirmation by Western Blot, at 4 weeks would be good enough considering that your exposure was not a high risk one.

I already mentioned that Flu like symptoms are not diagnostic of HIV and could very well be a normal viral flu.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 3 minutes later
Thanks, I will update when I get my results
doctor
Answered by Dr. Kakkar S. 2 hours later
Brief Answer:
You are welcome

Detailed Answer:
Thank you for writing to us. Keep me updated.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8898 Questions

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