Please help me understand!

[ConcernedDude]

Thank you for taking my question.  I have scoured the internet and keep coming across conflicting information.  It appears that aidsmed and poz are very authoritative sources, so I trust what you have to say.  Here are my concerns.

Day 1 (today is Day 11):  I trimmed and shaved my pubic area, which resulted in several small cuts and some razor burn.  Later that evening I went to a strip club less than four hours later and got a dance that resulted in some unprotected frottage.  She was nude and during the dance my pants and underwear got pushed down, resulting in a few seconds of frottage with no penetration, however she was very wet and I think she had an orgasm.  Also, I licked the outside of her nude vagina once during the dance. 

Day 6:  I had an encounter with a prostitute that consisted only of her performing protected oral sex on me and me licking her vagina only a few times without any vigor or intense cunnilingus.  I had bit the inside of my lip two days before but had no other known sores or openings.  I also fingered her and my finger was clean afterwards, so there was no blood.  We did not have vaginal or anal sex.

Day 9:  I developed a small rash on the side of my neck that itches a bit, worse after contact by my shirt or water in the shower.  I have read that acute hiv rash does not itch and I wore some new shirts in the days before the small rash appeared (not the day before, though) but it still worries me.  The rash appears more like folliculitis than a sunburn (I have read that acute hiv rash has the appearance of a sunburn).  I have kept a close check on my temperature and have had no fever at all.  I am having some throat issues but I realize they are related to a sinus infection I have developed.

What really worries me is that I have had sex with my wife since both events and I am worried sick that I might have infected her.  Can someone with knowledge please tell me if I had any risk at all?  If so, how high?  Does the acute hiv rash itch?  Does it really look like a sunburn?  Have I put my wife at risk?! 

I know there are issues to explore with my commitment to my wife since I am engaging in these events, but I do love her and cannot stand the thought that I might have put her at risk.  Every time I convince myself that I am silly for worrying, this darn rash starts itching and makes me worry.  That leads me back to the internet and as you know there are plenty of people who say what I engaged in poses a risk.  What do you all say???

[Jeff G]

The risk for sexually transmitting HIV comes from unprotected vaginal or anal sex .

Nothing you did was a risk for HIV and you need not worry you were infected in any of the ways you are concerned with . The secretions a woman makes when excited are not infectious for HIV so frottage and cunnilingus is not a risk nor is getting a blow job .

ALTHOUGH YOU DO NOT NEED HIV TESTING AT THIS TIME for this incident , anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

We don't discuss symptoms because they are rarely specific to HIV , so go see your doctor and find out what's up , its not HIV .

[ConcernedDude]

Whew.  Thank you.  And thank you for the quick response.  I take it the shaving cuts during the frottage and the bite on the inside of my lip when licking the vagina do not change your assessment? 

Do you have any idea why other, presumably knowledgable, sources say that performing oral sex could be a risk?  Not questioning you - just trying to understand things and see whether I need to avoid cunnilingus in the future, it is something I enjoy doing.

[Jeff G]

No , I read all your concerns and they were not a risk . Check this out and read it carefully . It covers why cunnilingus isn't a risk and you can apply the info to other risk factors as well .

Hiv transmission doesn't stand a chance of happening via female genitals to mouth - there are just too many obstacles on the oral route.

The first obstacle is the mouth itself. The mouth is a veritable fortress, standing against all sorts of pathogens we come into contact with every minute of our lives. It's a very hostile environment and saliva has been shown to contain over a dozen different proteins and enzymes that damage hiv.

Hiv is a very fragile virus - literally. Its outer surface doesn't take kindly to changes in its preferred environment; slight changes in temperature, moisture content and pH levels all damage the outer surface. Importantly, it needs this outer surface to be intact before it can latch onto a few, very specific cell types and infect. 

Which leads to the second obstacle. Hiv can only latch onto certain types of cells, cells which are not found in abundance in the mouth.

The third obstacle to transmission this way is having hiv present in the first place. The female secretion where hiv has been shown to be present is the cervicovaginal fluid. This fluid is actually a thick mucus that covers and protects the cervix.

The fluid a woman produces when sexually excited comes from the Bartholin's glands, located on either side of the vaginal opening. I have yet to discover one shred of evidence (and believe me, I've looked) that shows this lubricating fluid to have any more hiv present than other bodily secretions such as saliva, sweat or tears. Saliva, sweat and tears are NOT infectious fluids.

So there you have it. Once the results of the serodiscordant studies started rolling in, what we know about hiv transmission on the cellular level was validated. The only people who were getting infected were those who had unprotected anal or vaginal intercourse. Period. One of the three studies went on for ten years and involved hundreds of couples. .