Possible Precum on healing Anal Fissure? And generalised itchiness?

[rocker_2011]

I met with a man (a stranger) for sex recently and I’m worried about my exposure.

At the time, I had a small anal fissure which was healing. As I was getting myself ready down there it was stinging slightly, but at no point did I see any blood. I gave him unprotected oral sex (not to the point of ejaculation). We were about to have anal sex, and he started pressing and ‘jabbing’ my anus, and while there was no penetration he did press into it. I told him to stop and put a condom on. He did, and we then had protected anal sex.

I immediately started to wonder whether I had put myself at risk – I asked him what his HIV status is and he said he was Negative (though did not say when his last test was). I was concerned though that he seemed keen to go bareback after that (and during sex) – if he’s that willing with me, then surely he’ll be that willing with other people right?! The incident was in Manchester (UK) where statistics say that 9% of gay men have HIV, so this has worried me also. I checked the condom afterwards for tears and leaks – of which there weren’t any to my eyes.

I don’t recall him having very much precum at that point, but the worry that gets me is that during his ‘jabbing’ he might have released some precum which (if he is positive) have infected the fissure.

about 24hrs later, I was wondering whether to seek out PEP. I was seriously considering it, but then decided that it was only a small risk, and that there was probably nothing to be worried about. So I didn’t bother.

about 9 days later, I started feeling very tired and ‘out of it’ and have since been displaying unusual symptoms:
-   Pain and aching in lymph nodes (swelling confirmed by examination by my GP)
-   Some Muscle Aching & Stiffness
-   Mild Sore Throat (and one swollen tonsil)
-   Itchy Skin all over (and I mean all over – not limited to a rash, I’m itchy on my scalp, hands, shoulders, legs etc)
-   Fatigue and breathlessness after even mild exertion
-   Increased sneezing (not a typical ARS symptom I know – but I’m not particularly congested either)
-   Diarrhea (loose stools, but not completely watery)
-   Decreased appetite
-   One night sweat (possibly induced by stress before a job interview though . . . )
-   Possible Rash (Faint small pimples on shoulder – I’m unsure if these were there before) and blotchy red skin after I get out of the shower.

I’ve called up the THT and given the advisor the same information – he seemed doubtful of my exposure.

I went to my GP, who examine me. He confirmed that my lymph nodes in my neck were up, which he said was “not good news”. At that point I went all hot and started to panic in my head – he took my temperature afterwards, which was about 37.7C (although I wonder if my hot flash of panic had affected that) which he said was a slightly raised temperature and indicated a viral infection. I have been taking my temperature orally regularly and it has generally been about 36.5C. I also to him about this incident, and he seemed to want to know if any semen got onto / into me – I told him I didn’t think any did. When I started to press him, he seemed to back track and say a 100 diseases could be causing this. He suggested it would be best to rule out glandular fever before considering HIV. So I am due to go in tomorrow and get some blood tests done for Glandular Fever – though he remarked he thought that at my age (26) it would be unusual not to have had it (I can’t recall if I have ever had it).
I want to go get a DUO test tomorrow at 18 days (too early, I know, but I want at least to get some solace).

I have admittedly a history of worrying myself about HIV exposure I guess. Whilst having flu once I was convinced I had contracted HIV. I also convinced myself that I had got an STD when I had a sore / dry throat for a while. I went on PEP last year after an incident of unprotected sex. And in November 2011 I had a very similar episode, where I was displaying all these symptoms (plus retching and vomiting) for over a month after exposure. In all these cases, my tests came back negative. The interesting thing I find about the last incident I mention is that my symptoms then were almost identical to the ones now (although I was being sick then too), and even it’s the same tonsil which has swollen (the GP said that wasn’t much to link them as being due to the same cause . . . but I still wonder).

I’m not sure why I’m posting here. I’ve looked around these sites enough to know that I can’t be diagnosed based on symptoms (and that testing is the only way), and that working out percentages and probabilities is not helpful. I guess I just want to sound my situation out and maybe get others’ opinions.

Any general view about the risk of my exposure?
Would the ARS rash ever appear as very faint pimples?
Also, has anyone ever heard of *generalised* itchiness being an ARS symptom (i.e. not an itchy rash but itching all over the body)?

[Ann]

Rocker,

Neither symptoms nor the lack of symptoms will ever tell you a single thing about your hiv status - ONLY testing will.

That said, you have not had a risk for hiv infection and you do not need to test specifically over this incident. Frottage (rubbing genital areas together without penetration) is NOT a risk for hiv infection. Sexually speaking, the only proven risks are unprotected anal or vaginal intercourse. You didn't engage in unprotected intercourse.

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

ALTHOUGH YOU DO NOT NEED TO TEST SPECIFICALLY OVER THIS RECENT 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.

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

Ann

[rocker_2011]

Thanks for your reply Ann. It's good to be able to talk about this.

I'm not sure I would consider it frottage just. He did press his penis head into my anus, and I am worried at this point maybe some precum was released and my fissure was exposed - I guess that presents a 'theoretical' risk. I didn't mention also that he did rim me, and I used my own spit and vaseline as lube (not a great idea I know). Does this alter your view at all?

I also found a pale white jelly film on my upper gums this morning - which has got me concerned about possible thrush.

[Andy Velez]

Rimming is not a risk for HIV transmission.

And even if it turns out you do have thrush, that is not an HIV specific symptom. You ought to have that checked out for a doctor to diagnose if it actually is thrush or not.

[Ann]

Rocker,

You absolutely should NOT use Vaseline as lube when using latex condoms - you should ONLY use a water-based lube. (You can use oil or petroleum based lubes with polyurethane condoms such as Avanti, but never with latex condoms.)

Oil-based lube can degrade the latex and cause the condom to break. However, when a condom breaks it is VERY obvious and this did not happen to you, so you got away with it this time.

Next time you may not be so lucky, so remember - NO VASELINE!

Make sure you read though the condom and lube links in my signature line. A correctly used condom rarely breaks.

Rimming is not an hiv risk. Not only is saliva not infectious, but it also contains over a dozen different proteins and enzymes that damage hiv and render it unable to infect.

The main risks associated with rimming are to the rimmer, not the person being rimmed. Hep A and B and parasitic intestinal infections are the main risks. If you enjoy rimming, you'd be wise to make sure your hep A and hep B vaccinations are up-to-date.

Please do not keep coming back with lists of your symptoms. They're meaningless and we do not discuss them. Not only are they more often than not totally unrelated to hiv, but if we put any importance on symptoms, it could lead people who have had risks - but no subsequent symptoms - to believe they're ok and don't need to test. Many people never experience a single seroconversion symptom when infected, so you can see why we place no importance on symptoms. ONLY testing will reliably inform a person of their hiv status.

If his penis definitely did enter you without a condom (called dipping), then yes, this is a risk, although a lower one than full-on penetration. I really do not think you should stress out about this (if there was definite, but shallow, penetration), but you would be wise to test. You should be testing regularly anyway.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. A six week negative must be confirmed at the three month point, but is highly unlikely to change.

When you go to the GUM clinic, make sure you get a FULL panel of STI testing - and remember to enquire about hep A and B vaccinations. Make sure you're up-to-date and if you're not, arrange to have them done.

I do not expect you to test positive over this situation, even if shallow penetration did take place. Test to be certain and for your peace of mind.

Ann

[rocker_2011]

Thanks again guys for your responses and reassurance.

To follow up on the above, I took an HIV DUO test yesterday at 28 days as the symptoms I reported haven't abated much. It's come back negative thankfully. I test myself regularly (about every three months, maybe more) anyway, but this has given me reassurance over this exposure.

And no more vaseline! Promise! I will be investing in some silicone based lubricant (I find water based lubricant dries up and even burns uncomfortably).