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Symptoms of HIV?

Question: 

Hi Dr,
Thanks for your time, Sorry for long story,
I involved in intercourse with one of prostitute, I received blow job with condom, and than I did vaginal intercourse with condom, but due too fear I stopped intercourse within 1 minute. than I asked her for hand job with condom but after 1 minute again I stopped her and told her to remove condom because still I was worried about HIV. Finally I done but I think that while she was doing hand job with condom is on. she might carry vaginal fluid on her hand which can transmitted HIV to me. I think that I might have small cut on my penis balls. after second day of the incident, I got fever ( it is like Hay fever symptoms like runny nose, watery eyes and fever. everyone is suffering around me ), but than I started google about ARS and symptoms.Immediately, I am pretty sure that I had an anxiety attack. Symptoms worsened within 24 hours of internet surfing. Clogged throat, clogged ears, sharp pain under front of chin, pain under sides of jaw (no swollen nodes that I could feel), sore jaw and teeth (clenching?), sore throat( never felt pain while eating or drinking), loose stool( it is not like diarrhea), white tongue ( I felt burning after I eat spicy food ), the list goes on and on. More than 2.5 months of that incident I felt like chest pain and pain under armpit. I have asked that prostitute she told me that she is negative but I do not know whether she is lying to me or not.
No kiss or vaginal licking involve.
Please Dr Could tell me whether I am on risk or not.
Can HIV transmit by hand job?

Answer: 

Hello and thank you for your inquiry.

We understand that you are wondering if you are at risk for acquiring HIV from an encounter you had with a sex worker. During this encounter you received oral sex and a hand job, and had vaginal intercourse. All three of these activities were performed using a condom for protection.

Each of these three activities carries a different risk level and the length of time you engaged in each activity does not affect our assessment of your risk.

Receiving a hand job is no risk, meaning transmission of HIV is not possible from this activity.

Receiving oral sex is a negligible risk, meaning there are no evidence or no documented cases of transmission, however, there is a theoretical possibility. In your case, the risk would be further reduced by the use of a condom.

Vaginal sex with a condom is a low risk for HIV transmission, meaning there have been cases of transmission from these activities under certain conditions, such as condom failure. Condoms are a highly effective strategy to help prevent the sexual transmission of HIV when used consistently and correctly. Condoms have been well studied in laboratory tests and it has been determined that condoms are impermeable to HIV, meaning that HIV cannot pass through them. Condoms can fail to prevent an exposure to HIV if they break, slip or leak during sex. (1)

You mention that you may have had a small cut on your scrotum at the time of this encounter. The fact that you are not certain about the existence of this cut indicates that it was far too small to provide the access to your bloodstream necessary for HIV transmission.

It is impossible to attribute your symptoms to HIV in the absence of a positive HIV test result. There could be many different potential causes for these symptoms, and only a visit to your doctor can help you sort this out.

Since the incident happened 2.5 months ago, you have a few options for HIV testing. Depending on your location, either a 3rd generation ELISA or a 4th generation EIA (aka DUO or COMBO or ab/ag) test is recommended.

Third-generation HIV tests are antibody-only laboratory screening tests. Third-generation tests can detect HIV infection in 50% of people by 22 days after infection; 95% of people by 40 days after infection; and 99% of people by three months after infection.

Fourth-generation HIV tests can detect both the p24 antigen and anti-HIV antibodies. Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection.

Recommendation: Due to the low risk associated with protected vaginal intercourse, please refer to your physician for an HIV test.

Regards, AIDS Vancouver Helpline/Online volunteer, Dyson