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VERY REAL SYMPTOMS & NEW HSV after Naked Frottage. HIV Worried

Question: 

Thanks for your fantastic website and advice. Unfortunately my symptoms are very very worrying after I thought I had a negligible exposure. Please help.
I am 28, male and had a nude body to body massage with a female escort 11-weeks ago. Vigorous frottage occurred with unprotected genital to genital contact and no penetration. She rubbed my front and back. There was massage oil so I can not comment on her vaginal secretions. Afterwards I washed. i became very anxious the next morning (8hrs later) and washed my genitals quite vigorously and unfortunately some soap entered my urethral causing significant pain and burning immediately which persisted for the next 2 weeks. I then developed:

At 4 days: swollen lymph nodes in my groin and right neck lasting 3 weeks
At 10 days: New genital HSV infection (first time) with ulcers around anus. Saw Dr and completed Acyclovir but they recurred as soon as I finished treatment. I am now require ongoing supressive therapy but the vesicles still come and go with itching along with buttock nerve pain up to now (11 weeks)
At 11 days: fever lasting one night with night sweats lasting 2 nights. 2 small oral ulcers which later cleared up.
At weeks 2-3: General fatigue which lasted 1 week
At 5 weeks: severe oral thrush (complete white tongue) confirmed by Dr. Completed 2 courses of Nystatin followed by a course of Amphotericin lozenges. Still no improvement at all currently.
At 5 weeks: a few very dark purple macules and unbelievably itchy along left forearm - these lasted 1 week and left small scars.
At 6 weeks - new rash - multiple small pimple like spots occasionally white or red covering my face upper chest, afew on my arms and sides of my feet. Some itchy some not itchy. New spots are still appearing daily now.
At 8 weeks normal stools but now covered in white spores/spots. Still ongoing
At 8 weeks: total 3kg weight loss. Pants and belts are loose. People have commented. Eating normal appetite however
At weeks 10 drenching nights sweats daily. I am sleeping topless in very cold room. Needing to change bed linen daily. Terrible insomnia waking at 3am every night and cant get back to sleep. Averaging 4hrs sleep per night. This is still ongoing over a week.

I am usually perfectly healthy and I am very worried about HIV especially now that I have persisting HSV on and off for 3months now, oral thrush for weeks still and drenching night sweats.

Questions:
1. I thought frottage was negligible risk. Is this true? Some website even say no risk but I am suffering so so much with real signs.
2. Would my urethral burning with soap 8hrs after exposure increase my risk (damaged mucosa)? Is there a chance I could have washed some remaining virus down my urethral at this time.
3.I heard that air exposure does NOT kill HIV. Air just dries the fluid containing HIV and it slowly becomes inactive over several hours. Is this true?
4. What is my likely HIV risk with all these symptoms

I am completely freaking out as I was shocked to get Herpes which has required over 2months of Acyclovir. Now all my symptoms/signs are pointing to HIV and I am scared to get the 3month test. Each day seems to get worse.
Please Help!!

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after engaging in naked frottage. From the information given, this scenario is determined to be Negligible Risk (there are no evidence or no documented cases of transmission).

The scenario mentioned above could meet the three components of the Transmission Equation if an HIV-containing fluid (eg. vaginal fluids) was able to gain access to your bloodstream (eg. through your urethra during vigorous frottage). I will answer each of your concerns separately:

  1. Frottage is determined to be negligible risk because there is a theoretical possibility of transmission when genitals and the accompanying fluids are rubbed together.

  2. Urethral burning and potentially damaged mucosa occurring eight hours after an exposure would not increase your risk of acquiring HIV. If the HIV virus had not already gained access to your bloodstream, it would be inactivated by exposure to oxygen before you had the chance to provide new potential areas of entry.

  3. The rate of inactivation of HIV is rapid when exposed to air, leading to a 90-99% reduction in HIV concentration within just a few hours (1). HIV is not instantaneously inactivated when exposed to oxygen, but its ability to cause a new infection declines very quickly due to the decrease in active HIV virus present.

  4. Your HIV risk is negligible based off of the information provided in this scenario.

In regards to your symptoms, it does appear as if something is going on. HIV is very unlikely to be transmitted during naked frottage. It is important to note that other sexually transmitted infections (STIs), such as chlamydia, gonorrhoea, or syphilis, are much more easily transmitted. It may be be beneficial to access further STI testing if you have not already done so.

Recommendation: There are no evidence or no documented cases of transmission. Refer to physician for more personalized answers and to inquire about expanded STI testing.

Regards,

AIDS Vancouver Helpline/Online, Marie