Miss Saigon
I am a 39 year-old male. I recently visited a bar in Vietnam, where I was kissed open-mouth by a commercial sex worker (CSW). I generally have mouth ulcers, and her tongue was in my mouth for about five seconds. There was no sexual activity. I never have had any bleeding gums or dental problems before. Now I have the following symptoms: On the third day, generalized itchy feeling all over my body, and constant irritation of facial skin (my main worry). Diarrhea after the ninth day, lasting just one day. A red rash 5 mm in diameter on my forehead after the 10th day, lasting for 3-4 days.
I have no fever or night sweats, no dry or wet cough, no apparent swollen glands, and no weight loss or visible white spots in my mouth (but I do have red ulcers in my mouth).
Am I at risk for HIV? Should I be tested? Is itchiness a symptom of HIV, as I have read on a North Carolina medical school website?
Signed, Itchy and Worried
Dear I&W:
The U.S. Centers for Disease Control and Prevention (CDC) states that open-mouth kissing is considered a very low-risk activity for the transmission of HIV. HIV is transmitted when infectious fluid such as blood, semen, vaginal secretions or breast milk enters another person’s bloodstream, usually through unprotected anal or vaginal intercourse, the sharing of contaminated needles, or when an HIV-positive mother nurses an infant. A mouth ulcer could be an HIV transmission point, but even if the CSW was HIV-positive, it is unlikely she had enough virus in her mouth to transmit HIV. In 25 years of the epidemic, the CDC has found only one case of HIV transmission through blood exposure during open-mouth kissing. (For the CDC’s HIV transmission fact sheet, visit http://www.cdc.gov/hiv/resources/factsheets/transmission.htm.)
Currently, CDC recommends routine HIV testing for everyone ages 13-64 years old. The test looks for the presence of antibodies to HIV, not HIV itself, so it will not be positive until enough antibodies are present in the blood. Most people develop enough antibodies within 30 days after infection, and 99% of those infected will have antibodies detected by three months, so it is best to get tested at least three months after your most recent exposure to HIV. (Lindback S, et. al. AIDS, 2000).
Some people who contract HIV experience symptoms within a few weeks of infection. Symptoms include fever, fatigue and often, rash. However, itching is rare and tends to be mild (visit http://patients.uptodate.com/topic.asp?file=hiv_aids/4460). Other common symptoms include headache, swollen lymph nodes, and sore throat, but HIV testing is the only way to know if you have been infected. Visit http://www.thebody.com/content/art5998.html for information on early symptoms of HIV.
Tonia Poteat, AAHIVS
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Tonia Poteat, MMSC, PA-C, MPH, AAHIVS, has been providing medical care to people with HIV since 1996. She currently works as a physician assistant at the Grady Infectious Disease Program in Atlanta, Georgia. |
Is your provider an AAHIVM-credentialed HIV specialist™?
If you are living with HIV, you have a lot of choices to make when seeking care and treatment. One of your most important choices is your healthcare practitioner—so why not choose someone who is knowledgeable about HIV and experienced in its treatment?
The American Academy of HIV Medicine (AAHIVM)’s HIV Specialist™ credentialing program is the first and only clinical credentialing program offered domestically and internationally to physicians (MDs and DOs), nurse practioners and physician assistants specializing in HIV care. HIV care providers become designated HIV Specialists™ after meeting experience and education requirements, and successfully completing a rigorous exam on HIV-specialized care. Look for the letters “AAHIVS” after their name.
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Due to space limitations, not all submitted questions can be answered in this column, but every effort is made to ensure you receive the information you have requested. For more information about AAHIVM, call 202-659-0699 or visit www.aahivm.org. |
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