QUESTION
I had a brief but unsafe encounter with someone about a year ago where a man I didn't know well put his penis in me twice before I stopped him. As far as I know, he didn't ejaculate and I don't think he had any pre-cum either. I got tested for HIV 42 days afterwards and then again about three and a half months afterwards and both tests were negative.

More recently I had oral sex with someone - I both gave and received. As far as I know, he didn't ejaculate. I had a weird throat irritation a few weeks afterwards that wasn't painful but was annoying. I've spoken with this partner and he says he was tested about three months after our encounter and tested negative. Lately, the top of my mouth has been bothering me. My doctor says it isn't thrush but something more common that comes and goes. He did not prescribe any medication. I also seem to get canker sores every other month or so. I had a cold sore about a month ago too. Tonight I had diarrhea.

I know that HIV cannot be diagnosed simply by symptoms, but I was wondering if you could at least give me a better idea as to if any of these things combined seem like something I should worry about. Or could this just be stress and mind games?

ANSWER
It is very common after unsafe sexual exposures to be anxious and to attribute any and all physical symptoms to possible HIV infection. However, the HIV tests available today are highly accurate. Tests taken three months after a possible exposure are sufficient to rule out infection, assuming no other unsafe sexual encounters during that time period.

Symptoms of oral ulcers (cold and canker sores), diarrhea, and irritations in the mouth such as you describe are common things that many healthy people experience during the normal course of their lives. They can be caused by exposure to foods and colds, for example. People living in group situations, with roommates, or who work with others often have these complaints. A healthy immune system will adequately manage these trivial infections without any medical intervention.

That said, another cause of throat irritation can be gonorrhea infection of the throat. That is pretty common and between 5 and 10% of men who suck cock can have gonorrhea in their throat. While often there are no symptoms, occasionally it can feel like a typical sore throat. Only a doctor can make a diagnosis and prescribe treatment.

Sexually active people should get regular check-ups (every three to six months) for STDs including gonorrhea, chlamydia, syphilis and herpes. Depending on the type of sexual activity, it is recommended to get your throat checked for gonorrhea and your anus (or vagina) checked for both chlamydia and gonorrhea. It is also wise to continue to practice safer sex which includes condom use for anal sex and reducing the total number of sex partners you have (more partners puts you at higher risk for contracting STDs).

To your health,
Dr. K