[Question #10534] Oral Encounter

22 months ago

Hello Again,

I had a brief encounter with a woman from the bar age mid 40s. I performed unprotected cunnilingus on her and received unprotected fellatio. Both brief. There was also open mouth kissing involved. No penile-vaginal sex took place.

My big scare is that I found out after she is a drug user. She smokes crack.

This was 3 days ago and I feel the top of my tongue is sore and I feel raspy in the back of my throat.

I want to get back with an old girlfriend but am scared I might have caught something. What the chances of catching any STDs or HIV? I know oral is considered safe sex, but given her drug use I am concerned. Should I get tested?

Edward W. Hook M.D.

22 months ago

Welcome back to the Forum. I'll be glad to comment. The likelihood that you acquired an STI from the exposures you describe is low but not zero. Most persons, even those with multiple partners or those who use drugs, do not have STIs and most (certainly less than 10%, probably far less) single exposures do not result in transmission of infection when present. When persons acquire oral STIs the most common infection is gonorrhea. Oral STIs are typically asymptomatic and neither a raspy throat nor sore tongue are in any way suggestive of an STI.

There is no meaningful risk for HIV from the exposure you describe.

I cannot guarantee that you did not acquire an STI from the exposures you describe but it is unlikely. The only way to prove that not infection was acquired would be to test. If you chose to test, the appropriate tests to take would be an oral swab and a urine test, both tested for gonorrhea and chlamydial. I suspect that if you opt to test, the results will show that you are not infected but testing is always a personal decision. EWH

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22 months ago

Thank you Dr.

I will be getting tested just for peace of mind. I’ve been through this same scenario before, minus her heavy drugs. Many times this sort of thing has happened but this time it made me think.

Would you recommend no kissing my old girlfriend? Protected intercourse or cunnilingus?

I myself don’t really think I have anything, but my main concern is the minuscule chance of harming her.

Edward W. Hook M.D.

22 months ago

As I said, the risk is quite small. I certainly wouldn’t refrain from kissing and protected sex assures you that there is no risk. If you test, I anticipate that your results will be negative. EWH ---

22 months ago

Thank you,

Since I have one more reply. The back of my throat is a little sore to swallow, make anything more urgent?

What is the overall likelihood in numbers of contracting anything from giving or receiving oral sex, male to female? If one or the other is infected?

This is the only time I’ve ever considered getting tested for oral sex or even kissing, but the internet makes you more aware. Considering I’ve always read oral sex is considered “safe sex”.

Also, does duration of act play a role? Even it was about a minute.

I’ve read on this forum that unless it was male on male, the odds are so low testing isn’t suggested.

Edward W. Hook M.D.

22 months ago

Final response. STIs occurring in the oral cavity are typically asymptomatic. Your sore throat and difficulty swallowing in no way change my opinion.

Because it is relatively, uncommon, there are no good studies estimating the frequency of transmission through oral sex, either for fellatio or cunnilingus.

While it is logical that the duration of exposure might in someway impact the likelihood of transmission, this is also an area where there are no data

The reason that male on male exposures are higher risk is because STI‘s are more common amongst men who have sex with other men.

As you know, this completes this thread, which will nowbe closed. Take care. EWH.

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