Oral sex can be considered safe sex, especially in regard to HIV. While not completely risk free, there is a far lower chance of STD or HIV transmission than unprotected anal and vaginal sex. In fact there has never been a scientifically proved case of HIV transmitted mouth to penis. Based on how people believe they were infected -- which often is wrong -- CDC once calculated a transmission risk of one in 20,000 if the oral partner has HIV. That's equivalent to receiving BJs by infected partners once daily for 55 years before virus transmission might be likely.

Do I advise testing? From a medical/risk standpoint, no. However, anxious persons often are more reassured by negative test results than by professional opinion, no matter how expert. If you'll sleep better with a negative HIV test, by all means free free to do it in a few weeks. Alternatively, if you can contact your escort partner, ask her to be tested -- perhaps at your expense. If negative, you definitely won't need testing yourself.

I've been assuming your main concern is HIV. The risk of other STDs is higher. Absence of symptoms in the next several days will be reassuring, but you could consider a urine test for gonorrhea and chlamydia (valid any time more than 4-5 days after exposure) and a syphils blood test in a few weeks, perhaps along with an HIV test. In the meantime, do your best to not worry; if this is your only potentially risky exposure, it is very unlikely you caught anything.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

This was in fact my only risky encounter in the last several years. I am now in a relationship and have been monogamous prior to this encounter, and since the beginning of this relationship have tested negative for all potential STD’s.

My main concern after this exposure is gonorrhea or NGU. I know you said for HIV you’d feel testing is not necessary or advised but what about these two? Also, knowing what you know if you were in my position what would you do about sex with my girlfriend? We do not use condoms.

I have my regularly scheduled physical in December where I plan to have a full STD panel completed. So will test for everything else then. 

You can be testedfor gonorrhea if you want, but if youdo not have obvious symptoms (painful urination, pus dripping) within 4-5 days, you can be nearly 100% certain you don't have it. As for NGU, when it results from oral sex, it isn't a traditional STD -- that is, not caused by chlamydia or other likely harmful bacteria. The cause is believed to usually be entirely normal oral bacteria. And the chance of it for any single exposure probably is very low. If somehow I were in your situation, I might or might not get tested for gonorrhea after 4-5 days, just to be extra safe. If that test were negative -- and expecting to know the result after a day or two, i.e. about a week after the exposure -- and if still no symptoms, I would resume sex at home.

I’m bit confused, on the one hand it’s safe sex, but there is still a low risk.

I am not freak out and become overly anxious but can you help provide a bit of context around that please? When you say low risk, how does that play out with rough statistics/estimates ? Given whom I received oral from and the duration how does that factor in?

Trying to put everything in perspective, but have been dealing with a great deal of health anxiety since this incident almost 48 hours ago now and expect it to ramp up as I get into the timeframe when symptoms could potentially start.  

I would guess (that's all it is, an educated guess) that the chance you acquired any STD from the exposure described is under one chance in several thousand. I've seen many patients with gonorrhea following oral sex -- but that's over many years, amoung many more thousands of persons who had had oral sex but were not infected.

My health anxiety got the better of me and I decided to get a urine test done today, roughly 57 hours post the incident. I know you had said 4-5 days would be ideal, but if it comes back negative for gonnorhea how confident can I be in that result? 

Knowing what you know, if it is negative can I resume my regular sex life with my girlfriend? 

That completes this thread. I hope the discussion has been helpful.