Oral sex is much lower risk for all STIs, including HIV, than vaginal or anal sex. In fact, the chance of infection from condom protected vaginal sex probably is higher than for unprotected oral sex. There has never been a proved case of HIV transmitted mouth to penis. That doesn't mean it cannot happen -- probably it does -- but it's obviously very rare. Based on how people thought they were infected (which often is mistaken), CDC calculated an approximate risk of one chance in 20,000 for mouth to penis transmission from an HIV infected partner. That's equivalent to receiving BJs from HIV-positive partners once daily for 55 years before infection might be likely. The same estimate also applies to performing cunnilingus on HIV infected women.

As for your symptoms, blood counts, etc, they do not even hint at HIV. That HIV "could cause all these" isn't really true, or at least is an exaggeration. Acute HIV infection does not cause cough or sputum production, or a single enlarged lymph node, or the urinary and genital symptoms you mention. And early HIV infection doesn't cause blood count abnormalities or vitamin D deficiency. Some of your symptoms could be related to HIV, but other causes are far more common. And none of these symptoms point to the other STDs you mention. Your weight, sleep patterns, and smoking have no bearing one way or the other on risk of HIV or any other STI. Being uncircumcised raises the risk of HIV, but not by enough to be a serious consideration.

And your negative HIV test result is nearly 100% conclusive. However, Tridot is a "third generation" test that detects HIV antibody -- unlike the 4th generation blood tests that also check for HIV antigen. (The 4th gen tests are properly called antigen-antibody or AgAb tests.) If you would like a truly 100% conclusive test, have a lab-based AgAb test. But in the meantime, you can be certain you do not have HIV.

As for other STDs, I'll just address them directly:

HCV:  Not sexually transmitted at all except by traumatic (potentially bloody) anal sexual contacts among men having sex with other men (MSM). No need or point in testing for it.

HSV1 and HSV2:  Oral sex carries potential risk for genital herpes due to HSV1, but no risk for HSV2. The last can be acquired by vaginal sex, even condom protected -- but in absence of symptoms it is very unlikely you have HSV of either type. The standard tests are not very reliable and I do not advise HSV testing in situations like yours.

Gonorrhea:  Definitely possible from unprotected oral sex, but absence of symptoms (pus dripping from penis, painful urination) it is almost impossible you have it.

Chlamydia: Despite online buzz about oral chlamydia in recent years, it's a rare problem; and when present, it usually self cures within a couple of weeks.

HPV: Always a risk, including condom-protected sex. You can safely assume you have HPV and could be carrying it now. But HPV is a normal, expected, unavoidable consequence of human sexuality; and the large majority of infections remain asymptomatic and cause no health problems.

Syphilis:  Very low risk (most cases occur in MSM) but dangerous and sometimes asymptomatic, so it makes sense to be tested from time to time.

What to do going forward? Your sexual lifestyle makes it reasonable for you to have a urine test for gonorrhea and chlamydia, a blood test for syphilis, and perhaps an HIV AgAb test. You can expect all to be negative -- but better safe than sorry! Whether and how often to repeat these tests depends on frequency of sexual exposures -- but probably no more often than once a year. I would advise against any other STI tests. If you're under age 26, consider HPV vaccination.

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

HHH, MD

1. Once again, let me highlight that I had (still having) recurring incidents of dysuria (no pus/discharge), which cures with Cranberry supplements. But the pain associated with is intermittent. It keeps shifting between lower abdomen, pelvis and rarely testis. I did a CT scan, 

which showed small umbilical hernia, mild hydrocele, and extra renal pelvis. Are any of these caused by STIs (particularly Gonorrhoea, syphilis or chlamydia)? If not, could you please tell me how can the symptoms due to these be distinguished?

2. In case I have Gonnorhea/Chlamydia/Syphillis? Will the routine urinalysis, Ultrasound/CT scan cause any variations?

3. Can any of the above STIs be risky/incurable by the 4-6 months time period I mentioned? Do I need to take any special care other than refraining from Sex to ensure my partner’s safety?

4. I also had viagra pills during 1-2 sexual activities mentioned in the previous questions. I hope that does not increase my risk to STIs. Could you please confirm?

2. These tests usually are not abnormal in gonorrhea, chlamydia or syphilis.

3. Yes, these STDs can cause dangerous health problems within a few months if untreated. Syphilis can even be life threatening and can cause things like stroke and blindness, which can come on rapidly without warning.

4. Erectile drugs have no effect on any of this and do not elevate the risk.

You're obviously in a setting with sophisticated medical care option yet still not allowing yourself to be tested for the problems you are actually worried about. I'm going to make a guess you're an ex-pat in UAE or similar country. If so, it is nonsense that you cannot be tested for STDs or HIV. I've been in touch with an excellent clinic there that does such tests all the time in ex-pats. The results are strictly confidential from government authorities. And negative results do not risk deportation etc. And in the event someone has HIV, they need immediate life-extending health care, not available locally -- so such persons need to leave the country anyway.

I stress again that your risk is very low, but It is rank nonsense to not be tested for the problems you are worried about.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.