[Question #11289] Oral and Protected Sex

15 months ago

Hi Doctors, thank you for this informative site. I had an unprotected oral and brief protected vaginal sex at a message parlor 5 days ago, and the following two days I have been very stressed checking myself up and looking for symptoms. As far as I know there are no clear sign of symptoms on me yet. No sores, water blisters, and discharges etc. I don't know if the sw had any stds and if she has any openings in her mouth, I am very concerned about catching any std. And what are the signs I should be looking for, I plan to test so what should I test for and what would be the recommended time period for testing? Thank you in advance.

Edward W. Hook M.D.

15 months ago

Welcome to our Forum and thanks for your questions. I hope that my comments will help to relieve your stress. The encounter and exposures you describe was very, very low risk. I say this for the following reasons:

1. Most commercial sex workers do not have STIs, including HIV.

2. Even when they do, most single exposures do not result in transmission of infection

3. Your vaginal sex was condom protected, reducing your risk for HIV, gonorrhea and chlamydia to close to zero.

4. Few STIs are transmitted by receipt of oral sex. There are no proven cases of HIV acquired from receipt of oral sex, acquistion of chlamydia is very rare, and gonorrhea is only occasionally acquired from oral sex. Other STIs are also very very rare/

If you were going to develop STI symptoms, it is more than likely that you would have by now.

If you wish to test, the most important STIs to test for would be gonorrhea and chlamydia as these are the most common (although rare) infections acquired through the sort of exposure you report. You can do this with a urine test at this time and anticipate accurate results. There is no medical or scientific reason to test for HIV although it you choose to test for purposes of reassurance, you will need to wait until 6 weeks after the encounter for your results to be reliably conclusive. If you wish, you could test for syphilis at that time as well

I hope you find these comments reassuring. In your situation I probably would not bother to test at all but I also understand if you do choose to test. EWH

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15 months ago

Thank you for your response. The reason I was worried and thinking about testing is because sites on the internet are saying that symptoms would take weeks or months to develop, and I got paranoid by it and starts to constently checking for symptoms. Your response is really helpful.
The last remaining question I need a bit more clarifications is that should I get a panel test which includes the ones you mentioned now and expect an accurate result? The panel test I see near me includes a HIV RNA test, in this case would I still need to wait for 6 weeks to tests or should I get the panel test now and test a standalone HIV test after 6 weeks again. Thank you in advance.

Edward W. Hook M.D.

15 months ago

Much of what is found on the internet is misleading. There are no checks on internet posts for accuracy and much of what is said there is incorrect or misleading either because it is out of date, because it misinterprets things, it takes things out of context or because it is repeating things known to be untrue. Please use great caution regarding anything you find on the internet.

HIV RNA tests are rather expensive but provide conclusive data on HIV far sooner than the more widely used, 4th generation HIV antigen/antibody tests. RNA PCR tests provide conclusive results any time more than 11-12 days after and exposure while results from 4th generation tests are not conclusive until 6 weeks (42-45 days) after an encounter. EWH

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