[Question #11345] Unprotected Oral Sex with Sex Worker

Avatar photo
15 months ago
Hello Doc, 34 M So during the first week of May / 2024 (1 to 5), I had unprotected oral sex from 2 or 3 sex workers and protected insertive vaginal sex with another two. I pretty certain there were no condom breakage as the insertive vaginal sex was completed outside of the vagina through a masturbation (with the condom). After a span two to three days (towards May 3rd or 4th), I started feeling a burning sensation on the tip of my penis. I went to a Urologist (on the 6th) and did a blood and urine (with culture) work. There were no anomalies and the doc prescribed a course of Doxycycline for 5 days. This reduced the burning to an extent but recently I am having an excruciating pain in my right scrotum. This doesn't happen always but at times. I was diagnosed with General Anxiety Disorder in Feb (this year, 2024) and was prescribed some medicines. I have not religiously followed that medication. Since developing this problem with my penis after the encounters with CSWs, I have been suffering from extreme anxiety and stress.I have been reading a lot Reddit and the Internet and every symptom that I am observing in me is being related to a potential HIV symptom. I have had one or two night sweats, mild cough, a swollen lymph node under my right ear and stuffed nose but I haven't had any severe fever/rash or so. I do have a white toungue which I believe might be due to extreme anxiety or stress. Yesterday, at the 10th day mark, I had given my urine and blood at a lab. The urine was given for a complete STD test check and the blood was given for an early HIV Detection using PCR RNA test. Do you think I have chance to contract HIV ? Will the results be a positive ? I am literally at the verge of a mental collapse now. Thanks a MILLION!
Avatar photo
15 months ago
Just to add - the sex workers were from Thailand (Bangkok) [Probably not even worth mentioning but just adding in case]
Avatar photo
15 months ago
Also forgot to add - 
  • No pus dripping from penis. The urine is crystal clear
  • No rashes or ulcers on the penis
  • I had used a delay spray (Lidocaine) on the glans during two instances
Avatar photo
Edward W. Hook M.D.
15 months ago
Welcome to the Forum.  Thanks for your questions.  I'll be glad to comment.  The symptoms you describe are not those of recently acquired HIV.  HIV does not cause testicular discomfort, penile pain, cough or stuffy nose.  The symptoms of recently acquired HIV and other STIs are continuous.  Reddit is misleading you- the symptoms of the ARS are high fever, severe sore throat, and widespread muscle and joint aches.  An isolated swollen lymph node under your ear does not suggest HIV and is consistent with an every day sore throat of the sort most people get from time to time.  If your symptoms were due to HIV, your test would be positive.  

Please do not spray lidocaine on your penis, it may be irritating.  Please don't worry- your risk for HIV and other STIs is virtually zero.  Look elsewhere for the cause of your symptoms.  EWH
---
Avatar photo
15 months ago
Thank you so much for the reply.

Do you recommend I consult a Urologist to understand why the burning penile tip and occasional scrotum pain isn't reliving completely even after taking a course of Doxycycline ? Could this be NGU or Prostatis ? I understand you might not be able to give answers on what the disease might but just asking in case if you have any thoughts.

Also, if my PCR RNA Test and the complete Urine STDs (results would be published in 2 days from now) comes out negative, do you recommend testing further ? I will make sure I come back here and post the results as soon as I get them.

Thank you so much for what you do here. Much appreciated.
Avatar photo
Edward W. Hook M.D.
15 months ago
If the tip of your penis looks red or irritated, the dermatologist might be the best person to see. Otherwise a urologist might be helpful.

This sounds nothing like NGU.  Testicular discomfort of the sort you describe is not uncommon in person who are anxious and looking for signs of infection. I suspect urologist will confirm this.

Your STI tests will be conclusive and do not need to be repeated. HIV Renee’ PCR test however not conclusive until at least 11 days after encounter. I see virtually no risk of HIV from the encounter you describe if you wish to prove conclusively that you are not infected with HIV testing at, sometime more than 11 days after exposure is advisable. EWH. 
---
Avatar photo
15 months ago
Noted.

One last question - in an insertive oral sex, if I had ejaculated in the receivers mouth, does that put me in any risk (I had one such encounter in March with CSW in Malaysia). Also to add I had a negative HIV test back in Feb with 4+ months. So I am sure I have not put the receiver at risk but wanted to understand if I was at risk or not ?

Thanks once again!

Avatar photo
Edward W. Hook M.D.
15 months ago
As you know, we provide up to three responses to each client’s question. As this is my third response, it will be the final response and the thread will be closed after I post it.

There is no risk of acquiring HIV from receiving oral sex. There has never been a case of HIV acquired through receipt of oral sex. You will not be the first.  Whether or not you ejaculated makes no difference in your risk.

As I said above, your risk is very, very low and can be said to be virtually zero. Please don’t worry. EWH
---
Avatar photo
15 months ago
Thank you. Apologies. This is going to be my last ask (feel free to close post this one).

So even if lymph node under by right ear is paining sometimes, I do not need to associate this with HIV symptoms. This could be due to the cough/cold that I have now.

Also, regarding the scrotum pain, do you think it might be CPPS or Prostatis ? I am also experience a bit of pelvic pain.

Thanks a lot.
Avatar photo
Edward W. Hook M.D.
15 months ago
The lymph node swelling you report is in no way suggestive of HIV.  It could well be due to a cold

Yes, your scrotal pain could be CPPS but, as suggested, I would seek confirmation with a medical professional who can examine you (i.e. a urologist)

End of thread.  EWH
---