[Question #11378] STD/HIV RISK of Fellatio

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14 months ago

Hi Experts,

I visited korean brothel 3 times. 2 fully protected Blow job and 1 unprotected for 15 sec as she puts directly in her mouth and removed immediately and then protected blow job.What is the risk of HIV, other STD's associated for unprotected for 15 seconds. 

All occasion have kissed them kind of peck kiss on their mouth.(no saliva exchanged)  hugged them and fingered them deeply (may be 15 minutes) there is no cut on my fingers.They sucked my nipples and vice-versa.I read fingering is zero risk of STI including HIV?

One one occasion after the blowjob when i passed the urine there was some blood in it and stopped on next time when i was passing urine. Any risk?

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14 months ago
* Currently I am having sever headache, body itching, increased heart rate. Bit worried. Is this related to any STD's
* What are the STD's which is possible from the above occasion and what tests do you recommend for me based on the above occasion?  I understand expect Hepatitis  and HIV all others are curable. what are the risk associated with those 2 here?
* Is it safe to resume sex again with my partner again ? I don't want to put her at any risk. 
* I heard that exposed part of infection will show symptoms first. In that case penis should show right?

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14 months ago
Have joint pains with headache is too severe observed from today. I am worrying with those symptoms 
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H. Hunter Handsfield, MD
14 months ago
Welcome back to the forum. In preparing to reply I reviewed your two recent discussions with Dr. Hook. FYI, I agree entirely with his evaluation and advice.

One point to add about your situation -- implied but perhaps not stated in your previous threads:  Being immunosuppressed does not increase susceptibility to infections; when potentially exposed to HIV or other STIs, you are at no higher risk of being infected than anyone else. The increased infection risk from immunodeficiency is in reactivation of chronically carried infections like CMV, tuberculosis, and others. And also from a higher likelihood of complications, severity of symptoms, etc. But little or no elevated chance of catching any new infection.

Another general point about testing for HIV:  the symptoms of a new HIV infection (ARS or other symptoms) are not due to the virus itself, but to the immune response to HIV. Therefore, all persons with symptoms caused by HIV test positive on the standard tests. Stated another way, a negative HIV blood test would prove your symptoms are not caused by HIV.

You don't mention timing of your symptoms:  how long after the sexual events did they begin?

Going to your exposures and specific questions:  As I think you know, oral sex is very low risk; there has never been a proved case of HIV transmitted oral to penis. Based on interviews of infected persons about how they thought they were infected -- which often is mistaken -- CDC once calculated a risk of one chance in 20,000 for fellatio, if the oral partner has untreated HIV. That's equivalent to receiving BJs by infected partners once daily for 55 years before HIV infection might be likely. Exposure of blood at the time probably makes no significant difference, and kissing is zero risk -- especially the brief sorts of "peck" you describe. The risk of other STIs is higher from the oral sex, but still low. As for your symptoms, they are not suggestive of either HIV or any other STI.

To your specific questions, as best I can reply without knowing the timing:

1. The symptoms listed do not suggest HIV or other STIs. Probably they have nothing to do with the sexual events mentioned.

2,4. The only STI risk was from the oral sex:  gonorrhea, nongonococcal urethritis (due to normal oral bacteria), herpes due to HSV1, syphilis. Your symptoms don't fit with any of them. And yes, all would cause initial symptoms involving your penis (discharge, sores, etc).

3. The timing is important in answering about risk for your partner when you resume sex. If it has been a couple of weeks and you do not yet have penile discharge or sores, it is very unlikely you acquired any STI and it should be safe to have sex with your regular partner. 

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

HHH, MD
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14 months ago
Since i went on 3  times dates are 2nd May, 9 th May and 16 May. The first  two are fully protected blowjob. The 3rd one she puts my penis on her mouth and I immediately removed it(should not be more than 10 secs). 
 Also I took doxy PEP on May 17th as it was a unprotected exposure for 10 sec
What is the risk of hepatitis on the above exposure?  So just to confirm that i can resume normal sex after 2 weeks if there is no symptoms. 
What is the risk of fingering which i did them deeply for 15 minutes and there is no cut in my hands.
On 2 nd May after my first BJ I had blood in my urine for 2 times and then it stopped automatically. is anything to worry?
One more symptoms are mild sore throat and running nose. Little bit of blood during running nose is observed.
I am afraid a lot now, why i went there.

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H. Hunter Handsfield, MD
14 months ago
These were nearly zero risk exposures. Doxy-PEP was not warranted; it is advised only for men having high risk anal sex with other men. In your situation, it doesn't reduce the risk of infection anyway:  it reliably prevents only chlamydia and syphilis, and chlamydia is almost never acquired by oral sex, and syphilis is extremely rare in this situation. 

Zero risk for hepatitis, and fingering also is risk free for all STDs.

Bloody urine is not an STD symptom. If this problem recurs, you should get care, ideally with a urologist. It had nothing to do with your sexual exposures.

Finally, no STD causes runny nose, and you could not have acquired oral gonorrhea, the only STD that sometimes (rarely) causes sore throat. You caught a cold -- maybe from one of your sex partners, or anyone else in your environment, but no STD is responsible.
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14 months ago
Thanks doctor for the reply.

Will gonorrhea be cured with cefixime(400 mg) and 1g of azithromycin. Would would be recommend dosage for oral and other gonorrhea with the combination of cefixime? 

Kindly share your thoughts ?


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H. Hunter Handsfield, MD
14 months ago
This combination might work against gonorrhea, but not necessarily. Beyond that, I won't help you treat yourself, especially when there is almost no chance you were infected. If you see a doctor or clinic who recommends treatment follow their advice.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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