[Question #11397] HIV/STI Risk Assessment. Urgent Help

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14 months ago
Good Day
Incident: 14 Days ago I Received Unprotected blowjob( Oral sex) from a Trans Woman Sex Worker for around 1 Minute. Deep throating involved. Kissing open mouth.. No Blood present .I asked her for HIV status. She said she is Clean and NO HIV. 
 Me: I am a 25 year Old male  I am a virgin with no sexual activity besides the mentioned incident 
Trans Sex Worker-   From Thailand. living in South Africa  No visible sores or blisters or lesions on the lips and unsure if had any in her mouth. No blood Present . According to her she has NO HIV and is Clean
Symptoms: 14 Days since exposure. No visible symptoms in regards to my Penis, besides
Headache and neck pain- on and off
Loose stool/Upset stomach.
Very Mild throat irritation.
Fordyce Spots but had those for many years before incident.
Concern:
1) What are my risks for HIV ?
2) What my risk for the other common STI?
3)Testing is expensive, should i get tested and if yes. What tests should i go for  and when should I get them ? necessary ? 
4) What symptoms should i be on the look out for in the next few days/weeks that could be a sign for concern.

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Edward W. Hook M.D.
14 months ago
Welcome to our Forum.  Thanks for your questions.  I'll be glad to comment. The exposure you describe did not put you at risk for HIV and was low risk for other STIs. There has never been a case of HIV proven to have been acquired as a result of receipt of HIV or deep kissing.  You are not going to be the first.

Few other STIs are transmitted through receipt of oral sex.  In the absence of oral sores or lesions there is virtually no risk for syphilis.  Similarly, chlamydia is almost never present in the mouth and when it is, transmission almost never occurs.  Gonorrhea can be present in the throat and can be transmitted both through the performance of oral sex or, very rarely, through kissing.  Since most gonorrhea is symptomatic, this too suggests that you did not get gonorrhea from the expsoure you have described.  Your symptoms are not particualrlry suggestive of any STI.  

In response to your specific questions:
1) What are my risks for HIV ?
See above.  Virtually zero.  From a scientific perspective there is no need to test although if you are anxious or worried, testing may provide reassurance.  If any of your symptoms were due to HIV, the test would be positive (when symptoms are due to HIV, tests are ALWAYS positive).

2) What my risk for the other common STI?
Again, answered above.  If you choose to test, the most important test you could have would be a urine test for gonorrhea

3)Testing is expensive, should i get tested and if yes. What tests should i go for  and when should I get them ? necessary ? 
See above as well.  Testing is a personal decision in your case.  Testing for gonorrhea would be conclusive at this time.  Testing for HIV would be 99% conclusive at 4 weeks following the encounter and 100% conclusive at 6 weeks.  

4) What symptoms should i be on the look out for in the next few days/weeks that could be a sign for concern.
Symptoms of gonorrhea would be a penile discharge or burning on urination.  

I hope this information is helpful. If any part of my response is unclear, you have up to 2 follow-ups for clarification.  EWH
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14 months ago
It has been 22 days since exposure, no pain in urination or any discharge. I have not done any testing yet. Only concern is on my penis on the shaft there is a very small round like atrophic scar. Its a small round depression, crater or dent like on the skin. Could this be a syphilis chancre forming. It is not a raised bump but like an atrophic scar. Is this Syphilis?
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14 months ago
29 days after exposure i went in for blood tests and all test came back negative.
My final questions are
1) after 29 days with low risk exposure and results showing negative. Should i move forward and forget about the situation or should i still test after 6 weeks.
2) i will be having knee surgery in 2 weeks and just for general information. What are the risks of disease such as Hiv if i am to receive a tendon from a donor from a bone bank. Ie. I am getting a ligament from a cadaver? Thank you

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Edward W. Hook M.D.
14 months ago
1.  Yes, I strongly encourage you to move forward without continuing concern.
2.  Human materials that are transplanted into other persons, including tendons only come from person who have already been tested for HIV and other potential infections. There is no risk from the situation you describe.

I hope this information has been helpful to you. EWH.
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