[Question #11748] Unprotected recipient of oral sex. Flu-like symptons.
12 months ago
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Hello Doctors. First of all, thank you for the great work you are doing here. Now to the question:
12 weeks ago, I (M) went to the parlor and received handjob and unprotected oral sex from a female SW. There was no sexual intercourse.
I know this is not risky for HIV, but I was wondering what are the odds of catching other STDs, given the fact that it seems that my immune system has never been so weak before.
At least five times during these past 12 weeks I’ve had episodes of fever; sore throat; body aches; fatigue; cough etc…
Even though all these symptoms tend to go away within two or three days, it still worries me because I have never dealt with so many Flu-like episodes before in such a short period.
Let me add that: 1) I did not notice any symptoms on my penis (such as discharge, sores, burns etc.); 2) about 6 weeks ago I developed some stains on my abdomen but they went away after 1 week of antihistamine; 3) my GF (person I have frequent sexual interaction with) did some routine medical checkup 6 weeks ago and tested negative to DSTs.
To sum it up: are flu-like symptoms related to DSTs and given the information I gave would you suggest specifically testing for STD or resuming sexual intercourse with the regular partner?
Also: I did some regular blood test today (full blood count). Are there any measures I should pay more attention to (that could indicate some potential STD)?
Thanks in advance.
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H. Hunter Handsfield, MD
12 months ago
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Welcome to the forum. Thank you for your confidence in our services.
First, HIV and other STDs are rarely if ever transmitted by hand-genital contact. In my 50 years in the STD business, I have never seen a patient with an infection acquired by hand-genital contact, even when genital fluids are used for lubrication. So any risk is only from the oral sex event. And there has never been a scientifically documented cases of HIV transmitted oral to penis.
Immune deficiencies generally do not raise the risk of infection when exposed. This is the same for all infections -- colds, flu, covid, etc -- in addition to STDs. (Immune deficiency raises the chance of serious outcomes or need for more intensive treatment, but not the chance of infection in the first place.)You do not describe any symptoms that suggest you are truly immune deficient.
You also don't say what you mean by "flu-like" symptoms. That usually means fever, sore throat, muscle aches, and sometimes headache. I have no idea how interpret "stains" on your abdomen.
I'm glad to hear you and your regular partner were tested and negative for STDs 6 weeks ago. Presumably that included tests for gonorrhea/chlamydia (urine or urethral swab) and blood tests for HIV and syphilis, right? If neither you nor she has had new partners since then, you can rely on those results. However, your normal blood count doesn't mean anything one way or the other about HIV or other STDs.
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD
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12 months ago
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The flu-like symptoms I had several times in these past 12 weeks after the exposure were listed on the fourth paragraph:
“fever; sore throat; body aches; fatigue; cough etc…”
My main question is: could they be the result of STDs? My concern relies on the fact that before the exposure, I never had that many episodes of “flu” in a 12-week period.
Also: only my girlfriend (not the SW) got tested 6 weeks ago. I did not. However, I had sex with my girlfriend after my exposure and before her testing (she got tested for other reasons)…
Hopefully, this new information can lead to a better risk assessment.
Should I get tested? Should I interrupt having sex with my girlfriend? The fact that I did not notice any changes in my penis throughout these last 12 weeks is indicative that I do not have STDs? Or the several “flu”-episodes are indicative that I’ve gotten STDs from the exposure with the female SW?
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H. Hunter Handsfield, MD
12 months ago
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Sorry I passed over those symptoms. If they occurred all at once, they could have been the result of HIV, i.e. acute retroviral syndrome (ARS) -- but no other STD. And they don't suggest ARS unless they occur at the same time over a 1-3 week period, starting 1-2 weeks after a high risk exposure. Often there is a body-wide skin rash as well. Absent those features, for sure it was't ARS.
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Your partner's negative STD testing doesn't say much about your own STD status. All STDs are transmitted inefficiently -- i.e. not during most sexual exposures, even if a partner is infected.
From all you have said, I don't see a high priority for STD/HIV testing. But since you're concerned enough to have come to the forum, you might consider testing for the reassurance you would gain from the expected negative results (urine gonorrhea/chlamydia, blood tests for HIV and syphilis). OTOH, your risk is so low that it really isn't necessary. Putting it in personal terms, if somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry.
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12 months ago
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Thank you for the reply, Dr.
I got tested for HIV and syphilis. The result was negative as you predicted!
I am still not sure if I am going to test for gonorrhea/chlamydia, since the exposure was low-risk and testing where I live is a bit expensive.
Anyway, I will use this final opportunity to ask you the following questions:
a) If a male patient of yours has had no symptons in the 14 weeks after an oral exposure, is this a good indication that he has not gotten chlamydia/ghonorrea? In other words: how often do individuals who got infected develop symptoms in the weeks following the exposure?
b) Statistically, what are the odds of a girl who has chlamydia/ghonorrea transmit it to a male by giving him unprotected oral sex once?
c) If a patient of yours find out years after his only exposure that he got clam/ghonorrea, would these diseases still be treatable?
d) Are there other STDs (other than HIV, Syphillis, Ghonorrea and Clam) that could be transmitted through this incident (unprotected oral) and that are worth testing for?
Thank you so much for your services, Dr. I am sorry if I made any grammatical mistakes… english is not my first language.
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H. Hunter Handsfield, MD
12 months ago
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a) Symptoms of gonorrhea typically start within 5 days, chlamydia within 2 weeks. With no symptoms at all, gonorrhea is extremely rare. Chlamydia can be entirely without symptoms, but is never acquired by oral sex. So even without testing you can be confident you caught neither of these infections.
b) Of all women with chlamydia or gonorrhea, under 5% with gonorrhea and under 1% of those with chlamydia have oral infection. When oral infection is present, it is transmitted maybe one time in 5 for gonorrhea, and almost never for chlamydia.
c) irrelevant question. The immune system clears gonorrhea within a few weeks and chlamydia within a few months. No matter how long either infection is present, it is easily curable with the standard antibiotic doses used for recently acquired infection.
d) No, there are no others for which accurate lab tests are available.
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.
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