[Question #12224] I had unprotected oral sex with a sex work rumored to have an undisclosed STD

9 months ago

(Male 32 years old)Hello, for the past few weeks I have been at one of the lowest points in my life and I have been making very questionable decisions. One that has been hard to live with was that I had unprotected oral sex with a prostitute and ejaculated into her mouth 14 days ago. I was under the influence of alcohol. I know for a fact that she is a drug user as I watched her smoke from her pipe. No wounds were present on my penis and while her mouth wasn’t in the best looking condition it didn’t appear to have any sores or wounds but I did not check well. No blood was present from what I saw. Through reading forums she was suspected of having an undisclosed STD but it was never confirmed among forum users except “use caution”. I even called her number and asked her and she said she was “clean”.

At day 10 post exposure I started experiencing symptoms such as sore throat, runny nose and cough. I also noticed my tongue was covered in white looking “hairs” accompanied by breath that happens when I’m sick. I am overweight and not the healthiest person when it comes to diet or oral hygiene. I am trying to not be overly paranoid but the anxiety is killing me.

I plan on testing tomorrow with STD checks full panel and RNA early detection test which will be 15 days post exposure. This was definitely a wake up call to make better choices in life but I’m scared I may be too late.

So in conclusion I’m asking what is the likelihood of contracting HIV through unprotected insertive oral sex with ejaculation in the receivers mouth?

9 months ago

Also to disclose for my symptoms I did recently go from Florida to the Rocky Mountains in Colorado. So I’m trying to tell myself that my symptoms are due to my overall diet and hygiene choices accompanied with the extreme weather change.

My symptoms started around day 9 or 10 and it’s now day 14 and I’m starting to feel a lot better. My white tongue has been improving with more consistent brushing and using Colgate Peroxyl for the past day.

H. Hunter Handsfield, MD

9 months ago

Welcome. Thanks for your question.

You are at little if any risk of STD, and especially no risk of HIV: there has never been a scientifically well documented case of HIV transmitted mouth to penis. Ejaculation or not makes no difference. Based on how people thought they were infected with HIV (and they often are wrong), CDC once calculated a risk of one chance in 20,000 if the oral partner had untreated HIV. That's equivalent to receiving unprotected BJs by infected partners once daily for 55 years before infection might be likely. In other words, zero. Other STDs are higher risk, but still very low. Gonorrhea is the most important possible infection from such an exposure, but absence of symptoms (pus dripping, painful urination) is almost 100% evidence you weren't infected. And most sex workers don't have oral STDs anyway. Finally, most people don't lie when asked directly about STD or HIV status, so your partner's belief she is "clean" means she probably is.

Neither HIV nor any other STD causes cold symptoms like runny nose and cough. You caught a cold (or maybe covid or influenza) -- and these are also the main causes of white coated tongue. And acute HIV symptoms do not clear up in a few days; they last a couple weeks at least.

From a medical or risk perspective, you do not need testing for HIV or other STDs. Of course you are free to do that for reassurance. Your negative HIV RNA PCR test at 15 days will be negative and conclusive. If you seek other STD tests, have a urine gonorrhea/chlamydia test (valid any time) and a syphilis blood test after 6 weeks.

So all is well. I'll be happy to comment again if you'd like to return to let me know your test results. Stay mellow in the meantime; I am very confident all will be negative. Let me know if anything isn't clear.

HHH, MD

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