I have a question regarding a recent encounter I had. I got curious and went to an adult arcade. Temptation got the best of me and I briefly engaged into giving a stranger an unprotected blow job at a gloryhole. The encounter was very brief (less than a minute) and there was as no ejaculation or precum that I was aware of. I immediately regretted my decision and stopped and left. 

The next morning I noticed that my gums are a little bit swollen and I often have bleeding gums when flossing or eating apples. My question is how at risk am I for oral transmission of HIV based off this encounter? 

Thank you! 

Oral sex is safe sex:  not completely free of STD risk, of course, but a lot lower chance of infection than unprotected vaginal or anal sex. HIV is not a significant risk:  although there have been cases of HIV acquired by performing oral sex, they are rare; the most common estimate of risk (from CDC) is one chance in 10,000 -- and that's only if the penile partner is known to have untreated HIV. Your risk was even lower because you don't know your anonymous partner has HIV, there was no ejaculation, and the exposure was brief. 

And neither HIV nor any other STD can start to cause symptoms so soon. The earliest possible symptoms, e.g. if you acquired oral gonorrhea, start 2-3 days later -- and in fact over 90% of oral gonorrhea causes no symptoms at all. Swollen gums are not cause by any STD at all. If you remain concerned, you could seek medical care to check your gums and perhaps have a throat swab for gonorrhea, but even this would be primarily for reassurance. You also can have HIV testing in a couple of weeks if you remain concerned. But for all practical purposes you were at no risk for HIV.

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

HHH, MD

I appreciate your response. My concern about the swollen gums was more about increased susceptibility to exposure rather than a symptom. 

I guess my biggest worry was about it being an anonymous encounter with someone whose status or sexual behaviors are unknown to me and the possibility that precum would infect me through my swollen (although not actively bleeding) gums.

 

I have made an appointment for oral swab test at a date 3 weeks from my exposure. I am considering an HIV RNA test within 2 weeks as well. From my understanding, the event was low-risk enough to not warrant PEP, correct? 

Gonorrhea testing is valid any time more than 2-3 days after exposure; you don't need to wait 3 weeks. If somehow I were in your situation, I would not have any HIV test at all. But it's up to you.

Indeed there are "mixed results" in the evidence for oral gonorrhea by kissing. It's clearly a risk in some men who have sex with other men, but appears to be extremely rare between men and women (or women and women) if it occurs at all. The reasons are not well understood, but it is likely that kissing between men more often is prolonged and vigorous than between men and women. Oral gonorrhea in women is almost entirely limited to women who have performed oral sex on their male partners.

That completes the two follow-up comments and replies included with each question and so ends this thread. Thanks for your thanks; I'm glad you found the discussion reassuring. Best wishes and stay safe.