[Question #12910] STD/HIV Insertive oral

4 months ago

Hello I hope you guys are having a wonderful week. I made a mistake yesterday which I won’t get too deep into. I had Insertive oral yesterday for about 5 minutes with a male. I’m just hoping for some affirmation. They said they were on PREP and had been tested two weeks ago. My first question is does PREP delay 4th gen test results? Could they have been infected and not know about it when they tested because it was delayed. Second of all are oral sex encounters where you’re the one receiving the blow job no risk in terms of HIV? Secondly should I test for anything? If so what do you believe should be tested for later down the road. I have really bad Sexual anxiety from being fairly promiscuous at a young age and getting syphillis once. So I’m just looking for some confirmation on HIV risk and STD/STI testing. Thank you

H. Hunter Handsfield, MD

4 months ago

Welcome to the forum. Thanks for your confidence in our services.

This was a no-risk event for all practical purposes. There has never been a proved case of HIV transmission oral to penis. If it happens, it is exceedingly rare. And PrEP doesn't alter the reliability of HIV testing -- but because the risk was zero, it really doesn't matter anyway.

Should you test for anything? From a risk analysis standpoint, it isn't necessary. The overall risk for all STDs is very low; and absence of symptoms after a few days is good reassurance that y9ou acquired no infection. You're free to be tested anyway if you like: reassurance alone is a valid reason for testing, even when the risk is minimal. If that's your situation, have a urine gonorrhea/chlamydia test in the next few days (more than 4-5 days after the event); and a blood test for syphilis after 6 weeks. But if I were in your situation, I wouldn't feel the need and would continue unprotected sex with my wife with no worries.

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

HHH, MD

---

3 months ago

So essentially risk is HIv from receiving a blowjob is 0. It’s basically impossible to acquire it this way? What are the chances of syphillis? No sores were present on lips.

3 months ago

Also if I don’t get a syphillis chancre in the next few weeks is there any point in testing at all?

H. Hunter Handsfield, MD

3 months ago

HIV risk from receiving BJ? Answered above: start reading with "This was a no-risk event...." I haven't changed my mind in the last couple of hours!

Presence or absence of "sores on the lips" makes little or no difference in syphilis risk. But the chance your partner had syphilis and, if so, that you caught it is extremely low. And as you suggest yourself, it will be strong evidence you weren't infected if you don't develop a penile sore in the next 2 weeks. As I also said above, you're free to have a syphilis blood test in a few weeks if you would like confirmation you were not infected.

---
---

3 months ago

I have a couple final questions just out of curiosity. Do syphillis sores only show up at point of infection. Like said you were given a blow job could you have a sore in your mouth a month later? If only a blow job was recieved. I assume not? I cant seem to find an answer. More just curious than anything. and one more question are 4th gen finger prick tests 100 percent reliable at 6 weeks. Or about as reliable as possible? The alere determine combo ab/ag to be specific.

3 months ago

Also when’s the earliest a sore might show up? I’m assuming 2-3 days is too early haha. I think I bit my cheek super hard while sleeping. Now I have a roundish sore in my mouth lol! With a white inner circle. And it’s a bit swollen. Ease the anxiety doctors lol!

3 months ago

And last question I swear. Are RPR tests reliable at 6 weeks? I’m seeing some sources online saying 12 weeks or 90 days. But all the answers here say 6 weeks. Why is that’s

3 months ago

Sorry for all the questions. I appreciate the help though.

H. Hunter Handsfield, MD

3 months ago

Wow. Your mind is working overtime on this.

"Do syphillis sores only show up at point of infection?" Yes.

Fingerstick HIV tests are equally reliable as lab based tests on drawn blood.

"Also when’s the earliest a sore might show up? I’m assuming 2-3 days is too early". Correct, much too early. Typically 10-20 days after exposure. Your oral lesion isn't syphilis.

"Are RPR tests reliable at 6 weeks?" Generally considered so, but older information often cited longer times. The problem is that there has been no rigorous research to give a conclusive answer. However, neither I, Dr. Hook, nor other syphilis/STD experts we know have rarely if ever seen a patient in whom it took longer than 6 weeks.

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.

---