[Question #1779] hiv worries

43 months ago
i'm married man lives in israel.
for the last 5 years i devloped a bad habit. at leat ones   in two weeks im using csw service - sometimes females and sometimes transexuals. im never doing penetrations. its always included just frottage, deep kissing, oral (for me only, im not giving) and some times fingering - both sides... the oral sex almost always protected with condoms, accept for 3 times when it didnt. i'm always feeling bad after those acts and promise to my self that its the last time.  unfortunately, im not succeed to stop. 
worried from hiv or other stds are part of my life for years. i'm afraid to put my wife and family in risk.
i've been tested for hiv and syphilis before 1 year, it was negative.
my questions are - 
do you think those acts can put me in risk for hiv or other std's? especiaslly those three times when i didnt use condom for oral and the kissing acts.
do you think i need tests for any std's? negative test will give me peace of mind just for short time - i know the real solution is to stop with those acts.
do you think its safe for doing sex with my wife? 
thanks a lot
hope my english is clear enough.

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

Welcome to our Forum.  I'll be pleased to comment on your questions.  Before I do, let me complement you for your safe sex practices.  Most of the sorts of activities you describe (manual stimulation/masturbation, frottage, deep kissing and protected oral sex are entirely safe sex with no risk for acquisition of STIs, including HIV.  with unprotected oral sex there is a small risk for gonorrhea or non-chlamydial NGU but the risk of these infections is quite small, even with partners who are CSWs (remember, giving a client an STI is bad for business.  As a result, most CSWs take appropriate precautions and get checked regularly for STIs).  If more than two weeks have passed since you last received unprotected oral sex and you have not experienced symptoms you can be confident you did not acquire an STI because almost all gonorrhea and NGU is symptomatic.


As for your specific questions:

do you think those acts can put me in risk for hiv or other std's? especiaslly those three times when i didnt use condom for oral and the kissing acts.
See above.  The risk of receipt of unprotected oral sex is quite small and their is no risk from deep kissing.

do you think i need tests for any std's? negative test will give me peace of mind just for short time - i know the real solution is to stop with those acts.
At this time I see no medical reason for STD testing. On the other hand, if it will give you peace of mind, tests for gonorrhea and chlamydia can easily be performed on a voided urine specimen and you may want the peace of mind that a negative test would provide. I have no objection to you seeking testing, I just see no medical reason for it.
 
do you think its safe for doing sex with my wife?
Yes

I hope these comments will be helpful to you.  Stay safe.  EWH



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42 months ago
thank you for you're answer!
last two questions - you wrote -" The risk of receipt of unprotected oral sex is quite small and their is no risk from deep kissing"
1.do you mean small risk for HIV or for other std's or both?
2. does there's risk for syphilis from deep kissing with TS or csw?
best regards!
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

1.  My comment was in regard to HIV but the statement is appropriate for all STIs.

2.  Almost no risk for syphilis from kissing anyone, including TS or CSW.  They would have to have a lesion that was directly contacted.  Oral lesions are very, very rare.  EWH

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42 months ago
oh, I thought receptive oral is zero risk for HIV.  I thought just the one who suck is at risk.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
The words re confusing.  Receptive oral sex refers to the person whose mouth is receiving the penis, not the person with the penis.  Receipt of oral sex is not the same as receptive oral sex although the wording sounds similar.  There has never been a case of HIV shown to be acquired through receipt of oral sex.  On the other hand, a few people who performed oral sex on others (i.e. were "sucking"), did acquire HIV, leading to an estimated risk of HIV from performing receptive oral sex of less than 1 infection per 10,000 exposures to infected partners.  EWH
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42 months ago
i need to practice my English... 
thanks again.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Your English is fine. The wording is confusing.  EWH
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42 months ago
hi again!
I thought I'm over with those worries, but yesterday I noticed 2 very small sores on my lips. it's looks like acne. I squeezed one and a little white liquid bumped out. the sore is really small and little pain.  the lips are little swollen at the sore area. I know it's not herpes cause I know how herpes looks like. is it possible to be syphilis? the last encounter was 3 weeks ago and included deep kissing with TS.
I don't know what to do, I'm afraid to put my wife at risk.
pls help.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Our Forum calls for up to three replies per client and your questions have surpassed that. Therefore this will be my final post as part of this thread.  Obviously I cannot examine you to comment.  What you describe does not sound like a syphilis lesion as these are usually larger and solitary.  Despite the atypical appearance this is more likely to be an HSV-1 outbreak than anything else.  In our clinic, in addition to a clinical examination, at this time we would do a syphilis blood test (once a lesion is present, the blood test is typically positive) and a PCR or culture for herpes virus.  I know the clinical resources for such testing are available in Israel and that is what I would try to do.  


I hope my comments and suggestions have been helpful to you.  As I noted above, this reply will complete this thread and it will be closed in a few hours. EWH  . 

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