[Question #3059] STD risk after oral sex

40 months ago
Hi experts
I am really concerned about a recent exposure at a massage parlor. The lady used a make shift dam of polythene (I am not sure if it was a proper dam?)  around my scrotum and penis and gave me a blowjob for 2-3 minutes. I came inside the polythene dam. I saw red spots on  my penis glans and my urethral opening was inflamed. I observed this within half an hour of the oral sex. What STDs am I at risk of from this exposure? I am not confident if the dam provided fool proof protection. I already have oral HSV1. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Welcome to the forum. Thanks for your confidence in our services.

There was no risk of any STD from this exposure. Even without protection, oral sex is safe sex:  not totally free of risk, but with low risk for all infections and zero for some. Second, any polyethylene (or latex) is an effective barrier; you can be sure it functioned properly as a dam. The "red spots" on your penis don't sound serious, and not like any condition that would increase STD or HIV risk if exposed. (And of course no STD can show symptoms within 30 minutes of exposure. 24-36 hours is the minimum.)

So I do not advise any testing on account of this exposure. You are not at risk at all and there is no need for worry.

I hope this information helps ease your fears. But let me know if anything isn't clear.

HHH, MD

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40 months ago
Dr. HHH,

Thank you so much for the prompt reply. This definitely helped to lower my anxiety.

I had redness close to the end of my penis head- like skin erosion or abrasion. I am uncircumcised. Could I have gotten HIV from her saliva due to this tear on my penis glans skin ? Should I consider taking Prep? I have to leave for a long international trip in a week and am very worried if I caught an STI. Apologies for being like this.
Can I get any conclusive tests within a week, or do I have to wait longer? This is only yo out my mind at ease.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Slight redness or erosion of the penis head occurs from time to time in uncircumcised men, usually due to yeast infection or "nonspecific" balanitis. However, genital herpes also can cause such erosions; if this has been a recurrent problem for you, consider seeing a doctor to determine the cause and make sure it isn't herpes. However, as I said, it is impossible that this is from something you acquired during the exposure described. 

The polyethylene effectively prevented any contact that could transmit any infection. Saliva contact doesn't matter: it does not transmit HIV (in fact, saliva kills HIV -- one reason why contact with someone's mouth of any kind is safe sex for HIV).

There is no test that can accurately detect HIV after only a week. At about 2 weeks, you could have an RNA blood test for the virus, but even that isn't quite conclusive until you also do a blood test at 4 weeks. In the meantime, I'm glad these comments have helped reduce your anxiety. 
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40 months ago
Thanks again Dr. HHH. This is a great service and can't thank you and the other experts enough. 

I will go for a blood test at 4 weeks to completely help me let go of this encounter.

Apologies if I am asking you to repeat yourself, but wanted to make sure that my understanding is correct- for practical purposes, does contact of someone's mouth and/or saliva on eroded skin of penis head present no risk for HIV? The eroded skin on my penis head looks exactly like what you described in your previous reply.

I woke up this morning feeling slightly feverish with slightly sore throat , but I have seen your replies on other threads mentioning that HIV symptoms don't start until at least 10 days post exposure, is that correct understanding? 

Also, thanks a lot for your comments about Herpes causing the skin erosion. That has been a cause of concern for me,  I have seen multiple doctors including 2 dermatologists, one Infectious Disease and PCP, and they have termed it as yeast or 'balanitis' . My concern is that the erosion has been there for almost 2 months now, and gets more red whenever there is friction and then goes back to being less 'red'.  It does hurt a bit when rubbed or poked, which worries me more.  Does this sound like Herpes to you? 

I have had a negative IGG 6 weeks post and negative WB 8 weeks post last risk exposure. I have been reading advice here, and waiting for the 16 weeks mark to repeat the WB test. Does this sound like a good option?

Thank you once again.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Look, nobody can say such contact is zero risk. But if there has never been a proved or reported case of HIV being so acquired, what do you conclude about the risk??? There is no zero risk in any part of life:  people drop dead without apparent cause, lightning kills folks from time to time, and deadly illnesses can develop suddently. If you live in the US, there is 1 chance in about 2,000 that some sort of accident (vehicular, fall, drowning, etc, etc) will kill you in the next 12 months. In that context, being a 1 chance in many million of catching HIV (hundreds of times lower) shouldn't occupy you mind.

Correct on timing of symptoms. You need to do your best to avoid attributing every twich, tingle, and cold to this zero risk event!

No, this doesn't sound to me like herpes -- but more important are the opinions of two dermatologist. From all you say, there is no chance this is herpes. Presence or absence of a bit of pain when "rubbed or poked" make no difference either for or against herpes. I would not have recommended testing for HSV. But since you have started down that path, you probably should continue until you've had a conclusive HSV western blot 16 weeks after the first onset of the first such penile symptom. It will be negative for HSV2 but probably positive for HSV1.

That concludes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.

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