[Question #3578] Oral sex concerns

34 months ago

Dear experts,


I have received unprotected cunnilingus (I believe that is the spelling) and performed fellatio 3 times (one of them protected) on a man that I dated. These encounters occurred several months ago. I have no other previous sexual history. From my understanding, oral sex is considered a low risk activity. Is it true that in particular cunnilingus is considered an even lower risk? Also I have heard that the STI risk decreases if the man does not ejaculate in your mouth, is that also true? I am going to get tested soon but I am still incredibly worried about my chances for STI's and I would like to know about my potential risks.  

Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
 Welcome to our forum. I will be glad to answer your questions. You were right, oral sex is low risk for acquisition of all STI's. Among the varieties of oral sex,  both receipt and performance of cunnilingus is amongst the lowest risk sorts of penetrative sexual activity that one can take part in.    Further, in general the longer one is engaged in a sex act, and the more exposure to genital secretions one has, the higher the risk. Finally, I would end it is important to remember that most persons do not have STI & AIDS and, even in the unlikely situation that your partner  had an STI, most single exposures do not lead to transmission. 

 If you are concerned, testing of your throat as well as your journals is easily performed using swab tests and is highly reliable. Personally unless there is something I have not understood from your post, I doubt that that is necessary  but of course there is no reason not to pursue testing if you desire.

 I hope that this information is helpful to you. Take care. EWH
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34 months ago
Thank you so much for your reply. You have certainly eased a lot of my anxieties. I have an appointment to get tested tomorrow. However, I am currently menstruating. Would menstruation affect tests in any way? 
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
No menstruation will not detract from the accuracy of standard lab tests for STIs.  A word of warning however, even some doctors are under the misperception that STI tests are less accurate during menstruation- that is not the case.  EWH
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34 months ago
Hello,

Thank you for all your advice. My Chlamydia, Gonorrhea, and HIV results were negative. however, on the HIV test result said "test result that is non-reactive does not exclude possibility of infection with HIV-1 or HIV-2 non reactive results may be because of antigen and antibody levels that are below the limits of detection of the assay." Then it lists my results as non-reactive HIV p 24 ag and HIV-1/HIV-2 ab not detected. Should I be concerned since it says it doesn't exclude possibility of infection? Or is this a normal disclaimer for these tests? The other tests included a sentence that were similar in nature.
Lastly, the clinic did not offer me a herpes test since i had no symptoms and she stated that the test had a high false positive. Would you recommend me getting tested for herpes and syphilis? Thank you so much for your help
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Thanks for sharing your test results.  Regular testing of this sort is a good idea for sexually active persons, even in the absence of symptoms.

As far as the wording on your HIV test, you can have confidence that you do not have HIV.  These are standard disclaimers meant to protect the manufacturers of the tests.  This sort of wording is put in place protectively by manufacturers and reflects the fact that in the first few weeks after acquisition of HIV the test can be negative.

On a personal level, I'm delighted to hear that your clinic did not recommend herpes testing as this means the word is getting out.  All too often these tests are offered without an understanding of their limitations and lead to unneeded drama and concerns, particularly for lower risk persons such as yourself in which falsely positive tests are several times more common than detection of true infections.  From what you describe above, you do not need testing for HSV.  Your risk profile for syphilis is similarly quite low and I do not feel that your history warrants this.  OTOH, if you wish to be tested, commercially available syphilis tests are far more reliable than those for HSV so if you really want to get tested, there is no reason to as the test will probably not be misleading.

I hope the information I have provided has been helpful.  As you probably know, our Forum provides up to three responses to clients and as this is my 3rd response, this thread will be closed later today without further responses.  Take care.  Stay healthy.  EWH
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