[Question #3912] Oral confused

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86 months ago
I'm 40 yr guy from tel aviv. Reccenetly i came back from vacation in moscow russia.
Stupidly i had encounter with transexual sex worker, it was before 8 days... i sucked her penies with condom, and she sucked my without condom. She try to penetrate me with condom but i refused cause its my first such expirience and i was nervise so i want to try just what i thought was safe ... so she just put for a few seconds her penies (with condom) in the enter of my anus but for sure there wasn't any penetration.
Seens iv'e been worried about hiv i start read about hiv among msm in russia and i was shocked about how high are the rates. I dont jnow but i guess this transexual was a really high risk partner. Yesterday i developed really bad diarrhea so its made me much more worried. 
P.s i didnt saw any sores, blood or cuts in her tongue or lips.
Some expert saying thus is zero risk, some saying low. I talked with local hiv helpline and the counselor told me they never heared about hiv from oral and i have nothing to worry about but those nice guys are not doctors they volunteers .so  Im scared that maybe they are wrong...
Im married so if theres reality chance to be positive from such exposure im in trouble.
Please tell me if i need to avoid sex with my wife and if you see medical reason for test. Beside diarrhea, everything feels ok.

Hope my  english is clear enough.
Thank you!
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Edward W. Hook M.D.
86 months ago
Welcome to our Forum.  I'll be happy to comment.  This was a very low, perhaps close to no risk event.  The rate of HIV among transsexual women in Russia is relatively high but still less than half are infected.  Condom protected sex is safe sex so there should be no risk from your performing oral sex on her or when she put her condom-covered penis at the entrance of your rectum.  There are no instances when HIV has been proven to have been acquired through receipt of unprotected oral sex from a partner with HIV.  Thus as long as condoms were used from the beginning to end of each sort of exposure, there is no realistic risk of HIV to you from the activities that have been described.  you do have a small risk for getting gonorrhea or chlamydia from receipt of unprotected oral sex however and it would be in your best interest to get a urine test for these infections as well.  I do not see a need for HIV testing related to these events however. 

I hope this information is helpful to you.  If there are further questions, please do not hesitate to use your up to two follow-up questions for clarification. EWH
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86 months ago
Thanks for youre answer.
You saying those acts was no risk for hiv. But youre estimate the risk - very low or close to no risk. Can you explain to me why there is a small possibilty of transmision hiv if receptive oral isnt a risk she was with condom when i sucked her, she didnt penetrate me at all.
 Does it safe to make love with my wife? Im still confused.
Thank you.
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Edward W. Hook M.D.
86 months ago
Sorry if my answer confused you.  In science one can never say never because new things are discovered every day and very, very rare things do occur.  As a result I said both  that what you described was "a very low, perhaps close to no risk event." , then explained why I said what I said and then summarized as "there is no realistic risk of HIV to you from the activities that have been described".  If you had asked if you were going to be hit by a meteorite falling from the sky I would have said the same thing.  As long as what you experienced was as described you should not be worried.  Accordingly, I would also suggest that  there is no reason related to what you wrote to worry about having unprotected sex with your wife.  EWH
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86 months ago
Thanks alot.
Sorry for the misunderstanding. Now is much more clear to me. 
One last question, i had diarrhea for 1day (start 7 days after the exposure) its now 10 days after the exposure and the diarrhea is almost gone but the exrement is still much softer than usually. Beside this theres no other symptoms like fever or strep throat...
Is Sign of diarrhea isn't "redlight" when it appear week after such exposure?
This was my last question, thank's for youre great service.
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Edward W. Hook M.D.
86 months ago
While diarrhea can sometimes be part of the ARS of recently acquired HIV, when it is part of the ARS it occurs in combination with high fever, sore throat, and sever muscle and joint aches.  Isolated diarrhea is not suggestive of the ARS.  I would not worry.

As you point out, this is my 3rd reply to your questions, thus this thread will be closed later today.  I'm pleased you found my comments helpful to you.  Take care, stay safe.   EWH
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