[Question #427] Received Oral Sex & Rashes Prior to Oral Sex

94 months ago

Dears Experts,
I have question regarding Possible HIV infection through receiving Oral sex. 2.5 months back I received oral sex from a massage worker which lasted around 4 to 5 mins maximum mixed with masturbation and I ejaculated outside her mouth. Before that I had some rashes on the tip/head of my penis around 2 month before the said incident and I had never involved in any sexual activity other than masturbation from massage worker. However I visited dermatologist who gave me off the shelf cream ( I am not sure what was that but I searched with reference to cream he gave and This medication is used to treat skin conditions such as eczema, psoriasis, allergies, and rash)  and inflammation went but left some marks which were there at the time of receiving oral sex and currently also but no major inflammation. Can you pls assess my risk of possible HIV transmission as I am really worried but I have not done the testing till now. Observed some red rashes on my shoulder & arms and had sore throat after 3 days of the incident.
Pls advise on my risk specially with penile skin condition I have mentioned.

Edward W. Hook M.D.
94 months ago

Welcome to the Forum.  I'm please to comment.  The events you describe did not put you at risk for HIV.  Most commercial sex workers do not have HIV but still more importantly, there are no proven instances in which a person has gotten HIV from receipt of oral sex from an HIV infected sex partner.  The presence of a penile rash does not change this.   The subsequent rash and sore throat that you experienced following the event likewise do not change my opinion.  From a medical perspective I see no reason for HIV testing related to the event that you describe.  If you wish to test for your own peace of mind, then at this time any U.S. FDA approved (i.e. commercially available) test for HIV will provide you with reliable results. 

I hope this information is helpful to you.  EWH

94 months ago

Dear Dr,
Thanks for prompt reply and this is really helpful. However I have few concerns.
How confident are you based on your experience, history of patients you have seen in your medical practice and medical literature that receipt of oral sex pose very less to no risk?

And if very less. How likely is the transmission through receipt of oral sex especially in the given condition of rashes I have describe on my organ?

There are many sources saying different things over internet and people claiming they have been infected through this practice.

By the way can you pls share if your judgement is based on the reason that Saliva itself is less infectious?

Does Saliva transmit HIV virus?

Does minimum exposure to Air (such as during Oral sex) changes the characteristics of the virus?

How safe is this activity if a person wants to continue in future specially considering the other person is HIV + with high viral load (Though I sincerely wish no one is the world gets the virus)

Thanking you in advance.

Edward W. Hook M.D.
94 months ago
Much of your follow-up questions is repetitive.  Repeating the question will not change my answer.  As far as my expertise, you can research me on the Internet and make up your own mind as to whether you want to believe me and my more than 30 years of taking care of persons with and at risk for HIV and other STIs.  Alternatively you can believe the misleading information you find on the Internet.

As for the questions you asked which I have not answered,
Saliva not not transmit HIV.  There are no cases in which exposure to saliva from an infected person led to HIV infection.

Yes, exposure to the air kills HIV virtually immediately.  This is the reason the virus is not spread by mutual masturbation or contact with contaminated surfaces.

As I said in. Y original reply, the activities you describe are not associated with any known risk for HIV.  EWH
94 months ago
Dear Dr Hook,
Thanks for your reply. Apologies if you found my questions repetitive bt i hope experienced person like u can easily understand the mental state of mine. I have a question. I have been noticing after few weeks the incident mentioned earlier that my tongue is white coated with some small cuts on it and it is continuing since then till now. Is it something related to HIV symptoms?
One more question from ur vast experience. Usually poeple give reference of studies of HIV - and + couples who were tracked for years and only performed unportected oral sex with other protected activities. And no one was found getting infected? Do those studies r applicable in real world as people participating in studies must be on treatment and mostly having lower or undetectable viral load. Pls help to understand.
Edward W. Hook M.D.
94 months ago

Changes in the color or appearance or the tongue, as well as sores or cuts to the tongue are not signs of HIV.  Persons who have had HIV for years (average- 9-10 years) and are in far advanced stages of the infection may get oral lesions but even then, the changes you describe would not fit HIV.

The data showing that receipt of oral sex from and HIV infected person is NOT a risk factor for infection are vast. They are included in studies of couples, following exposure to infected commercial sex workers, and in other carefully designed scientific studies.  The viral load of the infected person does not change this.  None of these suggest that infection has been transmitted by receipt of oral sex.  To this I add my own reading of the scientific literature and care of persons with and at risk for HIV for more than 30 years.

Bottom line- this was a no risk event.  There is no reason for concern. 

As per Forum policy, this is my third and final reply.  If you cannot accept the information I have provided, you could test to prove what I say to yourself (but only once, testing if you are not going to believe the result is silly) or can open a new question.  I hope you will not need to do that.  Take care.  EWH