[Question #4794] HIV and oral sex

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79 months ago
Dear Doctors,

Firstly i would like to thank you for this wonderful service. It really puts people at ease to be able to access health advice in this way.

My question is in relation to a common question, that of HIV risk and insertive fellatio.

Approximately 7 months ago, i had a single instance of insertive oral sex with a heterosexual female partner. I was tested at 8 days and 31 days post this event and nothing significant was shown (apart from a minor yeast infection).

However my physician says i should be tested again now to ensure a conclusive result. In your view, is this necessary? my practice uses the HIV duo test.

Thanks.
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Edward W. Hook M.D.
79 months ago
Welcome to the Forum and thanks for your question.  I'll be glad to comment.  You are correct, this is a familiar question.  In general, in considering the need for testing, one should consider both the likelihood that a partner had HIV (typically low) and the sex act involved.  In your case, assuming you are in North America or Western Europe,unless there is something specific you did not mention, the statistical likelihood that your partner had HIV is a small fraction of 1%.  Second and perhaps even more importantly, there are NO cases in which HIV has ever been proven to be transmitted through receipt of fellatio despite many instances where it has been studied.  Finally, with the combination HIV antigen/antibody ("duo") tests currently in use, over 99% of recent HIV infections are detected by 28 days/4 weeks after exposure.  Thus, in my opinion, there is almost nothing to be gained from further testing and no reason for continuing concern.

I hope that this comment is helpful to you.  EWH
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79 months ago
Thanks for the very prompt and helpful response Dr Hook.

I am in Western Europe and the low rates of HIV and the relative risk you highlighted are a source of huge relief.

I apologise for wasting your time with an already common question. I think an element of irrational paranoia overtook me when i recently developed a rash on my torso and in a silly moment of weakness i googled symptoms and this was noted as a symptom of HIV on some (perhaps less than reputable) sites. This caused me to speak to my physician and they recommended further testing for conclusivity. However, if your professional opinion is that this wouldnt be required, i am more than happy to defer to that.

Thanks
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Edward W. Hook M.D.
79 months ago
Asking a common question is not a reason to apologize.  Glad to have provided some information which I hope will be helpful to you.  As I said, I really see no scientific reason for continued testing. 

 I would warn you however to stay away from Google.  All too often the statements made there are out of date, taken out of context and sometimes are just plain wrong.  EWH  
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79 months ago
Thanks for the prompt and kind response Doctor Hook,

And just to finally set my mind at ease, are you content that a red rash on my torso would not be a common manifestation of any sexual related issue? The episode related earlier was 7 months ago and was the last unprotected sexual activity that i have undertaken. And as noted, 2 subsequent tests have not shown anything untoward.

Thanks
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Edward W. Hook M.D.
79 months ago
Correct, I would presume that the rash you noted is not suggestive of an STI.  You are in the clear.  EWH---