[Question #4861] Anxiety after cunniling/HIV and STD risk?

25 months ago
Hi Dr,s I am a 20Yos  male. Sorry for my bad English. I hope you can understand what I write. I travelled to Taiwan 9days ago and engaged in a one night stand.I met a white girl from East Europe who stayed at Taiwan for about 2years.  I kissed and performed a cunniling and fingering on her. So there is no any intercourse or Bj at all. After I fingering her for 30mins around, I touched my eyes (fluid already dry). This is my first sexual behaviour and I am so scare now. I have few questions to ask.

1. I understand that HIV is extremely low to zero risk?  I asked again for peace of mind because I don’t know it is still up to date and this happen in Taiwan not the US. Can a rapid p24combo test at 14days and 29days p24 combo lab based blood test conclusive?
2. I am so afraid of syphilis. I feel pain in my throat after 3days of exposure, and now the pain is gone but started to feel something inside my throat each time I swallowing mouth water(after 7-8 days of exposure). And I read a lots of DR HH’s reply. He said syphills is rare in the US but how about Taiwan. Therefore, I want to ask what is the possibility of me getting syphilis? Should I be worry about this and can a 29days blood test be conclusive?
2.5: I find some dark red spot on my bottom lip. What happen. It is like dry blood. Is it a symptom of any std?
3. Will the symptom of any STD show in my genital? Or I should just worry about my oral?
4.the risk of HSV and HPV? Can a Blood test for HSV2 and oral swab for HPV conclusive after 29days? 
5. I do a throat swab test for gonhorrea and chlamdia after 5days of exposure. It need 3week to wait for the report. Can I trust this report? Will it be too early to test?
6. Is all HPV can immuned by myself? The chance of hpv symptoms on my mouth?

Sorry for my bad English. Looking for forward for your professional reply.
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
 Welcome to our forum and thank you for your confidence in our services. I will be happy to provide some information.  Your English is fine.  Let me start by reminding you that most women, including women in Taiwan, do not have STIs, including HIV.  Even when they do have an infection however, even unprotected genital intercourse usually does not lead to transmission of infection. The activities you describe were quite safe. Masturbation of a sexual partner with your hand and fingers is a no risk event for all STIs including HIV.   Cunnilingus does carry some small risk for acquisition of some STI's however that risk is also low.    Please find my answers to your specific questions below: 
1.   Your risk of HIV from this encounter is essentially zero. As mentioned above masturbation is safe sex and there are no proven cases of HIV acquired through cunnilingus. If you choose to test combination HIV antigen/antibody tests are 99% sensitive at four weeks and entirely conclusive at six weeks following an exposure.   In my opinion you do not need testing. 
2.  I would not worry about Syphilis either. Syphilis is also uncommon in Taiwan and particularly uncommon among women. 
Your symptoms began too soon after the event to be due to Syphilis.  Also, when when Syphilis occurs it does not cause a sore throat. If you choose to test, results will be conclusive at four weeks.
2.5.   The spot you describe does not sound like any STI. 
3.   The symptoms of STI is a occur at site of exposure. If cunnilingus was your only exposure, any symptoms which might occur would occur in your mouth or throat. 
4.   Your risk for HSV and HPV is also low. We recommend strongly against blood test for HSV. 
5.   Your five day throat swab test is entirely reliable. There is no need for additional testing. 
6.   See my comment about HPV above. Your risk is very low. In general however if you have not been vaccinated for HPV it is probably a wise thing to do as a general healthcare measure. 

 I hope my comments in the information I have provided are helpful. Please don't worry I am confident that you are fine. EWH 
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25 months ago
Thank for your reply. It makes me feel so much better. I have few more questions to ask.
1. I touched my eyes after fingering. Is it safe?i worry that my finger would carry std virus to my eyes.
2. I just look at my lip few minutes ago. I find a couple of little blister inside my mouth.very small, no pain and not itchy. And they didn’t occur closely.do I need to worry about HSV2?
3. I read some rumours said that cunniling unlikely to spread STI  to throat. Because it woman genital cant touch  your throat. Is that real?
4. Feel something inside my throat  when I swallowing is not symptoms of std?if it is, which std will have the highest chance to occur?
5. I read some old reply from this website, it said HPV is hard to survive in oral.is that real? Can it “grow” in my throat to make me feel something inside my throat?And so do HSV? It is like 1 in 10000to infect  Because of performing cunnilingus?
6.Do you agree that a 28 days blood check for hiv and syphilis is enough for my situation?do I need to worry about any std that have higher risk to infect me?if i have to, what kind of symptoms would likely to show.can I say that I am in extremely low risk to get any std from my situation ?

Thanks. You really help me a lot ! It is days 9 after my exposure. It is a long waiting until 28days for my test. It makes me really anxiety. Even I understand that it is a low risk situation but I am still worry that I will be super unlucky. 
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Straight to your follow-up questions:, some of which are a bit repetitive
1.  No risk.  STIs are not transferred from site to site because of finger contamination.  Nothing to worry about.
2.  Very unlikely, HSV-2 almost never causes oral infections.  
3.  The precise reason that cunnilingus rarely leads to infections is unclear but anatomy is likely part of the issue.
4.  The most likely infection to occur following oral sex is gonorrhea.  These infections are typically asymptomatic.  
5.  Again, when HPV does occur in the throat, it is typically asymptomatic.
6.  As I said above, if I were you I would not bother to have blood tests.  If you feel you must, 28 days tests will provide you with accurate information.

I think you are worrying too much.  EWH
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25 months ago
This is 12days after the exposure.
I only find some foreign sensation in my throat.
(Is it a possible symptom of std?)
1. Does it mean I AM IN VERY LOW RISK for any STD infection?
2.I don’t see blister that cause pain or itchy in my oral/lips.Can I rule out HSV infection now(12days)
3.how long can I rule out gonorrhea? What is the most possible symptom of gonorrhoea infection will occur in oral? (I understand that it is likely to be asymptomatic) Will it cause serious damage to my body if I don’t treat in on time?
4. What’s your prediction with my report of STD, if I test for syphilis, hpv and hiv .
5. Jusy to confirm. I am very low risk for syphilis right? (I am scare so I ask again. Sorry for keep asking same thing)
Thanks Dr Hook.

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
1.correct.
2. Yes
3.  This was a no risk event for gonorrhea. If symptoms would occur they would occur typically within 3 to 5 days of exposure. 
4.   There is no reason to worry that you might have acquired an STI from the exposure you have reported. 
5.   The answer will not change. You are not at risk for syphilis. 

 This is my third response to your questions. Therefore as per forum guidelines, this thread will be closed now. Please be aware that returning to this site with additional similar anxiety-driven questions may result in deletion of your question without an answer. Please don't worry. Take care. EWH 
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