[Question #5391] Unprotected oral/risks

22 months ago

I was involved with man for about 3 months. Have had a few encounters of unprotected sex (2 or 3 times) and oral sex. Got tested about 31 days after sex and 21 Days after oral sex everything negative except HSV1 not sure if I have oral or genital. Sores were on genital but came up negative swab. Had protected sex again Mid March and unprotected fellatio with no ejaculation. I noticed after I had a sore on my gums but I believe that was there before I performed. Now I’m worried that there is risk of hiv or something else. A few days later got canker sores and even about a week or so later got 2 sores in mouth including a blood blister. Also have had constant headaches off and on. I had a bad headache on left side of head which was unbearable. Never had one that bad before. Felt like a migraine. And the whole one side my face hurt and teeth hurt. Also had a rash on both arms..somewhat itchy but not sure if related to STD. And a pimple like sore near my vagina. It looked like a zit with a Whitehead. The rash went away within a day or two. I’ve also noticed my face is constantly flushed . Headaches had also returned for a while. This is all within 2-4 weeks of exposure. Not sure if all related to stress or STD. I reached out to the guy, he’s told me he’s clear except for the HSV1. But can’t show me proof. I’m not even sure I got from Him or someone else (HSV1). But my concern is these more serious STDs. Is there a reason to get tested again after this last exposure? We no longer speak so I feel like until I get the proof I need I will never calm down and if I don’t have to, I’d rather not spend the money for more testing. But what other choice to do have to calm me down! Thank you ! 

Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome to our forum.  Your history of exposures, symptoms and test results are complex so forgive me if I get anything wrong.  If I do or off anything in this reply is unclear, feel free to use your up to two followup,questions for clarification.the bottom line is that you had unprotected oral and vaginal sex with a prior partner,  since then you have had a variety of symptoms which cause you to worry about the possibilities of STIs, including HIV, other than HSV1.  .your most recent tests were 31 days after your last genital sex and 21 days after your last oral sex.  

If this is correct and you had genital or oral tests for Gonorrhea and Chlamydia those results should be believed and no further testing for these STIs is needed.  Blood tests for HIV are 99% reliable at 4 weeks (28 days) and are entirely definitive at 6 weks(42 days).  Syphilis which is quite rare, would result in a positive test by 30 days after last sex.

Finally, regarding HSV-1 blood tests are generally unreliable boy in terms of sensitivity and I. Terms of having relatively high false positive results.

I hope this information is helpful.  In general, the symptoms you describe are more consistent with tension and anxiety than the STIs I mentioned.  If you have been tested at the times described and have negative test results, it is unlikely that your symptoms are due to STIs.  

I hope this information is helpful.  As I said above, please feel free to provide more information or seek clarification.  EWH
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22 months ago
I had unprotected oral and protected vaginal sex. I was tested prior to that last encounter with same man but not after this last encounter.  The symptoms I experienced were after this last time. (Rash, headaches, canker sores etc..) Hope that makes sense. I know there is a slight risk of infection with oral sex so I didn’t know if it would make sense to get tested again, I’m not as concerned about the protected sex since there’s not much risk if condom was used. As far as Hsv1 my igg was over 40 when I was tested last a couple months ago. Is it possible to have that high within 1-2 months since exposure. ? Overall my main concern is the unprotected oral sex if there is reason to go back and get tested since I’ve had symptoms that could be from STD.. hope I am clear and make sense. Sorry for confusion. 
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Thank you for the clarification.n Your unprotected oral sex with this partner was very low risk, particularly since you had previously had unprotected oral sex with this partner.  Like you I would not worry about the protected vaginal sex.  If I were you, I would not feel the need for additional testing.

As far as your HSV-1 IgG, I suspect it would be unusual for you to have a value that hi so quickly after ab encounter.  It is more likely that this indicates a prior infection.  It does not give any information about the location of the infection you have.

I hope these further answers are more helpful.  EWH
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22 months ago
Should I be concerned about the rash on my arms and the headaches that occurred? I am usually worst case scenario with things so I’m probably overreacting. I can’t recall having fever or swollen lymph nodes.  Nothing that felt like the flu or anything. 
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
I am not sure what is causing your rash- your symptoms, headache and a rash could have many possible causes- an allergic reaction, a non-STI viral infection, a medication, etc.  While I would not worry about STIs, if these problems persist or worsen, my advice would be to see your own health care provider for further evaluation.

As you know, this is my 3rd response to this set of questions and we provide up to three responses to each clients questions.  This will complete this thread and there will be no further replies.  Take care.  EWH
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