[Question #5621] cunnilingus risk/ARS/testing

22 months ago
I've written before, and I've read enough of these posts to give myself a logical if not emotional answer, so I'll try to make this brief.

On May 31st, I engaged in unprotected cunnilingus with a woman I met online. It was pretty vigorous cunnilingus for what that's worth. 

From roughly June 28th to July 1st (around 3 days), I had fairly significant body aches, slight chills, fever 100-101. A minor sore throat that started on day 2. All symptoms went away after 3.5 days. There was never any rash, lymph node enlargement, or anything else.

I don't think I would have thought about this at all, but I just started seeing someone new, and she asked that I get tested for STDs before we have sex. 

I had told her that I had already been tested after my last potentially risky encounter, because I didn't think cunnilingus was considered risky/test-worthy. But the combination of her request and these day-28/kind of ARS-like symptoms has me a little paranoid. I've seen slightly contradictory info on whether ARS can be so short or not. And whether 4 weeks after exposure is too late or not.  In fairness, you've been very consistent that cunnilingus is negligible risk, but my mind still plays tricks.

My question is: Do I need to test or not, in your opinion? My head says there's virtually no chance I have HIV, and anything else I might have gotten from cunnilingus would clear itself anyway, but I have bouts of paranoia about it. 

Thanks for your help. 
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome to the Forum.  I happened to be on-line when your question arrived so your response it a bit sooner than is typical.  I also appreciate both that you and your new partner talked about STIs and past testing, as well as your review of prior posts on out site.  these practices will serve you well.

Your synthesis of your risk from performance of cunnilingus on a casual partner on May 31 is on target.  Your flu-like illness occurred too soon to be consistent with the ARS and, as you know there has never been a case of HIV documented to have occurred as a result of cunnilingus.  As for other STIs, the major theoretical risk would be gonorrhea which occurs very, very rarely following cunnilingus (I've never seen a case in over 40 years and not for lack of looking).  Furthermore, available evidence suggests that many pharyngeal throat infections (typically following fellatio, not cunnilingus) tend to clear spontaneously in the week or two following acquisition.  

Were I you, I would not be worried (and I sense you are not).  OTOH, if your new partner feels strongly, as you know, a throat swab is easy and would quickly provide accurate results.

I hope this information is helpful to you.  EWH 
---
22 months ago
Hi Dr. Hook

Thanks for the quick reply. 

One follow-up. You said: 'Your flu-like illness occurred too soon to be consistent with the ARS.'  But it was 28 days later (May 31-June 28), which i know is not too *soon*...

Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
I apologize, I misread the dates and thought that only 3 days had passed since the event.  OTOH, 28 days is too long for it to be typical of the ARS.  No change in my assessment or advice.  I DO apologize for the confusion.  EWH---
22 months ago
Thanks Dr. Hook.