[Question #6440] Risky Oral

15 months ago
I exchanged oral sex with someone and I'm worried I potentially got an STD. I got a full STD check 4 days after exposure to the person.

It's been a full two weeks since the incident. 3 days ago I started to get a hot feeling towards the tip of my penis. Also my testicles were a little sore. Nothing else yet. 

Also, I have been "inspecting" more down there and anxiety has started to take over. 

  • Was my test completely pointless or can I rely on any of those negative results?
  • What are the chances that I got something serious (HIV, hepatitis)?
  • Are my symptoms early signs of anything or is my anxiety taking over? 
  • What should I get tested for again and when should I go? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Welcome to the forum. I'm happy to help.

Oral sex is less risky than commonly believed. Most people probably could have oral with 100 different high-risk partners over a year and never catch any STD. That's not to say the risk was zero, but it's low for all STDs (much lower than unprotected vaginal or anal sex) and virtually zero risk for several of them. You don't say either the sex of your partner or whether you're speaking of receptive (receiving) or insertive (giving). These all have different risk levels. Of course your partner and his or her sexual lifestyle also makes a difference.

Your symptoms don't concern me at all. No STD causes those things, which are typical for genitally focused anxiety:  your anxiety is leading you to worry about minor symptoms or even normal body sensations that you otherwise would ignore nor not notice. And for sure stop examining yourself. Every frightened person in your situation eventually sees something that they believe is new or abnormal but is not. Anything you don't feel, or that you don't notice during normal daily activities (e.g. showering, using the toilet), doesn't matter.

Assuyming your "full STD check" included a urine test for gonorrhea and chlamydia, those results are conclusive. Good thing: gonorrhea is the single most common STD for which you might have been at risk, so you're mostly home free already. However, all blood tests for all STDs require at least 4 weeks and sometimes 3-4 months to become positive. But in the absence of symptoms, you can forget most others. The only additional testing you ought to consider -- mostly for reassurance, not because of real risk -- is a blood test for syphilis in 6 weeks. Even this is optional if your partner was female and not a sex worker or injection drug user. HIV has never been scientifically documented to be transmittedd by oral sex, except rarely by performing oral sex (BJ) on males (mostly among men having sex with men). Hepattitis is rarely if ewer transmitted by oral sex.

If you decide to have additional tests -- which acutally I don't recommend -- stay mellow in the meantime. But if you'd like more detailed advice, tell me more about your partner's sex, sexual history to the extent you know it, and exactly who did what with whom. In the meantime, relax. It's unlikely you caught anything. Let me know if anything isn't clear.

HHH, MD
---
---
15 months ago
I see. That’s helpful. I had a blood test but no urine test. 

What’s the difference between male/female? I’m worried that I possibly had a cut in my mouth or something and something like hiv got in there. There was no ejaculation in my mouth but I’m worried about any other fluid. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Most men who have sex with men are at far higher risk for all STDs than straight men.

The cut in your mouth makes no difference. If you performed oral on an infected male who was not on HIV treatment, one estimate (from CDC) is that there would be one chance in 10,000 of catching it. That's equivalent to giving BJs to infected men once daily for 27 years before transmission of the virus. And since cuts in the mouth are very common, you there must have been billions of exposures in the presence of such cuts, still with few confirmed transmissions.

Your "full panel" of STD tests wasn't very full, if no urine or urethral swab test for gonorrhea or chlamydia. And with an oral exposure, testing should include a throat swab for gonorrhea.
---
15 months ago
I guess it's my anxiety taking over, I'm very thankful for your response. My experience was with a woman but I just wasn't sure of her history. And I've read that if I've gotten something like HIV, I would have gotten really bad flu like symptoms by this point? 

This has helped my anxiety, I'll chalk it up to just that. I may get tested in a month or so just in case but I really appreciate your time. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Thanks for the thanks. But you're wrong about "really bad flu like symptoms".  New HIV infections can cause fever, muscle aching and other "flu like" symptoms, but often no symptoms or only mild. However, the chance any particular sexually active woman (in North America or western Europe) has HIV is very low, typically under 1 chance in a thousand. And cunnilingus (oral-vaginal) is extremly low risk for HIV; there has never been a scientifically documented case that it happened. Feel free to be tested for reassurance, but you definitely can expect a negative result.---