[Question #7015] Oral sex and hiv

62 months ago

Hi docs,

Thank you for the invaluable work you have been doing in the forum for people like me.

I am a male and I had a brief oral with a pre- op trans 6 months ago and i was the oral partner. No anal sex was performed as i know that is risky. The oral in itself was very brief, no deeptbroating. Although i smoke i have a decent dental health and noticed no blood while rinsing immediately after the incident. There was no ejacuation. I asked the concerned person about their status and they said- of course they were negative.

I have always believed that oral sex was safe without ejacuation. But i have had a boil on my groin now. I given azythromycin for the same for 9 days and after a month there is no swelling. But i have lost it since the boil . I am noticing 1mm redding bumps on my arms and they are itchy. Also some redness in the testicles. I reached out to the person again and asked their status , they said they were tested again 4 months ago and were ok. I dont know whether that is reliable.

I have read your advice on similar posts and have an understanding that it was low risk. But i cant test right now as the borders are closed in my district.

1)Do i need a test for hiv in this situation with absolute necessity given the symptoms after 5 months, I have had no fever these past months and this was a one off event, i am not sexually active and mostly confine to hetrosexual oral sex.

2) Can i resume unprotected oral activities witb my hetrosexual partner?

3) I know you cant give me absolutes, but is it true that the risk was really small and doesnt warrant much concern

4) what would you do if you were me and unable to test.

Thank you in advance for the services you provide.

Regards

H. Hunter Handsfield, MD

62 months ago

WElcome to the forum. Thanks for your confidence in our services.

Your research before asking this question seems to have found accurate information. There has never been a proved cases of HIV transmission mouth to penis. Ther are claims and probably some persons have been so infected, but scientific proof is lacking. Based on interviews of people who believe that's how they were infected, CDC calculated the risk at 1 in 20,000, if hte oral partner has untreated HIV. That's equivalent to receiving BJs daily by infected men for 55 years before infection might be likely. (In the other direction, i.e. penile to oral, the estimate was 1 in 10,000, i.e. giving BJs to infected male partners daily for 27 years.)

With those comments as background, to your questions:

1-3) Your risk wa zero or close to it. No testing is needed if you are not otherwise at risk. Resuming sex with your partner is a personal choice. Some anxious persons are more reassured by negative testing than by expert opinion or statistics. Feel free to be tested if it will help you stop worrying.

4) If I were in your situation and unable to test, I wouldn't worry and would continue sex with my wife without worry.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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62 months ago

Hi Doctor,

Thank you for the informative reply, it really provides assurance.

Although to clarify i was the oral partner with the mouth. Hence my risk is greater than receiving a blowjob.

I have also read a lot of your posts from medhelp and i waited for symptoms for a month but none appeared so put the incident out of my mind.

I know you cant judge symptoms over an app, but if you could provide me with your opinion regarding mine

1- a boil or a furnucle on the groin. It has gone now after a month.

2- small round red bumps on the body, they appear with an itch and disappear.

3- redness in the scrotum but i did apply a lot of anti fungal on the boil and was put on azithromycin and amoxycillin.

In your opinion is this realted to ars or any std?

I know you cant guarantee but just needed your advice.

I will going for a test when the covid situation is abit controlled.

Thank you again for being so informative and kind.

Regards

H. Hunter Handsfield, MD

62 months ago

"my risk is greater than receiving a blowjob." Yes, twice as high. But I assume that the calculation of 27 years with doing it once daily -- with infected partners -- is highly reassuring, right?

None of the symptoms described suggests ARS or any other sign of HIV.

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62 months ago

Hi Dr HHH

Thank you for the reassurance.

I finally found a lab and went for the Std panel today. I know it is reassuring but still as you said testing brings certainty.

I know i have exhasuted my follow ups, but if you would kindly keep the thread open, i would post the result that I am expecting the day after.

Thank you for the guidance.

Regards

62 months ago

Hi doc,

Got my results back, all negative.hope this is conclusive?

Thank you for all the guidance , it meant a lot for thr anxiety

62 months ago

Hi Dr Hunter,

One last question, the test didnt include hpv. Do i test for that seaprately, is it easily transmitted through oral sex.

Thank you again

H. Hunter Handsfield, MD

62 months ago

There are no approved tests for HPV in males and it isn't necessary. The only approved or recommended tests are for women, to be done along with (or sometimes instead of) a pap smear. You can find online sources that will offer tests, but there are often unreliable and confusing. It isn't even clear how to collect specimens for accurate testing of males. There are no blood tests at all. Everybody gets genital HPV -- it's unavoidable. You can assume you are or have been infected, but so is everybody else, including any sex partners you might have in the future. The main prevention strategy is vaccination, which prevents infection with the 9 HPV types that cause about 90% of HPV related cancers and 90% of genital warts. HPV can be transmitted by oral sex, but a lot less frequently than by vaginal or anal sex. Any single oral sex encounter is very low risk for HPV. Several websites have excellent information about HPV. Start with CDC (www.cdc.gov/std) and the sponsor of this forum, the American Sexual Health Associaiton (www.ashasexualhealth.org).

Glad to year your other tests were negative -- but of course no surprise! Thanks for the thanks -- it's good to know the discussion has been helpful. Best wishes and stay safe.

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