[Question #7146] HIV/STI RISK?

9 months ago
Hi Doctor,

Earlier this year, I had unprotected oral and protected vaginal sex with a csw. Due to the ongoing covid situation in my country I was unable to get tested. Around 4 months after the encounter, once the restrictions eased I finally got tested for HIV and that came back negative. Thank god. 

Problem is, just before the test I had gone to a mistress/bdsm worker who used sex toys on me. The sex toys were used with a condom and no actual penile-vaginal penetration took place. 

Additionally, over the past year I have been having recurring mouth ulcers/canker sores. I have read online that causes include increased stress,food sensitivity and smoking. I unfortunately fall in those 3 categories. However, i have become paranoid that the recurrences may be due to Herpes. I have not had any of the symptoms related to either HSV1 or 2.  

Questions:
1.Is there any viable risk from the bdsm encounter for HIV/STIS. If not,can I take my 4 month negative result as conclusive?
2.Can the recurring ulcers be a sign of Herpes?Am i overthinking this?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Welcome back to the forum. I'm glad to hear of your negative HIV test after a high risk exposure. I agree with Dr. Hook's previous comment about the relatively low rate of HIV in Pakistan. On the other hand, it isn't zero, and I'm a bit dismayed your had unprotected sex with a female sex worker. I hope you were tested for common STDs (gonorrhea, chlamydia, syphilis) in additon to HIV. If not, consider it now. And please get into a consitent condom habit! I

To your specific questions:

1) The sex toys business sounds enitrely safe. Probably she cleans them between customers -- and in the future you can ask her to confirm that. Using them with condoms should also bring any theoretical risk down to zero.  To your specific questions:

2) Yes, you're overthinking this. Aphthous stomatitis (canker sores) are not a herpes problem, and oral herpes does not cause recurrent sores inside the mouth. And of course you cannot acquire oral herpes by epxosure of your anal or genital area by sex toys. (But even if you kissed or performed unprotected oral sex, I would not worry about herpes because of these symptoms.

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

HHH, MD
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9 months ago
Hi doctor, Since my last post i have since relocated to Dubai, where as a government rule every expat is tested for certain diseases including HIV. The incidents listed above all took place  in dubai. 

The sex toys are washed after every customer and cleaned with the necessary soaps. Also,even during my session, she would change the condom with a new one before using it,hence multiple condom changes occured.

Thank you for your advice on the sores. In regards to gonorrhoea, syphilis and chlamydia, I am sure that i have not experienced any symptom related to the any of these, as at the height of my anxiety I would actually do a complete check for any changes to my body at least twice a day.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Thanks for the feedback. I'm glad to have been of help.---
9 months ago
Hi doctor, i just re-read your initial comment and you described the unprotected oral and protected vaginal as a high risk exposure. Could you elaborate on this please and and the herpes paranoia stems from the unprotected oral(mouth to penis) during the same incident. 

I do apologise if I was not clear.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
You were entirely clear; I just misread it. I thought both oral and vaginal were unprotected. That event was virtually zero risk for HIV, although moderate STD risk from the unprotected oral exposure. Apologies for misreading and for the mini-lecture about condoms!---
9 months ago
Hi doctor,
No problem doctor, happens to the best of us.

As a last,Would your advice on the herpes paranoia change given the above on the recurring mouth ulcers?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
As I said above, "Aphthous stomatitis (canker sores) are not a herpes problem, and oral herpes does not cause recurrent sores inside the mouth." I haven't changed my mind. I alsoc ommented on your low risk for an oral HSV infection from the exposures you have described. I'm sure your oral sores have nothing to do with any sexual exposures you have had.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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