[Question #7334] Unprotected oral sex

58 months ago

Before answering my question i would say thank you doctors. I've been going through a lot of anxiety over this and need some assurances. I am from malaysia and I recently had an encounter of unprotected oral sex with a street hooker . I was unaware of the fact that stds can be passed through oral sex . The unprotected oral sex lasted about 1&1/2 minutes, not more than 2 . She told me that she don't have any disease and has a family and a mother of 2 children. This was my first exposure. All i can say is she didn't deepthroat the oral sex . It was just the tip of the penis . And i was only the receipt of the oral sex . I went to do a full std screening after 48 hrs of exposure . All came back negative, eventually i know that the test conducted is too early but the doctor told me to come back after 3/6 months to do another test . No kissing at all. I have a few questions as below:

1. I am scared of contracting hiv through this encounter . Is it possible to have hiv through this ? I am very scared of this , I don't have any symptoms until now .

2. It is said that hiv isn't spread through saliva than why is oral sex considered as a risk .

3. I know other stds which you can get from oral sex is easily treatable, but can I reassure that if I don't get any other stds from this exposure , the chances of getting hiv is 0?

4. I am planning to get tested again next week at the mark of 6 weeks . I have read your forum and it is said that test at 6 weeks is conclusive? The clinic uses 4th gen test .

5. Overall do you think I will encounter hiv from this? Because it has been affecting me lately that i could be infected with hiv . Many internet research claims that it is easy to get hiv from receipt of oral sex . I am very very anxious. I just want to live my normal live back .

6. If you were in my place would you get tested after this exposure?

7. Why is the recommendation of 3 months included? If 6 weeks is already conclusive

Thank you doctor in advance . I just want to live my

Edward W. Hook M.D.

58 months ago

Welcome to the Forum and thanks for your appreciation. We're glad our information and commentary is helpful. That is our goal. The encounter that you describe was low risk. While some STIs can occasionally be transmitted through receipt of oral sex, this is about the lowest risk form of penetrative sexual encounter and even if your partner was infected, it is most unlikely that you were infected. There are no proven cases in which a person has acquired HIV from receipt of oral sex and other STIs are relatively uncommon, even if partners are infected. Further, while your tests were slightly early, your results are still quite reliable in terms of the most common STIs, gonorrhea and chlamydia and should be considered strong evidence that you were not infected. In answer to your specific questions:

1. I am scared of contracting hiv through this encounter . Is it possible to have hiv through this ? I am very scared of this , I don't have any symptoms until now .

The is NO risk for HIV from the encounter you describe. None whatsoever.

2. It is said that hiv isn't spread through saliva than why is oral sex considered as a risk .

HIV is very rarely acquired from performance of oral sex on an infected partner- about once in every 10,000 exposures on average but is very rare. There are no data to suggest that anyone has ever acquired HIV from receipt of oral sex.

3. I know other stds which you can get from oral sex is easily treatable, but can I reassure that if I don't get any other stds from this exposure , the chances of getting hiv is 0?

Correct

4. I am planning to get tested again next week at the mark of 6 weeks . I have read your forum and it is said that test at 6 weeks is conclusive? The clinic uses 4th gen test .

Correct. Your 6 week result will be completely conclusive.

Please don't believe the internet. The exposure you describe was a no risk event for HIV.

6. If you were in my place would you get tested after this exposure?

No, I would not bother to get tested. Testing however is a personal choice. If testing will be reassuring for you, then by all means, feel free to test to prove you were not infected.

7. Why is the recommendation of 3 months included? If 6 weeks is already conclusive

The three month recommendation is out of date. A six week combination HIV antigen/antibody test for HIV will provide conclusive results and does not need to be repeated.

I hope that this information is helpful. Please don't worry. EWH

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58 months ago

Thank you dr hook . It is really helpful but I would like to use the follow up questions that's been bothering me .

1. I know you said the risk of hiv through this is 0 but since she's a street hooker she might have had sex with plenty of guys before me. So if let's say she recently had unprotected sex with a hiv+ guy right before giving me unprotected oral sex , how long can the hiv virus be present in the saliva?

2. I forgot to mention that she is a smoker too but before I engaged in sex with her she told me that she doesn't have any disease because she had a family and this was just a side business that she have been doing. Will the chances of a smoker increase my risk of getting an std?

3. My girlfriend who is clean from all stds usually give me unprotected oral sex too but stopped recently since the exposure because I don't want to put her in danger. From your perspective is it okay to resume this act now without endangering her?

4. In any of your experience have you ever seen a 4th gen hiv test at 6 weeks turns positive after 3 months or more?

5. My malaysian doctor told me that hiv takes longer time and it's a very slow process and takes time to appear in the body . He told me to come back and get tested after 6 months. It's not that I don't want to be tested but it's a long period and my anxiety is taking over me . My question is why do they still offer this? Is it because there are a few cases of negative turning positive in 6 months?

6.can i just move on in my life once I'm done with my 6 weeks full std test? Thinking that i am free or should i be worried yet? Thank you once again

Edward W. Hook M.D.

58 months ago

1. the "what if", unlikely scenario is unlikely. It remains a FACT however that no one has EVER been documented to acquire HIV from receipt of oral sex and this sort of exposure has occurred millions of time. The question is irrelevant!

2. No change in my assessment

3. Yes, OK to receive oral sex from your GF. She is not at risk because of the exposure you described.

4. No, results at 6 weeks are CONCLUSIVE. This means the results will not change.

5. I cannot explain why your doctor suggested other than to suggest that perhaps he was being overly conservative. Results at 6 weeks are conclusive.

5. Yes, you can move on.

Hope this helps. EWH

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57 months ago

Thank you dr hook for the response, I'll would like to add a few more questions below

1. Is the window period for both hiv1&2 the same for 6 weeks? (Ag/ab) because i read in a few forums that hiv 2 takes a longer period to show up on a blood test and isn't detected using antigens. So would a test at 6 weeks be conclusive?

2. Even though I know that as you told 6 weeks test is conclusive but just wondering why the cdc still recommends a 12 week retest?

Pls keep this thread open so that i can share my results here . Thanks once again doctor

Edward W. Hook M.D.

57 months ago

1. Yes, results for both HIV-1 and HIV-2 are conclusive, particularly following the virtually no risk nature of the exposure you describe.

2. The CDC tends to be very conservative. Even so, most colleagues at the CDC agree that results of 4th generation tests are conclusive at 6 weeks.

As you know, we provide up to three responses to each question. This is my third response. Therefore this thread will be closed shortly without further responses. Take care. Please don’t worry. EWH

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