[Question #7675] Oral exposure

2 months ago
Hi Dr. I recently had a risky exposure. I had unprotected oral sex with a male (I am a male as well). He gave me fellatio for approximately 5 mins. I was very drunk and I didnt ejaculate. I dont recall givimg him fellatio but i do recall having his semen in my mouth. I think he masturbated and I subsequently took his semen into my mouth.

I dont think i had any cuts in my mouth but i did notice a slight graze on the inside of my lip the following day. The other male was around 55 years old. He was adamant he didnt have any STIs but wouldnt say when he was last tested, if ever. 

What are my risks of exposure to specifically HIV, Gonnorhea etc. HIV worries me the most. I have a female partner and am now worried I should abstain from sex with her. Would you personally be worried, does this exposure warrant a HIV test? Does it warrant other tests? This exposure was only a few days ago. 
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
Welcome to the Forum.  Thanks for your questions.  Oral exposures are among the least efficient (from a biological perspective) mechanisms for transmission of STIs, including HIV.    There are no cases in which HIV has been proven to be acquired through receipt of oral sex and acquisition from performance of oral sex is extraordinarily rare (even conservative estimates suggest performance of,oral,sex on an infected planter results in infection no more than once in every 12,000 exposures, on average).  There are no data on risk for HIV from swallowing semen from and infected person without performing fellatio directly on that person but I am confident that the risk for infection is far lower.

With respect to other other STIs, as noted above, there are no data related to the risk of swallowing infected semen without performing fellatio but without a doubt, the likelihood of acquiring infection is vanishingly low.  For receipt of fellatio the main risk is Gonorrhea and perhaps non-chlamydial non-gonococcal urethritis, both of which are most typically symptomatic.  The risk for both of these infections is relatively low and if you have not become symptomatic within 10-14 days of exposure I would not be concerned.

I hope these comments are helpful.  If any part of this is unclear or there are further questions, please don’t hesitate to use your up to two follow up questions for clarification. EWH 
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2 months ago
Thanks for your speedy reply Dr Hook. Just a few follow up questions. 

1. Based on the exposure and the low percentage risk in relation to HIV would you advise getting tested solely based on this single exposure before engaging in sexual relations with my partner or are the numbers so low and the risk that minimal for it not to be of realistic concern. 

2. Likewise in relation to other STIs, should i wait for a period and get tested before engaging in sexual relations or would a symptom free period of 14 days be adequate. 
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
1.  I see little reason to worry about HIV from the exposure you report. I do not feel strongly that you need testing nor do you need to abstain from unprotected sex with your regular partner.
2.  STI’s are substantially more common than HIV but as I mentioned above most of the STI’s that you were risk for from receipt of oral sex are become symptomatic within a week to 10 days of exposure. 14 days without symptoms would be sufficient and make the likelihood that you acquired an STI from receipt of oral sex negligible. You could be tested before that if you wish (around 4 to 6 days) and be sure that you did not pose a risk to your partner.

Hope this helps. EWH 
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