[Question #795] Unprotected Oral Sex and Herpes

90 months ago
hey doc,

I'm 32 year old married Indian male. On 20th May visited to a massage parlor I did something very stupid. The massage parlor worker gave me oral sex, I'm scared that she gave me HIV because I was not wearing a condom. I did not come in her mouth, she gave me oral for about 2-3 mins. She was boasting about how she gives oral almost to every customer.

I have a history of herpes, short itchy pimples on the head of the penis. One doctor misdiagnosed them earlier as Balanits.  A skin specialist got me tested and the result came back as herpes, this was 5 months back. He gave some medication and it was causing lot of drowsiness so I stopped the pills, it was affecting my work.

although when this incident occurred I had no pimples or any other problem, neither have I had anything since. 

Here are my specific question:

1. Are there chances of me getting HIV because of my herpes/balanitis condition? I read on some website that there is no way for a reciever to get HIv because there has to be lot of bleeding involved which there wasn't.
2. is there a need to be tested?
3. Can i go back to normal sexual relations with my wife? with no chance of affecting her.
4. I want to see a counselor for my behavior, but will do after putting this incident behind me, I feel guilty and disgusted. Puke whenever I think of what I did.

Please review and advise.
90 months ago
I would like to add that I was tested for hiv in dec last year and the result was negative. Also sorry about submission in the wrong category, cannot find button to edit and move to the right category.
H. Hunter Handsfield, MD
90 months ago
Welcome to the forum. Thanks for your question. 

1) With regard to HIV risk, oral sex is safe sex, with an extremely low risk of transmission of the virus, if any risk at all. There has never been a proved case of HIV transmission mouth to penis. One estimate by the US Centers for Disease Control and Prevention (CDC) is that the virus might be transmitted once for every 20,000 exposures, if the oral partner has HIV. That's equivalent to receiving oral sex by infected partners once daily for 55 years before transmission might be likely. Having genital herpes increases the risk of HIV if exposed, the elevated risk is only about double, i.e. a two-fold increase. So that means that your risk would have been one chance in 10,000 instead of 20,000. Still exceedingly low. And even these figures assume your partner had HIV, which she probably did not. In summary, the chance you acquired HIV is zero for all practical purposes.

2,3) For those reasons, from a medical standoint there is no need for testing. If somehow I were in your circumstances, I would not do it, and I would continue unprotected sex with my wife without any concern that I could infect her with HIV. But of course you are free to be tested if the negative result would increase your confidence you were not infected.

4) Do not confuse your shame and guilt over a sexual decision you regret with the medical consequences of that decision. They are not the same. Deal with the former in whatever way works best for you, but don't worry about the latter.

I hope this has helped. Best wishes--  HHH, MD

90 months ago
Thank you doctor. I don't want to waste money if there is no risk. As I mentioned I was not having herpes when the incident occurred, in fact I have it only when I have unprotected sex with my wife, which I have not for months so haven't seen it for months. So I'm unsure of what this infection really is?

but I digress I'm relieved to here your assessment, I have decided I'm going to move on and forget this ever happened and skip testing. maybe even take a short vacation to clear my mind.

Thanks again for your help.
H. Hunter Handsfield, MD
90 months ago
Genital herpes due to HSV2 increases HIV risk regardless of whether or not there is an outbreak at the time. But that doesn't change my assessment and advice: you were not at risk for HIV from this event. (Based on your description, I'm also not certain you have genital herpes, by the way. But that's a topic for a separate discussion, should you wish to ask a new question about it.)

Thanks for the thanks. I'm glad to have helped.