[Question #9486] Brief unprotected blowjob HIV/STD risk

32 months ago

I had 2 exposures last week with 2 escort girls thru an agent. 1st exposure 10 Dec 1AM: Fully naked body massage. Unprotected handjob with oil/lotion. French kissing (<1min). Me giving breasts & nipples licking (<1min). No vaginal contact at all (she wore panty). Ejaculate thru handjob. No any sort of discomfort afterwards. 2nd exposure 11 Dec 11PM: Fully naked shower tgt (with body soap). During shower, my bare glans rubbed her area around bellybutton, breasts, nipples, buttocks (upper back part close to waist), total under 5min. After shower, unprotected handjob with oil/lotion. Unprotected blowjob (<1min), licked my bare glans, shaft, scrotum. Then protected blowjob with condom (5-10min). Licked my nipples. She also rubbed my penis (with condom) outside her vagina twice (5s each). No insert/penetration for sure. Then i took condom off and rubbed in between her breasts till ejaculation (<1min). Right after 15min i had shower, felt high burning pain when glans touched water, so painful that cannot touch water for >2s. The next morning, no more pain with water, but small continuous pain around urethral opening, noticeable when sitting, walking and after urinating. Skin around opening looked red too. Till today (5 days after 2nd exposure), still having that small pain around urethral opening and red skin is fading gradually. No pus dripping, discharge, painful urination. I got paranoid that asked the agent about the 2nd girls's status, was told she got tested 1-3 wks ago with negative results. She also only works for 1-2 days per wk. Questions (1) 1st exposure was practically no risk of any std/HIV/HPV? (2) Any std risk in 2nd exposure shower body rubbing? Soap can act as protection? 3) For that 1min unprotected blowjob, any std risk esp. HIV/HSV2/Syphilis? Do you consider 1min event is practically no risk? (4) Any practical risk of 10s vagina rubbing with condom? (5) My symptoms can be gonorrhea or any std? (5) Any test needed and when?

Edward W. Hook M.D.

32 months ago

Welcome to the Forum and thanks for your questions. I'll be glad to comment. Before I get to your specific question, let me remind you that most commercial sex workers do not have HIV or other STIs and even when they do, most exposures do not lead to infection. In your case, overall, these were low risk exposures. The only direct penetrative exposure you had was your brief (<1 minute) receipt of oral sex and that was low but not no risk as occasionally persons can get gonorrhea or NGU from receipt of oral sex if the partner happens to be infected (probably unlikely in your case- oral infections are relatively uncommon and your exposure was brief). With that, let's address your specific questions:

(1) 1st exposure was practically no risk of any std/HIV/HPV?

Correct- no risk at all. There are no STIs acquired from receipt of masturbation, French kissing, the vaginal contact you describe, or having your nipple and breasts licked. There is a theoretical but inconsequential risk of HPV from any direct contact and I would not worry about it.

(2) Any std risk in 2nd exposure shower body rubbing? Soap can act as protection?

No risk from shower body rubbing. The presence of soap would reduce risk for infection but even without soap, there is no appreciable risk.

3) For that 1min unprotected blowjob, any std risk esp. HIV/HSV2/Syphilis? Do you consider 1min event is practically no risk?

See my comment about your unprotected receipt of oral sex above. The risk is very, very low

(4) Any practical risk of 10s vagina rubbing with condom?

No risk

(5) My symptoms can be gonorrhea or any std? (5) Any test needed and when?

Your symptoms occurring during and so soon after your encounter are too soon to be due to gonorrhea or other STIs. My suspicion is that the friction rubbing and musturbation caused minor abrasions which were irritated by the soap. I suspect your discomfort will improve over the next few days as appear to be the case

I hope this helps. If there are further questions or any part of my response is unclear, please use your up to two follow-ups for clarification. EWH

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32 months ago

Thanks Dr. Hook for your reply. I am going to take a panel test due to reassurance and my fear. Would you please advise (1) Test window period, (2) incubation period, (3) How confident are you i didn't get it from both exposures (4) What are the high risks/most common ways to get the sti. I'm Asian btw. Thanks a lot for your help again.

(1) HIV. Read from other thread that HIV RNA test is conclusive at 11 days, correct? Is 4th gen test at 6th wks needed afterwards?

(2) HSV 2. Read that Igg test is not reliable but this is the only test available in my country, what's the percentage of getting false positive result along with no presence of symptoms? Also if symptoms are present, is it something that i won't miss like severe pain? I'm scared that i could miss it.

(3) Syphilis. If symptoms are present, is it something that i won't miss? I'm scared that i could miss it.

(4) HBV. I did tests of HBV surface Ag, HBV core Ab, HBV surface Ab a year ago, all negative. I was told that i was vaccinated with HBV when i was small but seems the antibody is gone.

(5) Gonorrhea. Till today 6 days post last exposure, no presence of discharge.

(6) NGU. Till today 6 days post last exposure, no presence of discharge.

(7) HPV. My place provides penile swap test, from scrotum, shaft to glans. How accurate/reliable do you see this test is? Is this even approved?

Edward W. Hook M.D.

32 months ago

In general the test window period and incubation period are about the same. I've already commented about your level of risk- it is low. Your questions basically ask for a textbook of STIs. Please re-read my original response carefully and try to control your anxiety. On to your follow-ups with brief responses related to your very low risk encounters:

(1) HIV. Read from other thread that HIV RNA test is conclusive at 11 days, correct? Is 4th gen test at 6th wks needed afterwards?

$th generation, combination tests for HIV are conclusive at 6 weeks following an encounter. Many consider HIV RNA PCR tests reliabile any time more than 11-12 days following an encounter but also, being cautios, recommend a 4th generation test at 6 weeks. Nothing you described put you at risk for HIV.

There are no good answers to your questions. HSV blood tests are unreliable following exposures such as your and are virtually never acquired from receipt of oral sex. We recommend testing for HSV unless you have lesions. If lesions appear, you should have a PCR test for HSV from the lesion

(3) Syphilis. If symptoms are present, is it something that i won't miss? I'm scared that i could miss it.

Your risk for syphilis is very low. Should a lesion appear, you should have a blood test.

(4) HBV. I did tests of HBV surface Ag, HBV core Ab, HBV surface Ab a year ago, all negative. I was told that i was vaccinated with HBV when i was small but seems the antibody is gone.

If you were vaccinated, your risk is virtually zero even if exposued. Nothing you describe suggests exposure to hepatitis B

(5) Gonorrhea. Till today 6 days post last exposure, no presence of discharge.

Testing for gonorrhea and chlamydia using a urine test is reliable any time more than 5-6 days following an exposure. As for other STIs your risk in miniscule.

(6) NGU. Till today 6 days post last exposure, no presence of discharge.

No symptoms, no concern.

(7) HPV. My place provides penile swap test, from scrotum, shaft to glans. How accurate/reliable do you see this test is? Is this even approved?

Testing of the sort you describe is not recommended. Most sexually active adults will acquire HPV unless they are vaccinated. If you want to know more about HPV please read other threads on the Forum on this topic.

One reply remaining- responses will be brief. Again, I emphasize that the risk for any STI from the exposures you describe is negligible and not something I would be worried about at all. EWH

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