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Oral/STD

Dear Dr. Handsfield

Thank you for your endless work.
I have checked diverse discussions in this forum, but I am a little bite confused.
Sorry, that you have to repeat the same things over and over...please, do not delete it!!!

12 days ago, I (man) received oral sex from a Russian feamle prostitutes in mid Europe. Actually, I was looking for a condom, but she was faster than I...so it was unprotected oral sex (could NOT see any blood on her lips...).

So, I have two questions.

1) Sometimes, you say that it is no risk (at all) and there is no testing required regarding HIV. Sometimes, you say it is a low risk. What is it actually. Do a I need testing? Do you think that this is a risk?

2) Last week, there was a contemporary article, that In Europe Syphilis is growing in numbers due to unprotected oral sex. After this 12 days I have no signs of ulcerus, discharge or other things. How do estimate the risk of other std's like syphilis and when is testing required (how many days later?)

Thank you
Best regards from Europe

Pete
4 Responses
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Avatar universal
I read the following today, and I think it is a terrific way to consider the risks: (it is from http://www.aidsmeds.com/lessons/Transmission4.htm)
"Here's a good way to think about theoretical risk [of oral-genital HIV transmission]: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex
Helpful - 2
Avatar universal
Whats with these devoshki (Russian for girls) causing all these problems, eh? :) I had a similar incident, though with a local student in Moscow rather than a worker.  Alas, they are too beautiful for our good I think!
Their vexing, however, will not have given you HIV.
The doctor has never recommended testing for someone having only received oral sex.  There have been no cases of HIV being proven to transmit this way--this satement has been testified too by the doctor on this forum, the San Francisco health department, etc.  If you are worried, here are some sites:
http://forums.poz.com under "Do I have HIV"?
Look for some of the common responders (they have thousands of replies listed) who have read through thousands of people's stories (both HIV positive and negative).  They know what they are talking about.
http://www.dph.sf.ca.us/sfcityclinic/drk/hivaids.asp
The health department of one of the largest HIV populations in the country--they see new HIV cases every day.  Never from receiving oral.

Furthermore, there have been several studies of couples who one is + and one is -.  One, from Spain, even included risk factors such as viral load, etc and racked up ~16,000 instances of oral sex with NO NEW INFECTIONS.
The only studies indicating oral sex is at all unsafe, have been deemed to be based upon unsound epidemiological data.  The doctor here has said so.

If you are STILL unconvinced, go get a test.
Coincidentally, although there is a mountain of evidence against it, I am still a bit worried too.  This is very natural and normal.  Everyone thinks they will be the first case ever of this, myself included, but c'mon.

As far as syphillis goes, you will have to ask the doc.  But whats a few shots of penecillin, eh? :)
Helpful - 1
Avatar universal
Thank you both, Dr. Handsfield & Splashsplash, for the clarification and reassurance.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
1) Usually I describe such exposures as "zero risk, or too low to measure"; or "zero risk for practical purposes".  But I do not try to be absolutely consistent each time and sometimes just say zero.  The point is that although some reports suggest that receiving oral sex was the source of a new HIV infection, such transmission has rarely if ever been definitively proved.  That doesn't prove it cannot occur, but it means it's too rare to worry about.  In general, I never recommend HIV testing after single low-risk exposures on medical or risk-assessment grounds.  However, I commonly recommend testing when a person is anxious and frightened, because the negative result helps some (not all) such persons work through their fears.  If that applies to you, get tested.

2) Syphilis and HIV are different diseases.  Oral sex has always been responsible for a minority of syphilis transmissions.  I cannot comment on a "contemporary article'--presumably not from a scientific source--that I haven't seen, but it is plausible that syphilis transmissions by oral sex may be rising in parts of Europe.  That doesn't mean that oral-genital HIV transmission is an important or growing problem.  Most people with syphilis develop an obvious sore (the chancre) at the site of exposure, typically 3-6 weeks later.  If concerned, a blood test can be done at 6 weeks to assure against syphilis.

HHH, MD
Helpful - 0

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