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STDs (Expert Forum)
CMV - Protected Oral Sex Concern
Answered by
University of Washington
Seattle - WA
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IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
CMV - Protected Oral Sex Concern
by concernedpapa, Sep 07, 2006 12:00AM
Hello Dr.,
I'm writing about a recent interaction that I had with a massage worker. I took a drunken trip to a massage parlor, and as you've seen many times on this web site I received protected oral sex from a female worker.
I've looked through some of the other postings and I gather that my risk of acquiring an STD ranges from VERY small to none at all. However, I am still concerned for two reasons. 1. Because like many of the men here I have a very guilty conscience. And, 2. Because my wife is now ~27 weeks pregnant. (This is of course the reason that I hadn't had sex in some time and was out fooling around, but that is NOT an excuse. I feel pretty terrible about what I've done. Hindsight is 20/20.)
Regarding the pregnancy, I'm only concerned that I might have possibly contracted cytomegalovirus (CMV). I have no idea if I was previously exposed. I did not kiss the sex worker. She did not apply the condom orally. I was careful to avoid getting her saliva on my penis while removing the condom. However, I'm afraid that some saliva may have run down to my anus. (Sorry for being so graphic.) I'm not sure if this happened, but I worry anyway.
So, should I be worried about getting CMV from this act? My concern is obviously that I may have contracted CMV and may later transmit it to my wife, who may transmit it to our unborn son, who may then have developmental problems.
I've looked at the statistics on CMV and birth defects, and based on the ranges from the March of Dimes site on CMV I have between 0.5% and 0.05% chance of causing developmental problems in my unborn child from this act. And that's assuming that the probability of transmission from the worker to me and me to my wife is 100%. So the risk logically seems vanishingly small, but the implications for our child and the rest of my life seem very high.
Sorry for the excessive detail. Here are some specific questions.
1. Should I be tested for CMV?
2. How soon after exposure will the CMV antibody appear in a test? It would be great if I could be tested twice. First to see if I was previously exposed as a child and a second time to see if this occurrence exposed me.
3. If I have been exposed for the first time, what can I do to avoid transmission to my wife? Will sharing a drinking glass lead to transmission, or is more intimate contact required like kissing / sex?
4. How soon after my own exposre would I present a risk of exposing my wife?
5. Is first time exposure late in the pregnancy more or less risky for the fetus? I would assume less.
Obvioulsy, I would never have done this if I had recognized that this was a risk. I'm a natural worrier anyway, but I feel like this might be a legitimate health concern.
Sorry for the long posting. I know that you must have many. Feel free to answer only the questions that you consider the most important.
Worried and guilty,
-J
I'm writing about a recent interaction that I had with a massage worker. I took a drunken trip to a massage parlor, and as you've seen many times on this web site I received protected oral sex from a female worker.
I've looked through some of the other postings and I gather that my risk of acquiring an STD ranges from VERY small to none at all. However, I am still concerned for two reasons. 1. Because like many of the men here I have a very guilty conscience. And, 2. Because my wife is now ~27 weeks pregnant. (This is of course the reason that I hadn't had sex in some time and was out fooling around, but that is NOT an excuse. I feel pretty terrible about what I've done. Hindsight is 20/20.)
Regarding the pregnancy, I'm only concerned that I might have possibly contracted cytomegalovirus (CMV). I have no idea if I was previously exposed. I did not kiss the sex worker. She did not apply the condom orally. I was careful to avoid getting her saliva on my penis while removing the condom. However, I'm afraid that some saliva may have run down to my anus. (Sorry for being so graphic.) I'm not sure if this happened, but I worry anyway.
So, should I be worried about getting CMV from this act? My concern is obviously that I may have contracted CMV and may later transmit it to my wife, who may transmit it to our unborn son, who may then have developmental problems.
I've looked at the statistics on CMV and birth defects, and based on the ranges from the March of Dimes site on CMV I have between 0.5% and 0.05% chance of causing developmental problems in my unborn child from this act. And that's assuming that the probability of transmission from the worker to me and me to my wife is 100%. So the risk logically seems vanishingly small, but the implications for our child and the rest of my life seem very high.
Sorry for the excessive detail. Here are some specific questions.
1. Should I be tested for CMV?
2. How soon after exposure will the CMV antibody appear in a test? It would be great if I could be tested twice. First to see if I was previously exposed as a child and a second time to see if this occurrence exposed me.
3. If I have been exposed for the first time, what can I do to avoid transmission to my wife? Will sharing a drinking glass lead to transmission, or is more intimate contact required like kissing / sex?
4. How soon after my own exposre would I present a risk of exposing my wife?
5. Is first time exposure late in the pregnancy more or less risky for the fetus? I would assume less.
Obvioulsy, I would never have done this if I had recognized that this was a risk. I'm a natural worrier anyway, but I feel like this might be a legitimate health concern.
Sorry for the long posting. I know that you must have many. Feel free to answer only the questions that you consider the most important.
Worried and guilty,
-J
Doctor's Answer
by H. Hunter Handsfield, M.D., Sep 07, 2006 12:00AM
, Sep 07, 2006 12:00AM
Because you are an adult, the odds are good you already are infected by CMV. Ditto for your wife; most people by your age already have been infected. That virus isn't only sexually transmitted. But to the extent there is sexual risk, it is generally thought to be from unprotected vaginal sex, not by kissing or other non-genital sexual contact. As you say yourself, "he risk logically seems vanishingly small", and there are no guidelines to answer your questions. The main risk to pregnant women probably comes from exposure to infected children during pregnancy, not sexual acquisition.
Thus, my direct responses to your questions are: 1) No. 2) CMV seroconversion takes a few weeks; I cannot be more precise. 3) The only way to be sure would be to avoid all kissing and all unprotected sex. I wouldn't worry about shared glasses and utensils. 4) Whatever risk there is probably is highest in the first few weeks after acquisition. 5) The risks are greater early in pregnancy.
You are obscessing inappropriately and unnecessarily about this. Let it go, pregnant wife or not.
Good luck-- HHH, MD
Thus, my direct responses to your questions are: 1) No. 2) CMV seroconversion takes a few weeks; I cannot be more precise. 3) The only way to be sure would be to avoid all kissing and all unprotected sex. I wouldn't worry about shared glasses and utensils. 4) Whatever risk there is probably is highest in the first few weeks after acquisition. 5) The risks are greater early in pregnancy.
You are obscessing inappropriately and unnecessarily about this. Let it go, pregnant wife or not.
Good luck-- HHH, MD
I'm certain that I'm needlessly torturing myself about this, but I was wondering if your comment about letting it go is because the protected oral sex was unlikely to transmit the virus even if she was contagious? Or is it just that it's highly unlikely that she had it and was contagious, that I haven't had it, and that my wife hasn't had it?
I guess I'm really obsessing about this. I guess it's time to forget about it.
-J