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Dr. Hook - Oral Sex with Menstruation
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Dr. Hook - Oral Sex with Menstruation

Dear Doctor,

Last week I met a girl at a bar in the bahamas. She was Colombian. We went back to my place, and I performed cunnilingus on her, for a maximum of 30 seconds. I didn't notice any blood. She then put a condom on me and performed protected oral sex. We finally had 2 minutes of sex when I realized what was happening wasn't right. I know for a fact that the condom did not break.

The next morning I realized that there was dry blood on two of my fingers and a bit of blood on the bed sheets. I didn't have a sore throat, however I had been coughing on a daily basis for the last two weeks. I also remember that for the two mornings before this encounter, when brushing my teeth some blood would occur from my gums. It wasn't anything special, and would go away right after the brushing.

In my situation, I am more scared about the cunnilingus. I would like to know which STDs I should be worried for, and if HIV is a possibility? If HIV is possible what are the odds of getting it? Many people on this site have said the chances are 0.

Please also note that I saw her with an older man the following day, so she may have a lot of sexual experience. Also, she was pretty serious about the protection. Finally, I noticed that only 0.5% of Colombians have AIDS, and assuming she is an escort (even though I didn't pay her), I would assume she had a greater possibility (maybe 5%) of having it.

Should I go get tested, if so when should I go? I was planning on going now for STDs in general, then in 6 and 12 weeks.
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Welcome to the Forum.  To restate your question, you are concerned that you may be at risk for an STD (including HIV) from performance of cunnilingus on the woman you describe.  You are correct that there should be no risk to you from her performance of condom protected oral sex on you, nor from condom protected genital contact.

Let's start with oral sex.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  This includes by all of the people who had gum disease (bleeding), mouth sores, etc.  I no longer even recommend HIV testing for persons such as you whose only exposure is oral sex.

As for other STDs, the major STD to test for is gonorrhea.  Occasionally (but not often) gonorrhea is spread to others through oral sex.  The likelihood of this is low- most people, even most commercial sex workers do not have gonorrhea and most exposures to infected partners do not result in infection. Cunnilingus in particular has a particularly low risk of transmission.  Chlamydia is too rare to be a concern and unless there were lesions present, there is no risk for syphilis or for herpes.

I hope this comment is helpful. This was a very, very low risk exposure.  EWH
9 Comments
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I can't stop thinking about this.
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Avatar_m_tn
The coughing was the two last weeks prior to the encounter*
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Avatar_m_tn

Can I go get tested for the STD that you mentioned right away? Or should I way a couple of days / weeks?
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Avatar_m_tn

Can I go get tested for the STDs that you mentioned right away? Or should I wait a couple of days / weeks?
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300980_tn?1194933000
Tests for gonorrhea taken at any time more than 24 hours after your exposure will be reliable.  EWH
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Avatar_m_tn
I will update you in the following weeks.

Thank you for your time and patience.
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Avatar_m_tn
Did you original response take into consideration the blood on the bed sheets that were related to menstruation from the woman's part?

~thanks
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300980_tn?1194933000
Last answer- yes, my original answer did  consider the possiblity of blood on the bed sheets.  End of thread. EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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