Pls kindly help me - desperate

[helpmepls168]

Hi, doctors,

I am a male in China. i know the opinion from HIV Prevention Community on unprotected oral sex is "no risk". but would you pls kindly read me discription before making judgement?

1. unprotected passive oral sex by a commercial sex worker (female) for around FIFTEEN MINUTES. no other exposure. i am not sure wether the answer will be changed due to that long period (15mins). according to my estimate, the girl will provide service to no less than 10 people each day.
2. there was a ulcer on her lip and she said she caught a cold that day.
3. should i have hiv test? in china, ulmost all doctors say it is risky and should have hiv test
4. What if she is infected?

Thank you
Helpmepls168

[Edward W Hook, MD]

Welcome to our Forum.  I have read your description above and there is nothing about it that raises any concern that you are at risk for acquisition of HIV.  As we have said many, many times there is NO scientific evidence that performing oral sex on a partner has lead to acquisition o f HIV.  These data are from large studies reporting on thousands of exposures.  In addition, there are no well documented situations in which persons  have clearly acquired HIV through oral sex.  This is true even if the person have oral ulcers, bad dental hygiene, or cuts in their mouth or lips.  As a result, we do not see any medical reason to recommend testing in this situation.

I realize that there are reports on the internet which suggest that HIV can be passed this way but they are NOT based on scientific fact or observation.

therefore:
1.  this was a no risk exposure.
2.  That she had an ulcer on her lip does not change this.
3.  There is no medical reason for testing . If you choose to test, you are testing to convince yourself that there is not a problem.  I am confident that if you test, the test will be negative.
4.  The she might have been infected makes no difference.  

I hope my comments help.  there is no risk from the exposure you describe.  EWH

[Edward W Hook, MD]

No, this would not change my answer.  It is now time for this thread to end.  Take care.  EWH

[helpmepls168]

I am last question, would you pls kindly give me a help.
I am not sure whether i have been infected with other STDs before this oral sex since i have no any symptoms of STD before this exposure. But if i think about the worst case: if i have some STD without symptoms and have the oral sex, will your answer be different? still no need for test? Thanks

[helpmepls168]

You are always helpful. Thank you very much!

[Edward W Hook, MD]

The only STDs which really are important to test for are gonorrhea and nongonococcal urethritis (NGU or NSU).  Chlamydia is virtually never spread through oral sex.  Syphilis is quite rare and typically would present as a lesion at a site of exposure.  Herpes likewise typically presents with lesions. EWH

[helpmepls168]

Thanks a lot. I got it.

How about the quesiton regarding other STDs? I am not sure whether it is a good place to ask this kindly of question. Thanks again.

[Edward W Hook, MD]

Our statements to prior questions have not quoted a risk of 1 in 20,000 (or 10,000) but have said "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."  We have said this for years and as time has gone on, both Dr. Handsfield have come to the conclusion that there is no meaningful risk for HIV related to oral sex.  Thus the comments are really quite similar.

This assessment does not change whether or not you partner had blood in her mouth, sores in her mouth or dental/gum disease.  EWH  

[helpmepls168]

Hi, Doc, besides the other 2 questions (one about other STDs and the other about blood), i have the last question (sorry for so many questions):

i read your answers to other similar posts and notice you quote the odds of 1 in 20,000 for receiving oral sex. but in my post, you mentioned "no risk exposure". why is there difference?  just for curiosity.

BW
Helpmepls168

[helpmepls168]

Regarding HIV, can i ask one more question: i did not notice whether there was blood in her mouth that day. If there was blood, what is the risk? Sorry for bothering you again. Thanks

[helpmepls168]

Thanks a lot for your response. It is really a very strong reassurance for me. you provide me not only scientific comments, but also great relief to me. I think i should be able to go out of the woods of HIV. As you know, there is too much conflicting information on the internet.

Would you pls kindly let me ask another question regarding other STDs. Until today, it is already 12 days after the "exposure". I have no any symptom. So what kinds of STDs can be excluded and what STD should be tested?

Thanks again. i am really appreciated your help and professionalism.

Regards
Helpmepls168