Regarding Protected Oral Sex

[amirr299]

Yesterday I Received Oral Sex with a Condom on from a CSW. The act itself only lasted about 25-30 seconds and she applied lubrication (water based) before putting the condom on. I ejaculated in her mouth (with the condom on). And when I withdrew there was no discernible leakage. There was also a small bump at the base of my penis but her mouth never made contact with it.

My questions are.

1.) Should I be concerned over possible HIV infection from this incident?
2.) When should I be tested and what would be the best sort of test for this?
3.) Does the bump at the base of my penis increase the likelihood of transmission?
4.) May I post my results when they're out?
5.) What sort of symptoms should I be on the lookout for and when? Will any symptoms change your outlook?  

[Edward W Hook, MD]

Welcome to our Forum.  Condom protected sex is safe sex.  Further, in terms of your exposure, even unprotected receipt of oral sex is safe sex which has never been associated with risk for HIV.  You need not worry about the exposure you describe.  No need for concern and no need for testing.  

As for your specific questions:
1.) Should I be concerned over possible HIV infection from this incident?
No, there has never been a case of HIV proven to have been transmitted through receipt of oral sex from and infected partner.  You will not be the first.

2.) When should I be tested and what would be the best sort of test for this?
There really is no need for testing .  If you feel you must test for your own peace of mind, at 4 weeks after exposure a 4th generation, combination HIV p24 antigen/HIV antibody test will provide definitive proof that you were not infected.

3.) Does the bump at the base of my penis increase the likelihood of transmission?
No, not at all.

4.) May I post my results when they're out?
Certainly.  Even before you do, I am confident they will be negative.

5.) What sort of symptoms should I be on the lookout for and when? Will any symptoms change your outlook?  
Symptoms are a poor indicator of infection.  You are not at risk., Please do not worry.  EWH

[Edward W Hook, MD]

Mouth ulcers are not a sign of recently acuired HIV infection.  

The symptoms of the ARS (fever. muscle aches, sore throat, rash, joint painss and sometimes diarrhea) tend to come on all at about the same time, 2-6 weeks after an exposure. Less than half of person who get HIV have the ARS.  

Again,. I urge you not to worry.  EWH

[amirr299]

Hi Doctor

I just have a quick statement for clarity and a question. I'm having a test performed in a week (this is the third week exactly today). I've had no fevers, no swelling of the lymph nodes, I had one night sweat earlier in the week and couldn't sleep after (either due to anxiety or some other factor) and that seems fine only I need some reassurance on another issue. This week I've begun to develop several mouth ulcers. I've read that this is a symptom and given the outbreak I'm not sure what to make of it.

It should be known that I'm a smoker who is slowly trying to stop (went from a pack a day to only 3 individual cigarettes). I know smoking cessation would cause ulcers but I haven't altogether stopped. Also I used to live in Africa (never had sex there) and I've only lived in Boston for 3 months and it's gotten a lot colder.

Can you just clarify how consistent the ARS symptoms are? Is it a lot of symptoms at once or can it be a few? Are these ulcers anything I should be concerned about? I know it's a low risk exposure I just need some clarification.