The actual risks of receiving fellatio

[mranxiety44]

Dear Doctor,

Two days ago I foolishly got very drunk and ended up in a massage parlour in Japan receiving a service from a Chinese sex worker that included unprotected fellatio.  As far as I can recall she didn’t appear to have any lesions or open wounds on her lips, and during the course of our interaction I also touched her genitals and kissed her.  I deeply regret what I did and am now suffering from a great deal of anxiety as I have a long-term partner and fear that I could pass any infection I may have contracted on to her.
Having read a number of articles on this website as well as posts by other users, I understand that there are no documented cases of a male contracting HIV from a female through fellatio, and the general advice is that it is not a concern. Is my understanding correct?
The information available on the Internet is often contradictory so I would also like to know what, in your experience as a doctor, the incidence of males contracting STDs after receiving fellatio from a woman actually is, what you think my risks are, and what tests you recommend I have.
Any information about the above as well as any symptoms I should look out for would be greatly appreciated.

Yours sincerely

A very anxious man

[Edward W Hook, MD]

Welcome to our Forum and thanks for taking the time to investigate  answers to your questions by review of past interchanges with other MedHelp users.  You are correct, despite the incorrect stories to be found on the internet, that there are no instances in which someone has been documented to have gotten HIV from receipt of oral sex.  In your own case, the statistics show that it is unlikely that your partner had HIV and as I noted above, even if she did, there is little risk for infection.

Your major risk from receipt of unprotected oral sex, and that risk is quite small, is for development of gonorrhea or non-gonococcal urethritis either of which would make themselves known by the presence of burning on urination or a discharge from your penis.  If you are concerned about these possibilities, you can easily be tested for them with either a swab test taken from the penis or a urine specimen taken just as you begin to urinate.

I would not be worried.  I hope my comments are helpful to you.  EWH

[Edward W Hook, MD]

No it is unrelated to the exposure you descirbed.  . EWH

[mranxiety44]

I see.
I forgot to mention that about 24 hours after the event a single lymph node in my right armpit became mildly swollen and slightly painful to the touch. It is still in the same state now, more than 48 hours after the event. Could this be a symptom of something?

[Edward W Hook, MD]

Unless the woman had lesions on her mouth, the risk for both syphilis and genital herpes is also quite low.  EWH

[mranxiety44]

Dear Dr. Hook,
Thank you for your reply.
Being of a nervous disposition I will probably get tested for gonorrhea.
I am not sure whether you can ask follow up questions in this forum, but if possible can you tell me what the risks from syphilis and herpes are? If not no problem, and thank for your advice.