UNPROTECTED ORAL SEX FROM CSW

[tomjager]

Hello Doctors, I am freaking out here. I am a straight male that had 2 encounters with CSWs in a brothel in Brazil:

- The first one, in 01/25/2013, we only had PROTECTED vaginal sex, with very deep kisses. Four hours before I had shaved my testicles area with a machine;

- The second one, in 01/30/2013, we had PROTECTED vaginal sex and I received UNPROTECTED oral sex during 30 seconds and very deep kisses. I had a very little wound in the interior of my lips. We made mutual masturbation too, with the same hand touching vagina and penis;

Starting in the 02/01/2013, I had a  mouth herpes event. I always had mouth herpes, but usually cures in 2 or 3 days. I am still with herpes today (02/08/2013), and with a throat ache.

I have some questions for you?
1) Do I need a HIV test?

2) What is the diference between the contact vagina-penis and the contact mouth-penis? Why the second one is safe, especially for the receptive?

3) Is there a possibility to be infected with HIV with PROTECTED vaginal sex with the contact with the vagina and the base of the penis, which is not covered with the condom?

4) And to be infected with mutual masturbation, with the same hand that touch vagina, touching the penis, seconds after? What do you think?

Thank you very much.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You had accurate replies both time you asked the same questions on the community forum.  HIV is rarely if ever transmitted by oral sex; some experts believe it never happens, and certainly there has never been a proved case of oral to penile transmission of the virus.  Kissing never transmits the virus and of course condom protected vaginal sex is safe.

Your longer than usual episode of oral herpes is not a sign of HIV or any other immune deficiency.  Some herpes episodes just last longer than others, and most episodes take 10-14 days to heal, so your current episode doesn't sound unusual, even if it's taking longer than previous ones.

To your specific questions:

1) You should have an HIV test.  NOT because you are at significant risk, but simply for reassurance.  It is obvious you are seriously anxious about it and a negative test result probably will be more reassuring than anything I can say.  However, you'll have to wait a few weeks for an accurate test result.

2) The reasons some practices are more risky for HIV than others are complex and not completely understood.  Part of the reason oral sex and kissing are safe is that saliva kills the virus.  Anyway, the biological explanation isn't important. What matters is that you could have the activities you have described once daily for your entire life and expect to never catch HIV, even if your CSW partners were infected.  And probably they were not; most CSWs don't have HIV.

3) As long as the head of the penis and urethral opening are covered by the condom, protection is believed to be complete.

4) Nobody ever caught HIV by fingering or hand-genital contact, even when genital secretions are used for lubrication.

You're seriously overreacting to a safe situation.  It is exceedingly unlikely you were infected during the exposures described.  Get tested for reassurance, but stay relaxed in the meantime.  Assuming no other risky events, the results will be negative.

Regards--  HHH, MD

[tomjager]

Thanks again for your time. Much obliged for the explanation. I will try to relax.

[H. Hunter Handsfield, M.D.]

You need to use a little common sense. You shouldn't need me to remind you that sore throat, most commonly due to viral pharyngitis, is one of the most common symptoms experienced by human beings.  Probably fewer than one in a million of them are caused by HIV, even in people at high risk -- and I have already explained why your event was a very low risk one.

That's the end of this thread.

[tomjager]

Can I relax even with Pharyngitis being one of the symptoms of ARS, according to the some articles in Internet?

[H. Hunter Handsfield, M.D.]

"Viral pharyngitis" means you caught a cold.  You could have caught it from the sex worker, especially if you kissed her.

[tomjager]

Hello Doctor, today I went to see an otolaryngologist in Brazil to investigate my sore throat. I am with viral pharyngitis and I should take ketoprofen for 5 days. My limph nodes were OK and I hadn't a single episode of fever.

- This has some kind of relationship with my intercourse? I had herpes and this viral pharyngitis three days after contact with the CSW. Possibly ARS?

I will test myself for HIV in a few weeks, but I trust in you opinion.

Thanks in advance.

[tomjager]

Thanks Dr. I will relax and probably, when my Herpes go away, I will clearly see that I dont need a test and I guess I will not do it. I will try to relax and you are right: I am overreacting.

Thanks for your help. This site really rocks.