Unprotected Oral Sex

[wcn7]

Hi Doctor,

Thank you for taking my question. Last night I went to a seedy type strip club and, unfortunately, had too much to drink. I had two different lap dances in a private area, where the strippers/sex workers performed unprotected oral sex on me.

During the first dance, the stripper/sex worker probably performed unprotected oral sex on me for about 5 minutes.  The only thing I know is that she said that she is Colombian, has lived here in the US for a while, and has been a regular at this club for a while.

Later on during the night, I had another lap dance with another stripper/sex worker, who also performed unprotected oral sex on me.  She was black/African American and performed unprotected oral sex on me for about 15 minutes. I also remember that she had a tongue ring as well.

I know that, prior to them performing unprotected oral sex on me, they had also gone in the back rooms quite a bit to give private dances to other men- so I can definitely assume that they were doing similar type stuff with other men before me.  

Also, this morning I noticed that I have some scraped skin in different areas of penis as a result of last night.

In these two situations of the strippers/sex workers not using condoms to perform unprotected oral sex on me, I would like to ask the following questions:

1. Is there any risk that I could have been infected with HIV from these two situations?
2. If so, how much risk?
3. Do I need to be tested for HIV?
4. Are there any other STD's that I should be concerned about?
5. If there are STD's to be concerned about, how and when could I be tested?

Thanks very much for help

[Edward W Hook, MD]

This will be the last answer.  If you acquired gonorrhea from your exposure on Saturday, your tests will be postive.  You need to stop worrying.  this completes the thread.  EWH

[wcn7]

Dr.

I hate to be a pest, but have a follow-up question. I will be going back to the urologist, who prescribed me cipro for possibly having had a UTI a couple weeks back, in a week or less for a follow-up visit. I stopped taking the cipro last Thursday and then received unprotected oral last Saturday night. Will the urine test the urologist does in the next few days or week show gonorrhea, or will I have to go to a STD clinic for the urine test?  At this point, I haven't seen any discharge- just that my urethra appears to be red (not sure if this means gonorrhea or NGU?)

Thanks very much again, and sorry for the extra question

[Edward W Hook, MD]

The cipro you took could reduce the likelyhoo of eveloping symptoms if you had gonorrhea or NGU.  Testing using either a penile swab or a urine test would be the best way to make sure there was not an infection present. EWH

[wcn7]

Dr. Hook,

Sorry to post again. I forgot to mention that when I was just taking the cipro for a potential UTI, I did not have any discharge or burning when urinating symptoms.  I just had frequent urination and a few white cells in my urine.

Thanks again

[wcn7]

Dr. Hook,

Thank you for reviewing my situation.  For gonorrhea and NGU, If I don't get any discharge or burning when urinating in the next 7 days, would the urine test be the only test to take?  Incidentally, 3 days ago I finished taking a weeks prescription of ciprofloxacin 500MG that I was taking because of a urinary track infrection. Does that matter at all in regard to gonorrhea or NGU?

Thanks again

[Edward W Hook, MD]

Welcome to our Forum. We get many questions of this sort.  I'll be happy to comment, going straight to your questions:

1 an 2.  There is virtually no risk of getting HIV from the exposures you mention.  Most commercial sex workers do not have HIV an even if one of your partners did, 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.  

3.  In my opinion, based on the facts above, you do not need HIV testing.

4 an 5.  This is a slightly modified comment I made to another client-  "Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are acquired from oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you will most likely develop symptoms of urethritis (penile infection) in the next 3-5 days.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.   If you wish to be completely sure, you could go to your local STD clinic or health care provider to be tested at this time."  The testing which is most important is testing for gonorrhea and NGU, either of which is best one with a swab taken from the penis.  Alternatively, while not quite as good a test, a urine specimen taken just as you begin to urinate can be used. Either way, these tests perform best if you have not urinate for at least an hour before the specimens are collected.

I hope these comments are helpful. EWH