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oral sex
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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oral sex

Hi Doctor,

Last night I had protected vaginal sex with a stripper/CSW and then received unprotected oral sex from her.  I do not think the condom broke. However, because I did not have a full erection, the condom was sliding up, and I noticed that it was not covering all of my penis. I don't think it ever slipped off completely, as I saw her remove the condom from the head of my penis afterwards.  when I woke up this morning, I noticed a red area on my penis shaft that is irritated- kind of like friction burn. When I squeezed the area, it did produce some specs of blood on a piece of toilet paper.  I'm pretty sure this irritation was caused from her masturbating me prior to the vaginal and unprotected oral sex.

I'm nervous about having both protected vaginal sex with a CSW where the condom wasn't covering my full penis which had been irritated from friction and then receiving unprotected oral sex from her. I do not know the strippers health status, but I'm nervous by the fact that she would perform unprotected oral sex with a stranger.  

1.  What is my risk from this situation in terms of HIV?

2.  Because I have a small cut on my penis that was probably caused by her masturbating me before the vaginal and unprotected oral sex and I when I squeezed it specs of blood were noticed, would this increase the lilkelihood of acquiring HIV from the vaginal or oral sex?

3.  Do I need to be tested?

Thank you for your response Dr.
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Welcome to the Forum.  Your risk for HIV form the exposure you describe is virtually zero.  For starters, most CSWs do not have HIV. Secondly, your vaginal intercourse was condom protected and condom protected sex is safe sex. That the condom may have slipped down is not a problem as long as it did not slip off entirely and that does not seem to be the case from your report.  Third, although you may have experienced an abrasion related to your activities, HIV is not transmitted through masturbation and this is the case even if your partner's genital secretions got on you, as is often the case in such situations.  Finally, the risk of receiving oral sex, IF your partner had HIV (unlikely) is also virtually zero.  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.

Thus, the answers to your specific questions are:
1.  Essentially zero.
2. No, not from oral sex and your genital exposure was condom protected.
3. No, not from a medical perspective.  If you need to do so for your own peace of mind, a single HIV antibody test at 6-8 weeks should provide confirmation that you did not get HIV from the activities you describe.

Hope this comment is helpful for you.  EWH
6 Comments
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Hi Dr.Hook,

Thank you for your response. Am I correct in understanding that if the abrasion on my penis shaft was not covered by the condom during the vaginal sex because the condom slid up toward the head of my penis that this would not pose a risk for HIV- similar to having a cut on a finger while putting it inside a woman's vagina? Even if the cut or abrasion had occured just prior to the vaginal and oral sex?

Thank you Dr.
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300980_tn?1194933000
Thatis what I said.  EWH
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Hello Dr. Hook,

Sorry for this additional post, but believe it or not, I just happened to take a look at my underwear that I was wearing last night, and I noticed what appears to be menstrual blood on the outer side of the waistband of the underwear.  I was hoping it could have been lipstick or something else perhaps, but it certainly looks a lot like blood.  I felt calm before, but now I freaking out because if this was on my underwear and it came from the CSW's vagina then it could have gotten on to my abrasion that may not have been covered by the condom.  If it came from her mouth I'm worried because I received unprotected oral.  I didn't notice anything last night because it was dark in the room.

I'm sorry for this additional post, but I didn't realize this before.  Does this change your assesment from before turning this into a high risk episode?
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300980_tn?1194933000
No change.  You are thinking and re-thingking this.  You need to move forward, not continuuing this non-productive circular reasoning.  Last answer.  EWH
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Thanks very much Dr. Hook. I hope you have a nice 4th of July!
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H. Hunter Handsfield, M.D.Blank
University of Washington
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