Receiving oral sex and HIV concerns

[worriedOne15]

I am a 47 year old married male.  These two encounters are the only ones I have had outside my 18 years of marriage. My situations are:
Sept. 14 – unprotected oral sex (I received from another male) Oct. 1- brief (less than a minute) unprotected oral sex (again, I received but from a different guy)
I talked with both men prior to engaging in these activities and both assured me that they were both disease free including HIV. I am disease free also. This was a curiosity thing on my part, not the smartest thing I have done looking back.  It has been almost two weeks since my last encounter. During that time I have had no symptoms i.e. no discharge, no sores, no urgency to urinate, no fever, no burning or painful urination.  What concerns me is that I went to my doctor earlier this week for a slight discomfort in my prostrate area and a slight itch on the head of my penis for a few days. He did a physical exam, blood test and urine test.  No inflammation was seen, my blood did not indicate anything and there were no WBC in my urine sample. I did do another urine test for bacterial STIs and am awaiting the results. On the safe side, my doctor went on and prescribed ciprofloxacin (500 mg, taken two times a day for 10 days) to treat anything related to my prostrate but not for any potential infection (STD).
In my own investigation, I read that certain STDs can increase the risk for HIV. My question is, if I had caught a STD such as gonorrhea or chlamydia from the first encounter would my risk be higher during the second encounter? I have read that oral sex (receiving) carries little to no risk and I hadn’t given it much thought until I read about existing diseases elevating risk.  And since there is a chance I may have prostatitis, chlamydia could be a cause.  The oral was pretty much uneventful no blood or trauma. I am really worried at this point and feel my anxiety getting the best of me.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Some questions can be answered accurately based entirely on the title chosen by the user.  That is probably the case here.  HIV is rarely if ever transmitted from the oral to genital partner by oral sex.  Some experts believe it never happens.  So most likely you are not at risk and don't need testing for HIV.

Now I have read the entire question.  Guess what?  There is definitely no risk for HIV in this situation.  In addition to the trivial risk, if any, from such an exposure, it is unlikely your partners had HIV, since people rarely lie about HIV status when asked directly.

Your genital area symptoms indeed are typical for prostatitis and/or the chronic pelvic pain syndrome (google that term and for excellent information start your reading with the excellent Wikipedia article that will be near the top of the google hit list).  Despite what you apparently read somewhere, chlamydia is not a cause of prostatitis, and in any case chlamydia is rarely if ever transmitted by oral sex.  Such exposures carry small risks of gonorrhea and nongonococcal urethritis (NGU), but both of these are unlikely based on your symptoms, and you can expect the urine test for gonorrhea and chlamydia to be negative.

To the extent your anxiety is in response to a couple of sexual choices you regret, you'll have to deal with it.  But you really should not be worried about any medical consequences from them.  If I were in your situation, I would not be HIV tested.  To be maximally safe, I would await the urine test results -- and if negative would then resume unprotected sex with my wife, with no concern about infecting her with HIV or any other STD.

I hope this helps.  Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

Neither HIV nor other STDs are transmitted by hand-genital contact.  There are theoretical risks for HPV and HSV, but actual cases are vaninshingly rare if they occur at all.

Absence of WBC in urine is soft evidence against urethriits (gonorrhea, chlamydia, NGU) -- infection could still be present, but unlikely.

In summary, my reply above stands unchanged. You are not "missing anything".

[worriedOne15]

Thank you for your reply. It has helped ease my concerns. Looking back at my post, I failed to mention that I also received brief handjobs as well as the oral. The first guy didn't touch himself, but the second guy did.  He then touched me. Would this be an added risk? My second question is in regards to no WBCs on the first unrine test. I know it would not show any specific indication of a STD, but would it indicate that there is a infection which could be STD related? I have played the last couple of weeks over and over in my head. I know sometimes STDs can have no symptoms and I guess that has me a bit worried.  Like I mentioned, I saw no evidence of discharge and no burning feeling when I unrinated.  Just want to be sure I am not missing anything.  Thank you again.