STD Transmission and Testing

[jdub226]

Hello

A few months back I had anal sex with a man.  I was on the receiving end and I'm pretty sure he was using a condom.  At any rate, I was tested for all STDs including HIV at 3 weeks, 12 weeks and 6 months after.  All tests were negative.  The only thing I have done while/after testing is receive oral sex (not give) a couple times and some mutual masturbation/body contact.  Is there any reason to be concerned about having an STD or needing to have further tests?

[H. Hunter Handsfield, M.D.]

All experts agree oral sex is extremely low risk and many consider it zero risk.  There are no known cases of transmission by cunnilingus, and the risk of fellatio is in the range of once for every 10,000 events (for the oral partner, if the penile partner has HIV) or 20,000 exposure (for oral to penile transmission).  These figures are equivalent to giving or receiving BJs with infected partners once a day for 27 or 55 years before infection might be considered likely.

That ends this thread.  Time for both of us to move on.

[jdub226]

Is there any risk of HIV from oral sex?  I know I was tested after 4 weeks and 4 months of the last time I received oral sex.  The only issue I've had that has concerned me is some pain around my waist that has come and gone (not so much in the groin but like around the waist where my belt would be).  By the way, I did have urine taken so I assume that was for the others that weren't able to be tested by blood.  

[H. Hunter Handsfield, M.D.]

Oral sex is sufficiently low risk that STD testing is not recommended unless there are symptoms.  Instead of worrying about individual exposures, a smarter approach would be to just have standard testing once a year:  HIV and syphilis blood tests, and gonrrhea and chlamydia, with the specific site's depending on those potentially exposed during the preceding year.  (Blood tests for gonorrhea and chlamydia are meaningless and useless.)

[jdub226]

Well I had blood tests for everything at each tests (all those that you mentioned).  Do I need to be concerned about the recent oral encounters or just laying with someone?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You don't say exactly what STD testing was done.  Based on this single exposure, the only tests I would have recommended would be urine for gonorrhea, and anal swab tests for gonorrhea and chlamydia  (all of which would have been valid any time more than 2-3 days after exposure) and blood tests for syphilis and HIV, which should have been done once at 6-8 weeks.

With a negative HIV test at 12 weeks, you can be sure you don't have HIV.  Any and all blood tests at that time (and at 6 months) also are conclusive -- e.g. syphilis, HSV, hepatitis B, and hep C.

I hope those comments are helpful.  Let me know if anything isn't clear.

Best regards--  HHH, MD