Confused -need to better understand

[TonyT]

Well as other before me had done I went to a massage parlor and received protected oral sex from a female she also stimulated me with her finger in my anus.  I am fully aware that those two acts do no pose a risk for HIV or STD's for that matter (I will not allow myself to speculate whether she had a cut on her finger). But i also performed oral sex on her, without a barrier.  I have read many of your posts to others that cunniligus does not pose a risk even if she was HIV positive, however what if she also had an STD that I did not notice, say syphilis, would that increase my risk? I'm just confused when they say having and STD increases the risk of acquireing HIV.

Finally, if she did have syphilis i would expect to see a sore in the mouth.  If no sore materializes/symptom can i forget about it. Or is testing still warranted regardless.

You clarrification would be greatly appreciated.

[H. Hunter Handsfield, M.D.]

If you're going to ask speculative "what if" questions, you could go a lot farther than syphilis.  Chlamydia?  Gonorrhea?  Herpes?  (Herpes is the major STD risk for HIV transmission.)  What if she actually has HIV?  And isn't taking antiretroviral therapy?

You can play that game all you want.  The important thing is that nobody has ever been proved to acquire HIV by the exposures you describe.  The chance she had syphilis, or that you acquired it, is just as low as HIV.  You don't need testing for either infection unless, as you say, you develop symptoms that concern you.

HHH, MD

[TonyT]

Thank you for you response. As you said i will not play the what if game.  I understand that there is increase risk in catching HIV if one had an STD he was unaware of it.  But does the same apply if I was STD free and came into contact with someone with HIV and an STD. Does the activtiy i mentioned change from a non-issue for HIV purposes to something i would need worry about if I acquired an STD.

Thanks

I will not post another question after this.

[H. Hunter Handsfield, M.D.]

The risk of HIV is higher if either you or your partner had an active STD.  But being "higher" than near-zero doesn't mean much.  The risk is nearly zero regardless.

HHH, MD