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HIV Prevention  (Expert Forum)
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Deep Throating and my risk
Answered by
Edward W Hook, MD - HIV Prevention, stds
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.

Deep Throating and my risk

by John703, Oct 13, 2009 03:35AM
Hello I am a college student and had a MSM encounter- performed oral sex on another guy a while ago. It has haunted me ever since. Prior to performing the act I listened to your advice on this site and asked him his status and he said he said was negative, but when i asked him again afterword he has avoided me ever since . I realize that oral sex carries an extremely low risk but I am worried for several reasons, which are as follows: Before the act I smoked some pot and I deep throated his penis several times, until the point that my eyes began to water, but did pull out before ejaculation. I have read on here and several other sites and studies that the risk of hiv through oral sex is negligable, but have recently read a study that indicates that the tonsils are much more vulnerable to hiv than the mouth and are a possible route for hiv transmission during felatio. Here is a link to this study:

http://www.medicalnewstoday.com/articles/78090.php

1. Can you tell if this means that the way I performed oral sex or the use of pot prior to the act did in fact make it a high risk practice?

2. Following this I felt that I had symptoms that were similar to acute hiv, which are as follows: By no more than two days after I had a red a papule on my neck, and about three to four weeks later I came down briefly with a bad headache and a very soar throat along with a pretty stuffed up nose. Then by about seven to eight weeks I had the worst case of oral ulcers that I have ever had in my entire life. Do these symptoms indicate acute hiv? I have heard that oral ulcers are the most specific symptom and carry a rate of 85 percent specificity does this mean that my symptoms are very likely to be hiv?

3. Lastly, should I get tested?


Thank you

by Edward W Hook, MD, Oct 13, 2009 05:41AM
Welcome to the Forum.  I actually took a look at the article that you mention and would emphasize that it SPECULATES that the anatomy of the  tonsils MAY provide the opportunity for HIV infection to occur.  It is theoretical.  Place this in the context of the millions of people who have had oral sex with HIV infected partners yet have not gotten HIV and you should come to the conclusion that this paper is no reason to be concerned.  

I congratulate you on your steps to protect yourself by asking your partner about his status.  That is a good thing.  

As specific answers to your questions:
1.  No, there are no data to suggest that "deep throating" is high risk for HIV acquisition.
2.  The symptoms you describe do not suggest ARS.
3.  You have not mentioned any medical reason for needing HIV testing.  On the other hand, if you are concerned, there is no reason to not get tested once, particularly if you promise yourself to believe the test results.

Hope these comments are helpful to you. EWH
Member Comments (3)

by John703, Nov 08, 2009 10:13PM
To: Edward W Hook, MD
Dr. Hook, I hate to bother you again, but i simply have two more questions, which i feel necessary to ask in the hope of puting my anxieties to rest,

1. I still have one of my primary teeth and it is severely eroded so that it is fairly loose at the gum line, would this in any way have added to my risk?

2. And finally why are my symptoms not suggestive of ARS? I am just wondering.


I'm sorry to take up your time with reduntant questions and i sincerely appreciate you expertise.

Thank you

by Edward W Hook, MD, Nov 09, 2009 05:43PM
1.  No change in risk (or lack there of due to dental or gum disease.
2.  The "symptoms" of the ARS are non-specific.  As we have said time and time again, when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions). For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.
Take care.  EWH
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