Dr. Hook, I need some clarification

Dr. Hook: congratulations for this great service you provide worldwide.

A few days ago, I performed unprotected cunnilingus for about five minutes on a caucasian brasilian prostitute I contacted through the Internet, in Barcelona/Spain. We also had protected intercourse. She looked very young and clean.

Two days later I started freaking out about the oral exposure. I´ve been reading very many posts about this on Medhelp, hoping to find a case similar to mine. I also consulted Dr. Sean and Dr. Jose forum.

The fact is that I have found some conflicting information, and I would appreciate some insight:

1.- You state -and you are clear about it- that oral sex is NO RISK whatsoever, as there is no cientific evidence about HIV oral infections (http://www.medhelp.org/posts/HIV-Prevention/Risk/show/1623676).

2.- You say that you share this forum with Dr. Handsfield because "we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients".

3.- But Dr. Handsfield seems to have a slightly different opinion: he says "The advice has always been the same:  if a bare penis (no condom) does not penetrate another person's vagina, rectum or mouth, there is no risk for HIV" (http://www.medhelp.org/posts/HIV-Prevention/HIV-and-STD/show/1623391). That is, he seems to acknowledge there may be SOME risk in oral sex.

4.- In the international forum, Dr. Sean Cummings says: "We are firmly of the view that performing oral sex on an HIV positive person does pose a risk although it is tiny." (http://www.freedomhealth.co.uk/forum/f6/worried-about-cunnilingus-6855/)

My questions are:

1.- ¿Could you confirm me that cunnilingus is no risk in regards to HIV?

2.- ¿Should I get tested?

Thank you.

[Edward W Hook, MD]

Welcome to our Forum.  My sense is that you are concerned about this exposure and, in that context, are "splitting hairs".  In science we never say never as there are truly no absolutes.  In saying “never”, tomorrow something COULD happen.  If it does, some would call it the "exception that proves the rule".  Let me give you an example. There is actually a person who was sitting at home and had a meteorite come through their roof and strike them.  The meteorite is on display in an museum.  On the other hand, I am very comfortable in telling you that there is no meaningful chance that you will be struck by a meteorite while reading this.   The same is true for HIV risk from performing unprotected oral sex on a female commercial sex worker.  

Chances are that she did not have HIV and, if she did, since there are NO proven instances in which HIV has been transmitted by performing oral sex on an infected partner despite the fact that there have been millions of instances of oral sex between infected and uninfected partners. This is simply not something that you need to worry about.  That I say you don't need to worry about it may or may not help you with your anxieties.  If so, you may choose to get tested.  If you do, I am also confident that you will find that you did not get infected.

I hope this helps.  EWH
p.s.  You have chosen an instance where Dr. Handsfield added the word "mouth" to a statement about HIV risk. That said, I can tell you that you can also find numerous other instances in which he has stated that there is NO risk from oral sex with an infected partner.  EWH

[renatovicchi]

Thank you, doctor, your answer does calm my anxieties. If this is the level of risk, I don´t feel the need to test, I think I´ll wait for the meteorite ;-)

And thank you again for this great service, I am sure it is helping many many people around the world.

[Edward W Hook, MD]

Glad to help. EWH