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Oral Sex Risk

Hi Doctor....love your advice and knowledge.  It sure helps put people at ease.

I've had oral sex (MSM) with two different guys.  Both giving and receiving.  Neither time did I ever let any of them ejaculate in my mouth.  I was wondering,
1) what are the possibilities of getting ANY STD from this action...either giving or receiving?
2) I'm talking more about the STD's that cannot be cured such as HPV, HIV, Herpes and the such (if there's anymore that I missed...).  I'm quite scared right now....I should have used a condom, but was stupid (yet again).
3) Do I have a reason to be worried about HIV infection or and HSV infection as well?  
4)What should I be looking for symptom wise for any of the infections?

Thanks for your answers on this....I trully appreciate your work!
6 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
5) Maybe, but nobody knows.  The risk of HIV through oral sex is so low that it probably makes no difference and isn't worth worrying about.

Let's not get into a string of questions here.  If you decide to get tested, feel free to return with a comment to let me know the results.  Otherwise I won't have any further advice.
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Avatar universal
A related discussion, Went for my test today! was started.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
1) As I said, persons with the sort of sexual lifestyle you describe should have routine testing from time to time, like once a year.  If you haven't been tested recently, this seems a good time, since it's on your mind.

2) I already told you the HIV risks are low.  Probably your test will be negative.  But testing is the only way to know; I can't say anything more.

3) Oral HPV infections are quite common, but as I said, they usually remain asymptomatic and clear up on their own.  This isn't something to worry about.

4) Most new HSV infections (either HSV-1 or 2) cause symptoms in 3-5 days, occasionally up to 10 days, always within 3 weeks (if they cause symptoms at all -- some infections are asymptomatic).
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Avatar universal
Sorry, forgot to ask one more thing...

5. Also, I never let anyone ejaculate in my mouth.....does that lower the risk of HIV infection?

Thanks.
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Avatar universal
I completely understand what you are saying at the bottom of your response.  I am going for help/therapy and the one guy I was with I have been with before a few times, and today's session was a new guy i'd never met before, and no, I did not ask his HIV status or about any other STD's.

1.  Do you think I should go and get tested for all STD's?
2.  Should I be worried about HIV infection at all??
3.  Even if the guy had HPV on his Penis, and I gave him oral sex, I could still get HPV and not know it?  Does it actually survive in the mouth at all??
4. HSV-2 would probably show up within 6 to 8 days right?...or is it up to 20 days?

Thanks Doctor!
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll go directly to your questions.

1) Oral sex carries substantially lower risk for STDs than vaginal or anal sex.  There is risk for several but not all STDs are transmissible by oral sex.  Chlamydia is not, and HSV-2 is rare.  HSV-1, gonorrhea, and syphilis are possible for either the oral or penile partner; and nongonococcal urethritis (NGU) for the penile partner.  HPV can be transmitted from genitals to mouth, but rarely causes symptoms or any health problem in the oral cavity.  HIV transmission by oral sex probably occurs, very rarely.

2) Most people don't bother with condoms for oral sex, and experts don't emphasize them, since the overall risks are low.  However, if you want maximum STD protection in sex with other men, condoms make sense for oral as well as anal sex.  You're right about the incurable STDs, but except for HIV they rarely cause important health problems, so not really much cause for worry.

3) Search the HIV forum for innumerable discussions about HIV and oral sex.  The bottom line is that if the penile partner is infected, the risk for the oral partner has been estimated at 1 in 10,000; in the opposite direction, about 1 in 20,000.  Those odds are equivalent to having oral sex with infected partners once daily for 27 years and 55 years, respectively, before you might expect to catch HIV.

4) The symptoms of STDs transmitted by oral sex include blisters/sores of the mouth, throat, or penis; and discharge of pus or mucus from the penis.

My advice is to a) select your partners wisely (e.g., no anonymous sex in bath houses, bars, parks, etc); b) never, ever have sex with another man without first asking about his HIV status and discussing your own, and avoiding contact with those who are positive, don't know, or seem evasive about it; c) consider condom use, of course for anal sex, but to be maximally safe for oral sex as well; and d) visit a clinic or doctor for routine HIV/STD testing once a year or so.  Or find a partner who also is uninfected and commit to permanent mutual monogamy thereafter.  

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