Oral sex (cunnulingus) with a female sex worker

[sam_r]

Dear Dr.Hunter,
    Im a male 37 year old male with very good health.
I had a brief unprotected sex (1 minute) cunnulingus with a female sexual worker and followed by kissing. (no vaginal or any other type of exposure)

What ar emy risks? Do I need to get a PEP? Do I need to get tested for Chlymidia, Gonnorhea, Hep-B or any other STDs after a few weeks?
How long before I can resume sex (uncovered) with my regular female partner?

Thank you very much for your help!

[Edward W Hook, MD]

There is nothing I have ever heard or read which suggests that a sweet taste in one's mouth is in any way suggestive of any STD.  I would not worry. EWH

[Edward W Hook, MD]

For better or worse I am sure that you could talk someone into giving you  antibiotics but I see no reason for you to get them.  I would not prescribe them for you.

I woul consider it malpractrice to provide you with PEP.  

Theo only STD that there is even a reasonable reason to be tested for is oral gonorrhea.  
EWH

[sam_r]

Thank you Dr.Hook, the reassurance helps. There is however a plethora of STDs that can be theoritically transmitted that causes undue anxiety.

1. Do you think I should consult with a physician for a course of doxycyclene or atleast a course of antibiotics? is a PEP course appropriate?
2. Also, what STDs shoul I get tested for and when?

Best regards,
Sam

[Edward W Hook, MD]

Welcome to our Forum. Dr. Handsfield and I share the Forum.  I will be answering your question.  The risks of the exposure you describe are quite low.  Despite their work, most commercial sex workers do not have STDs and most exposures to infected partners do not lead to transmission. for oral sex (cunnilingus the risk of STD transmission is, in general lower than for genital sex and for some STDs (chlamydia and HIV in particular) the chance of transmission is so low as to not be a concern at all.  

Kissing is no risk for any STD (including HIV), even deep kissing and even with gum or dental disease. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.   Similarly, there are no reported cases in which hepatitis B has been transmitted by oral sex either.  

Bottom line, I would not worry about this exposure and would not hesitate regarding sex with your regular partner.  I hope this comment is helpful to you.  EWH

[Edward W Hook, MD]

This additional information does not change my assessment or advice at all.

This will conclude this thread. EWH

[sam_r]

Dear Dr.Hook,
Last question I promise..I beg of you to answer please...

I had damaged a few taste buds on the tip of my tongue right  before giving cunnilingus. No bleeding but sore/red.

Does this change anything reg. my risk of stds, especially HIV infection?

Thanks again! I don't know what I would have done without you and Dr.HHH

Best Regards!!

[sam_r]

I also read the sweet taste can eb due to stress..which it may very ewll be and I hope it is.
Thanks again!

[sam_r]

Dear Doctor Hook,
    Sorry to bother you again and again on this. I know you consider this closed.

But on the 3rd day of cunnilingus exposure, I have a sweet taste in my mouth when I put water I put in my mouth.

Bathroom water I gargle with tastes sweet, hot water from the cafe tastes quite sweet...
The sweet taste is on my tongue, part of the roof of my mouth and inner lips.

From your experience, is this an indication of anything I should be concerned with than when you last gave your comment?
I read on a different website that this could be an indication of STDs but I consider you an authority on stds.

I dont mind writing a separate question in the expert forum but I thought it was easier here as you know the context.
Best Regards