STD risk from receiving oral sex

[veryworried759]

Hello

I wanted to post this in an expert forum but ended up posting in a wrong one before.

I am a 25 y/o male, and 2 days ago when I was really drunk, I had a sex worker perform oral sex on me without any protection for about 5-7 mins. I did not ejaculate, but am really worried that i may have caught something. Apart from this one incident, I am not sexually active. I would like to know what the chances are that I may have been infected with herpes, HPV or HIV.

1) I do not remember seeing open sores on her mouth, but then again I was pretty drunk. Assuming she had herpes (hsv 1 or 2), what are the chances I would get infected from one incident of receiving oral sex?

2) Also, is it possible for me to have become infected with HPV through this?

3) As I understand, the possibility of getting infected with HIV from someone giving you a blowjob, while not zero, is very very small. Is this correct?

I understand that no sexual act is risk free, but what are the odds of getting infected with any of the above in a single encounter of reeciving oral sex?

I have been worried sick since this happened. I am mostly scared about the things that don't have cures. Am I over-reacting? I was thinking she could have been a drug user etc (and am not sure if that poses any additional risks). I am probably going to spend the next few months driving myself insane thinking about this..... when would be the soonest to get tested for each of the above infections?

Thanks a lot in advance.

[H. Hunter Handsfield, M.D.]

This question has been asked and discussed many times.  The quick answer is that STD transmission risk by oral sex, from the oral to the genital partner, is low -- not zero, but much lower than from vaginal or anal sex.  To the specific questions:

1) Herpes is a risk, but a low one.  Not for HSV-2, which is rarely carried in the mouth.  And for HSV-1, if you ever had a past infection with HSV-1 (as half of all adults have), you are immune or at least highly resistant to a new infection.  If no symptoms of herpes (penile blisters, sores etc) after 1-2 weeks, nothing more need be done.

2) Genital HPV is rarely if ever acquired by oral sex.

3) The average risk of HIV transmission from the oral to penile partner has been estimated at 1 for every 20,000 exposures -- which is equivalent to receving a ** by an HIV infected person once a day for 55 years.  And most CSWs aren't infected with HIV anyway. For all practical purposes, zero risk.

Other STDs you don't mention:  gonorrhea and nonchlamydial, nongonococcal urethritis (NGU) are the highest risks, but it is unusual to get these without symptoms.  Syphilis is rare in most settings in the US, including most CSWs; it can be transmitted by oral sex, but uncommonly and usually would cause a noticeable penile sore, typically starting 2-4 weeks after exposure.  If no abnormal discharge or urethral irritation in the next 1-2 weeks you probably were not infected with NGU or gonorrhea; and if no penile sores in the next month you're probably home free with respect to herpes and syphilis.

If you remain nervous, you can always visit your primary care provider or your local health department STD clinic for testing.  But if you don't develop symptoms testing probably isn't necessary. You definitely don't need blood testing for HIV or herpes.

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

[flummoxdude]

it's very reassuring. thanks.