Worry of Oral sex

[Worryman2011]

Dear Doctor ..

I would like to thank you for what you do here .. it is very appreciated work .

I will tell you my story and then I will ask my questions ...

15 weeks ago I was in Manila and doing massage by gay masseuse ( discovered later that he might be CSW also )
any way .. he performed on me oral sex .. he took my penis in his mouth for like 15 seconds then stoped and again for the same time then finally stopped and i decided to complete by myself ( hj ).
The gay was smoking 2 cigarettes before performing the oral sex on me ... also he was drinking water ..

now to my questions ..

1- I learned from the forum and from other sites that receiving oral sex is NO RISK .. so I tried to listen to them but u know gulty drive me to do HIV Ag/Ab test on 2 weeks mark coz i was thinking if 50% of ppl will develop detectable antibodies in 2 weeks then this will give me at least more relief .. test was neg. SO what is your Comments ?

2- Regarding Syphilis , There was no lesions in his lips nor his mouth as I checked ( I am a dentist by the way ) .. so what is the chances of contracting it ?

3- Regarding HSV , I do have HSV 1 since university .. but I am afraid of HSV2 .. Is it possible for HSV to transmit by Saliva ?

4- NGU, Goro and Chlamydia, if i didnt have any burning sensation in urination .. and it is now 2 weeks .. still any risk ?

5- I had abdominal problems 5 days after arrival .. with diarrhea so my doctor did stool analysis and found Giardia so I had 1 mg Ceftriaxon IV 3 days and also Cipro 500 and flagy 500 for next 5 days .. Is that possible to cure Syphilis, NGU, Goro and Chlamydia and prevent them from develop ?

6- If HSV2 and Syphilis can be transmitted without having outbreak .. Am I at risk from my patients .. as you know some times saliva could come in contact with my face ?

7- Is it possible for me to have unprotected sex with my wife ?

Thanks and sorry for the long list of questions ..

[Edward W Hook, MD]

Yes, it is OK to say that you have not had unsafe sexual activity,

NAATs are use to screen donated blood.  NAATS are not recommended for diagnosis of the infections you mentione but yes, a negative result makes it most unlikely that you are infected.

We'll end this threa now.  EWH

[Worryman2011]

Dear dr.

Thank you for your answers .. i am really fine with them ..
i need one thing to clarify ..
I do blood donation every some time and usualy they ask if i have unsafe sexual activity in the last 3 months.

So is it ok to say no as u stated that oral sex is not risk of hiv?
also they will use NAT test for every donation .. if i get negative result at 3 weeks mark does that mean that i am clear of HIV, HCV and HBV?

Thanks

[Edward W Hook, MD]

The presence of candida in stool is normal, particularly in persons who have received antibiotics as you have.

At two weeks testing for HIV with a combined HIV p24 antigen/HIV antibody test will detect most but not all HIV infectons.  The results of such tests are definitive at 4 weeks.   You however do not even need testing, receipt of oral sex is not a risk factor for HIV.  

EWH  

[Worryman2011]

Dear Doctor,

Thank you again for your reply ..

To make a point, i had my stool culture today which says that i have Candida albicants there ..

So giving the fact i am not so worry of HIV as i took ur words ..

But just to have last assurance from you with thanks .. Do u thing that HIV combo will pick me up if i am infected in 2 weeks ??

Does candida albicand have any relations

[Edward W Hook, MD]

No, no change in my advice now that it is 15 days rather than months.

I see no need for antibiotics at this time. EWH

[Worryman2011]

Thank you Doctor for your quick answer...

In fact I mean 15 days not weeks ... but it came by mistake ..

So now I have more resting  after what u said ..

any thing will be changed from 1-4 after knowing that exposure was 15 days ago ??

Also is it ok to take antibiotic now to prevent NGU which is not affected by the antibiotics i took , if yes then what antibiotic ?

Thank you again ..

[Edward W Hook, MD]

Welcome to the Forum.  As you know from reading other comments on this site, your exposure was low risk for STDs an no risk for HIV.  Further, at this time, 15 weeks after then event, if you were going to develop an STD, you would have done so by now.  Thus you have little to worry about, other than figuring out how to relieve the guilt an anxiety you appear to suffer from as a result of this exposure.  As for your questions:

1.  Your assessment is correct. At 2 weeks over half of persons with recently acquired HIV will have positive tests.  Your negative test serves as proof to my comment above- there is no risk of HIV from receipt of oral sex.

2.  Syphilis is transmitted by direct contact with lesions.  If he did not have lesions, there is no risk to you. In addition, syphilis is rare and very, very rarely transmitted by oral sex.  I would not worry. Further, it you had gotten syphilis from this exposure you would have had a sore on your penis long before now.

3.  Very very rare. If you had gotten HSV, you would have developed lesions within two weeks of exposure.  At this time there is no reason to worry.

4.  Very, little risk.  No something to worry about (BTW, you said 15 weeks above, did you mean 15 days?)

5.  The ceftriaxone would have prevented gonorrhea and syphilis.  The cipro would have prevented some but not all NGU.  Chlamydia is not a concern.

6.  HSV can be spread by DIRECT contact with an infected person who does not have lesions.  It is not spread in saliva.

7.  I would not be concerned.

I hope this helps.  EWH