Risk Assessment From Oral Sex

[seek_reassurance]

Dear Dr.

I am a married man and I engaged recently in an oral sex outside my marriage. This incident took place two days ago with a high class escort from Russia. She performed oral sex on me until I ejaculated inside her mouth. I didn't perform oral sex on her and we didn't engage in any other form of sex. I visited two doctors yesterday and both gave me two different opinions and I decided to get an expert and a tie breaker opinion. The first doctor advised me to abstain from sex until the 6 months window period passes so I can an HIV test. The other doctor told me that the incident was a safe encounter and since I was receiving it should not worry me. He added because I was the insertive partner, I was only exposed to saliva and it is not infectious in terms of HIV. He assured me that I should continue my unprotected sex with my wife and never think about my mistake. Moreover, He said the only risk comes if I was performing oral sex on infected man. My Questions Dr. as follows:

1) Is there any risk from my encounter or should I abstain until further testing is done?

2) Which statement do agree with?

3) What would you suggest me to do in this time?

4) Have you encountered a case where the insertive partner got infected by HIV from the receptive partner?

I am really afraid for my wife's health and I don't want to put her on the slightest risk.

Best,

J

[Edward W Hook, MD]

Welcome to the Forum.   I'll be pleased to be the tie breaker.  The first doctor you spoke with was incorrect. There are no cases of HIV which have EVER been proven to be acquired through receipt of oral sex.  Further, you do not know that your partner had HIV- most CSWs do not.

1) Is there any risk from my encounter or should I abstain until further testing is done?
There is no risk for HIV form this encounter and only a slight risk for other STIs.  The most common STIs following receipt of oral sex are gonorrhea and NGU, each of which are unlikely if you are asymptomatic and easily tested for, should you desire testing.  

2) Which statement do agree with?
See above. The first doctor's advice was overly conservative.

3) What would you suggest me to do in this time?
Relax.  I see no need for testing.

4) Have you encountered a case where the insertive partner got infected by HIV from the receptive partner?
No.

I hope these comments are helpful to you. EWH

[Edward W Hook, MD]

As i said earlier, I see no need for you to test at this time related to the exposure that you describe.  If you feel you must test, then test with a 4th generation, combination HIV antigen/HIV antibody test 4 weeks after your exposure.  If and when you test, I am confident the test result will be negative, proving that you were not infected.  EWH

[seek_reassurance]

Hello Dr. Hook,

Thank you so much for the relieving reply. I went again to my second doctor and I told him I had the chance to get an advice from Dr. Edward Hook. The doctor said whatever recommendation you will give me, he will follow it.

If I still have thoughts about being infected, what test do you recommend to exclude HIV infection? I am terribly sorry doctor for this question but sometimes anxiety can manipulate a person's mind from time to time.

Perhaps it is out of the scope of this form but at what time should I test for those STIs? Do you think after testing negative for gonorrhoea and NGU, it is safe to resume sex with my partner without the fear for HIV?

I apologise again for any inconvenience doctor but when I asked for testing, my doctor advised my to wait three months for these tests including HIV. However, he asked your opinion about the appropriate time to test.

Thank you so much doctor for your help and have a pleasant day.

Sincerely,

J