Very Brief Oral Sex and risk

[SFguy3881]

Hi Docs,

I went to a massage parlor in early April not expecting anything more than a HJ.  When she was giving me the HJ, she sucked my penis for a few seconds before I jumped up and stopped her. It lasted 2-3 seconds the most. We did not have any other sexual contact.  After this incident, I was really worried and think about if I can get any STIs including HIV.   I called her after a few weeks after the incident and she said she tested for all STDs and she was fine.

I developed a rash on my arms for 2 days in May(6 weeks after) and it went away in 2 days. Also had a UTI(blood in the urine) in late June (11 weeks after) and my doctor prescribed CIPRO and it was cleared in a week.  Other than these, I did not have any fever,sore throat, penile sore and penile discharge but always feel lightheaded, fatigue, and weakness in the arms and legs.

I have not done any testing so far.

My questions:

1)What is my chance of catching anything including STDs and HIV during this few seconds of oral sex? I have read that it is no risk.

2)Was my rash or UTI related to my exposures?  I read that CIPRO is not very effective in fighting STDs so if CIPRO cleared my UIT, can I assumed that it was not caused by STDs?

3)My fatigue and lighted headness really bothering me.  Do you think they are just from anxiety/stress?

Looking forward for your answer. Thank you.
1)What

[Edward W Hook, MD]

Welcome to our Forum. I will be happy to comment.  The exposure you describe did not put you at any risk for HIV and was very low risk for STIs.  Most commercial sex workers do not have STIs and most single exposures to infected partners do not lead to infection.  There are no proven cases of HIV proven to occur from receipt of oral sex.  Thus there is no medical need for HIV testing.  

As for other STIs, oral sex is an inefficient way to transmit STDs.  Even among persons with many sex partners, oral infections are uncommon and for a number of biological factors too complex to go into here, the efficiency of transmission of infections through oral sex is lower than for penetrative genital-vaginal or –anal sex.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; for all practical purposes, chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection) long ago although, admittedly your ciprofloxacin therapy might theoretically mask this.  In your case, following a single exposure and in the absence of symptoms, I would urge you not to worry. If you must, you could go to your local STD clinic or health care provider to be tested at this time.  The tests will be negative and in my opinion, you do not need testing at all.  

Fatigue and lightheadedness are not symptoms of STIs. Such symptoms could be due to fatigue, stress or some other casue but not due to STIs.  

I hope that this comment is helpful to you. EWH

[Edward W Hook, MD]

Final answer. Further questions will be deleted without comment.

WBs vary from person to person and over time. A low WBC is not a sign of HIV and shoul not be a concern.  Still no evidence that you have an STI of any sort  Your smptoms are not due to an STI.  Anxiety is on of many possible causes.  Discuss them with your doctor.

This thread is now over. EWH

[SFguy3881]

Dr Hook

I just went to do my physical and my WBC count is low for the first time from my blood test ,  is this an indication of Hiv inflection  or is something else?  Also,  I am suffering from constant dizziness and fatigue daily  .  Is it because if anxiety or symptons of hiv?  Thank you for your help!

[Edward W Hook, MD]

If you had a UTI, it would be unrelated to the sexual encounter that you described and coincidental.  Eight weeks would be a long time for an STI to take to become symptomatic.  EWH

[SFguy3881]

Dr.

Just got back from vacation couple days ago and just checked your response.  My question was will an UTI occur 8 weeks after my brief exposure if I caught anything and it would have occured much earlier?

[Edward W Hook, MD]

Enterococcus is a common cause of UTIs.   You need to relax and move forward.  Time for this thread to end. Take care.  EWH

[SFguy3881]

Dr Hook,

I looked at my medical record and the lab result showed that my UTI was caused by the bacteria -Enterococcus Faecalis.  Does it mean that the UTI was not caused by any other STD bacteria? Thank you.

[Edward W Hook, MD]

If you were infected and the infection is still present, testing would detect the infection.  If the tests are negative, you are not infected.  EWH

[SFguy3881]

Dr, Hook,

Final question,  If I have contracted any STDS and go to test now, will it still show up as positive since the exposure was 8 months ago or it has already cleared by CIPRO and will show a negative result?

You have been very helpful.  Happy Holidays!

[Edward W Hook, MD]

At this time there is no way to know if your "uti" was an STI or not.  To know this you would have needed to have been tested.  UTIs are unusual in men under age 40 but they do occur.  Cipro has some marginal effect in treatment of STIs but is not nearly as good as recommended therapy.  

Logically duration of exposure should effect likelyhooe studied.  EWHd of transmission but as you might imagine, this is not something that can b

[SFguy3881]

Dr. Hook,

Can you clarify your answer? Do you mean that my UTI was or was not caused by the STDs I might have gotten in April.  If CIPRO cleared my UTI, I was think it was not caused by STD since CIPRO is not effective in curing them.

Also, just out of curiosity, does the during of the exposure make any difference in terms of infection possibility?  Thank you.