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Insertive oral and cunningulus risk
Dear Dr,
I am 26 old heterosexual male. I have been always used to protected vaginal sex. But in the year 2010 i was involved in 6 unprotected oral exposures. Two of them cunninglus for very short period around 10-20 secs. Four insertive oral sex exposures for 2-3 min. All of them are with prostitutes. I never experienced any symptoms for all of them except two. which were insertive oral sex exposures with south korean woman in the end of november and first week of december. I got kind of sick feeling after 2 weeks. I went to my physician and he said there is nothing but little infalmmation in ear and the reason might be ear infection. He kept me on azithromycin for 10 days. I stopped it after 5 days because of diaherrea. I again visited physician 2 days after and he said my throat was red. He asked another round of zithromax for 5 days. After that my physician said everything is fine. I asked him does this symptoms look like any scary disease. He said there is nothing to scare about. But I was totally anxious because of the sore throat being a ARS symptom. I am still having discomfort in mouth and throat in january. So I visited ENT specialist though my physician didnt suggest me to go. ENT specialist tested me for strep an it came negative. I told them I was feeling dry mouth and discomfort in throat and about oral exposures. She ordered several tests CBC-differential, RPR, diabetes, ANA comprehensive panel. Everything came normal. But didnt ordered HIV test.
My questions are
1) Am i at HIV risk?
2) Is sore throat alone without fever, rashes, swollen lymph nodes symptom of ARS?
3) What is the basis for the statement HIV among prostitutes is not driving factor in US?
4)Would you recommend testing with these kind of exposures?
Thanks
I am 26 old heterosexual male. I have been always used to protected vaginal sex. But in the year 2010 i was involved in 6 unprotected oral exposures. Two of them cunninglus for very short period around 10-20 secs. Four insertive oral sex exposures for 2-3 min. All of them are with prostitutes. I never experienced any symptoms for all of them except two. which were insertive oral sex exposures with south korean woman in the end of november and first week of december. I got kind of sick feeling after 2 weeks. I went to my physician and he said there is nothing but little infalmmation in ear and the reason might be ear infection. He kept me on azithromycin for 10 days. I stopped it after 5 days because of diaherrea. I again visited physician 2 days after and he said my throat was red. He asked another round of zithromax for 5 days. After that my physician said everything is fine. I asked him does this symptoms look like any scary disease. He said there is nothing to scare about. But I was totally anxious because of the sore throat being a ARS symptom. I am still having discomfort in mouth and throat in january. So I visited ENT specialist though my physician didnt suggest me to go. ENT specialist tested me for strep an it came negative. I told them I was feeling dry mouth and discomfort in throat and about oral exposures. She ordered several tests CBC-differential, RPR, diabetes, ANA comprehensive panel. Everything came normal. But didnt ordered HIV test.
My questions are
1) Am i at HIV risk?
2) Is sore throat alone without fever, rashes, swollen lymph nodes symptom of ARS?
3) What is the basis for the statement HIV among prostitutes is not driving factor in US?
4)Would you recommend testing with these kind of exposures?
Thanks
MEDICAL PROFESSIONAL
Wrong. I doubt HIV has ever caused diarrhea by itself, i.e. never the only symptom. It only would occur in combination with a number of other symptoms.
You are always free to be tested if you remain skeptical about my advice. Stop searching the web; people with heightened anxiety like yours will always be drawn to the bad news that they tend to interpret out of context. In any case, there is no information you can add that could possibly change my opinion or advice, so that will be all for this thread.
You are always free to be tested if you remain skeptical about my advice. Stop searching the web; people with heightened anxiety like yours will always be drawn to the bad news that they tend to interpret out of context. In any case, there is no information you can add that could possibly change my opinion or advice, so that will be all for this thread.
Thanks for the reply. I am worried because I am experiencing loose stools from few weeks.
I have read some where diarrhea is common side effect of Hiv. If diarrhea is sideeffect in which stage it generally shows up. Your response is appreciated.
I have read some where diarrhea is common side effect of Hiv. If diarrhea is sideeffect in which stage it generally shows up. Your response is appreciated.
MEDICAL PROFESSIONAL
Yes; I would continue unprotected sex with my wife with no fear for her health.
Dr sorry to get back to u. I have one more question: Would u have unprotected sex if you are in my situation.
MEDICAL PROFESSIONAL
Welcome to the forum. Bottom line: almost certainly you don't have HIV. You really were not at risk and your symptoms don't suggest it.
Oral sex is safe sex with respect to HIV. There has never been a reported case, to my knowledge, transmitted by cunnilingus, in either direction. Many experts believe oral to penile transmission also does not occur, and the maximum risk estimate is 1 transmission per 10,000 exposures, if the oral partner is infected. That's equivalent to receiving oral by infected partners once daily for 55 years before infection might be likely. In addition, it is statistically unlikely any of your partners had HIV, which remains rare in commercial sex workers in the US and most industrialized countries. There are exceptions in some settings and populations, but in general it remains much less common than you might have assumed.
As for your symptoms, they sound like you caught a cold, nothing more. Any persisting oral symptoms might be due to a yeast infection, or some other minor issue. Yeast overgrowth and other symptoms can result from high doses or prolonged therapy with antibiotics, including azithromycin. Acute HIV infection usually includes not only sore throat, but also high fever and body-wide measles-like skin rash.
Those comments answer questions 1 and 2. That most sex workers in the US don't have HIV is simply an epidemiologic fact. Heterosexual transmission of HIV in general is uncommon here; the large majority of heterosexual transmissions occur in longstanding partnerships in which one person has HIV, usually without his or her knowledge. The reasons for the differences between industrialized and some developing countries are quite complex -- not practical to go into detail here.
As for question 4, from a medical or risk assessment perspective alone, there is no reason for HIV testing. However, since you are nervous about it -- enough to come to this forum and pay $20 for my advice -- you should be tested. Most people worried about HIV are not satisfied only by verbal advice about the low risk. Probably you will gain more reassurance from a negative HIV test result than you will from anything I can say. So my advice is to do it. For all the reasons above, you definitely can expect a negative result.
I hope this helps. Best wishes-- HHH, MD
Oral sex is safe sex with respect to HIV. There has never been a reported case, to my knowledge, transmitted by cunnilingus, in either direction. Many experts believe oral to penile transmission also does not occur, and the maximum risk estimate is 1 transmission per 10,000 exposures, if the oral partner is infected. That's equivalent to receiving oral by infected partners once daily for 55 years before infection might be likely. In addition, it is statistically unlikely any of your partners had HIV, which remains rare in commercial sex workers in the US and most industrialized countries. There are exceptions in some settings and populations, but in general it remains much less common than you might have assumed.
As for your symptoms, they sound like you caught a cold, nothing more. Any persisting oral symptoms might be due to a yeast infection, or some other minor issue. Yeast overgrowth and other symptoms can result from high doses or prolonged therapy with antibiotics, including azithromycin. Acute HIV infection usually includes not only sore throat, but also high fever and body-wide measles-like skin rash.
Those comments answer questions 1 and 2. That most sex workers in the US don't have HIV is simply an epidemiologic fact. Heterosexual transmission of HIV in general is uncommon here; the large majority of heterosexual transmissions occur in longstanding partnerships in which one person has HIV, usually without his or her knowledge. The reasons for the differences between industrialized and some developing countries are quite complex -- not practical to go into detail here.
As for question 4, from a medical or risk assessment perspective alone, there is no reason for HIV testing. However, since you are nervous about it -- enough to come to this forum and pay $20 for my advice -- you should be tested. Most people worried about HIV are not satisfied only by verbal advice about the low risk. Probably you will gain more reassurance from a negative HIV test result than you will from anything I can say. So my advice is to do it. For all the reasons above, you definitely can expect a negative result.
I hope this helps. Best wishes-- HHH, MD
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