Worried About HIV

[Anxious10]

7 days ago I had sex with a CSW. Here are the facts:

- She performed unprotected oral sex on me for about 3 minutes. She spent quite a bit of time vigorously flicking and licking the inside of my urethra of my penis with her tongue
- She performed condom protected vaginal sex on me
- 24 hours later, I noticed recurring irritation inside my urethra on the tip of my penis (sort of tingling/itching sensation). This continued until about today (so for 4 to 5 days)
- When I noticed the tingling/irritation on my urethra, I took 1.0g of azithromycin and another 0.5g of it the next day (about 28 hours after sex with the CSW)

A few questions:


1) I've read HIV infection in males (from females) occurs through the urethra of the penis.. Since the CSW licked/flicked the inside of my urethra so vigorously, does this increase the risk of HIV infection (or any other STD)?

2) Could my urethra irritation be caused by HIV or any other STD?

3) Would the azithromycin have "cured" any potential STD that I may have caught from her licking my urethra so vigorously?

Thank you

[Anxious10]

Thank you for your response. It has calmed me down a bit.. I'm a fairly logical person and based on reading the multitude of posts on this forum, it appears that the chances of a heterosexual man contracting HIV through oral and vaginal (even unprotected) sex is very low.

This may be off topic a bit but why then does HIV seem to spread so easily heterosexually in other parts of the world (Africa, SE Asia, etc..)?

I think the reason many of us that post on this board are so worried is that there seems to be a ton of articles that speak to how quickly HIV is spreading via heterosexuals around the world. If the transmission rates are as low as indicated, why are all these heterosexual men becoming infected in other parts of the world?

Tx.

[Edward W Hook, MD]

Welcome back to the Forum.  Your questions are similar to others we receive rather frequently.  I will answer them directly but you can also validate my answers by reviewing other posts on this Forum using the search function.  Some of my answers will be similar to the ones Dr. Handsfield gave you about 6 months ago as well. This was a low risk exposure. Most CSWs do not have HIV or other STIs. even with unprotected sex, most exposures to infected partners do not lead to infection.  There are no cases in which HIV has been shown to be acquired as the result of condom protected sex.  Similarly, condom protected sex is safe sex with essentially no risk of HIV or most STIs as well.  This was a no risk event. Your symptoms began sooner than is ever seen with STIs and thus you almost certainly took the azithromycin you took for no good reason.

In answer to your specific questions:
1) I've read HIV infection in males (from females) occurs through the urethra of the penis.. Since the CSW licked/flicked the inside of my urethra so vigorously, does this increase the risk of HIV infection (or any other STD)?
See above, Your receipt of oral sex is not a known risk for HIV.  that she used her tongue vigorously does not change this.

2) Could my urethra irritation be caused by HIV or any other STD?
Again, answered above- no!

3) Would the azithromycin have "cured" any potential STD that I may have caught from her licking my urethra so vigorously?
Yes, not that you were at meaningful risk.

4) If you were me, would you stop having sex until getting tested for HIV or any other STD? I'm worried that I may have caught something and don't want to pass it on to anyone
No.

I hope these comments are helpful.  EWH

[Anxious10]

One other question..

4) If you were me, would you stop having sex until getting tested for HIV or any other STD? I'm worried that I may have caught something and don't want to pass it on to anyone.

Thank you