Unprotected oral male on male - HIV and STD risk

[erowid]

Hello doctors,

You'll note that I also asked this on the community forum. I was happy and respect the answer I received from a trusted member there, but the professional level reassurance and further advice is well worth the modest fee.

The situation (from this previous Saturday): A 29 yo male in a long term heterosexual relationship out of town for business. Occasionally has curiosities about same sex interactions, and in a moment of weakness, decided to act them out. I posted an ad on Craigslist, an incomplete ad, at that (I forgot to put that I was looking for drug/disease free individuals). I responded to someone who offered this information, saying he was D/D free. He was an older man, in his 40s, which to me puts him in a low risk category. His penis was free of any visible sores or abrasions. There may have been an instance or too where I took it in a bit deep.

Due to ignorance, I brushed my teeth about 30+ minutes before the interaction. I did not ejaculate in his mouth, but he ejaculated in mine and I may have swallowed a bit, though I attempted to spit it all out. After about 10 minutes, I forced myself to vomit, thinking it would get the toxins out (naive, probably). I then again brushed my teeth and took a shower. The next day, I had symptoms of a UTI, mostly frequent urge to urinate with little coming out. That happened for a few days. The last few days, I wouldn't say I've had a sore throat, but that I've been a bit more phlegm-y.

On Monday, only two days after the incident, I panicked and went to the urgent care for STD testing. They did a urine test for Gonorrhea and Chlamydia (weird since I read you need to do it orally for oral forms of these STDs), and a blood draw for HIV (not sure if they did Syphilis as well). All results were negative, though HIV testing is obviously too early. HIV is obviously astronomically low risk, but should I be worried about it and other STDs? Can I resume heterosexual sex with long term partner? Thanks!

[Edward W Hook, MD]

Welcome to the Forum. As you have already heard, this was a very low risk exposure.  Your partner indicated that he was disease free and most people tell the truth.  Further and perhaps more importantly, there is little risk of infection from oral sex. There has never been a case of HIV proven to be transmitted by receipt of oral sex and there are only two or three cases in which giving oral sex to a partner has led to HIV infection. Thus even the most conservative estimates are that the risk of HIV from performing oral sex on an infected partner is less than 1 infection per 10,000 episodes and that estimate is conservative.

Your testing rules out the possibility of penile gonorrhea or chlamydia but it does not address the slight possibility of having gotten oral gonorrhea through your exposure. the risk of this, as for your risk of HIV is extraordinarily low but if you wish to be absolutely sure you were not infected, I would suggest a test for oral gonorrhea.  Personally, were I you, I would not be at all worried and would not seek further testing or worry about contact with my regular sex partner the real issue here is whether you want to put up with a very tiny risk or be absolutely sure.

I hope this comment helps. EWH

[Edward W Hook, MD]

There is no need for re-testing.  Of course you can do it if you feel you need the reassurrance.  EWH

[erowid]

Hello Dr. Hook,

Sorry to bring this up again, but any concerns with the short testing window (36-40 hrs after exposure) for gonorrhea and chlamydia? I'm mostly concerned because my partner is pregnant, and I recently had another bout of UTI-like symptoms (frequent urination and urge to urinate).

Should I re-test to be sure?

[erowid]

Thanks again for all your help. I'll assume really low risk for all STDs in addition to HIV unless you indicate otherwise.

[Edward W Hook, MD]

There are no data to answer this question.  The risk of infection however is so low to start with that it is unlikely that making yourself vomit after oral sex would change your already tiny risk for infection.  EWH

[erowid]

Thanks, but I think you misunderstood part of my question. I made myself vomit 10-15 minutes after incident. Would this reduce risk of transmitting an std? The thought behind it was to expose any std to unfriendly acid.

[Edward W Hook, MD]

No, neither your sore throat nor nausea or vomiting suggest HIV.  EWH

[erowid]

Gah, sorry. Final question, promise. What about tree throwing up thing? Would that reduce risks of any std transmission? Or was I way off in my thinking? Thank you so much.

[erowid]

Thanks doc. Sorry for multiple comments, but thought a brief follow up question might ease some nerves, specifically for other STDs. Would a lie grade throat discomfort (not sore, really, just a bit of discomfort) be indicative of anything?

[erowid]

Thanks for the response. It's greatly appreciated and you guys provide a tremendously valuable and affordable service in light of HCR/ACA.

I know I'm worrying about something with such a miniscule chance that I would be the miracle case if I had HIV, or even any std, for that matter. But as you obviously know, it's extremely difficult to turn off that worry center of the brain, especially with an unborn child involved. I may get the oral swab to be safe, though I may just inspect my mouth daily instead, and go in if there's a problem.

I'll follow up if anywhere along the way I test positive for anything.

[erowid]

Also, aside from a long term monogamous relationship (where the partner is pregnant :( ), this is my only sexual interaction, and certainly the only male-on-male sexual interaction I've ever had, and I'll never have another one. Was acting on a stupid curiosity, and hope I haven't ****** up my life (or, more importantly, my partner's)