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High risk std/HIV exposure

Dear Dr. HHH,

Thank you for your service. I am in utter terror and distress concerning a nightmare mistake I made last night. I was very drunk and found myself in an adult store in a shady part of town. I was propositioned by someone there to go to a private booth. This person performed unprotected oral sex on me (I am male) and unprotected anilingus on me. I did ejaculate in their mouth. Afterwards this person (who is African American) informed me that she was in fact a male and then proceeded to smoke crack right in front of me. On my way out running scared it was apparent there had been a drug situation going on there.
Now: I have heard that a gay, male, African American crack addict might have a higher chance of having HIV/AIDS.
So will you please tell me what my chances are and why of contracting HIV/AIDS or any other STDs from this encounter? Are such diseases transmitted through oral sex and analingus (especially given the possibility of his mouth having cuts from drug use, etc. and the fact that I ejaculated in his mouth? Please help me. I would deeply appreciate a thorough medical answer and any advice.
Thank you.

Thank you.
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Welcome to our Forum.  Unfortunately, you have posted on the wrong site.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your questions with this reply but, if you have additional questions or follow-up they must be on the HIV Prevention site.  Sorry

You are correct that among subgroups of people an African American crack user male who has sex with other men is more likely than average to have HIV.  Despite that, there is no risk of HIV from the exposure you describe.  Statistically, it is still unlikely that this person had HIV - most persons do not.  Furthermore, the quoted figure for HIV risk, if one receives oral sex (including analingus) from an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Many experts state there is virtually no risk at all from oral sex and both Dr. Handsfield and I agree.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

As for other STDs of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; 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 have acquired gonorrhea or NGU you will most likely develop symptoms of urethritis (penile infection) such as urethral discharge or burning on urination in the next 3-5 days.  Even if your partner had an STD (any STD and it is likely he did not), most exposures do not lead to infection.  In your case, after a single exposure I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time.  If you seek testing the important tests are for gonorrhea at both the penis and the rectum and the anus, as well as a urethral smear for NGU.  

I hope these comments are helpful. EWH
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