Unprotected oral

[kc26]

I am a married man and 2 days ago, i made the biggest mistake of my life. A prostitute performed an oral on me without condom. i come inside her mouth and spitted out. The massage followed for like 20 min, then i washed my penis with soap and water. I did not notice any cold sores on her outer lips and mouth but i not sure she has cold sores or not inside he lips or mouth.

I thought it was safe with oral sex unprotected but almost all information on the internet says that there are definately risks of infected with all sort of different kind of STDs with unprotected oral sex. That really freak me out and i am very worried about it

So far in 2 days, i have not notice any lesions or anything coming up in my penis. Maybe too early to tell. Except i feel sore in my left groin area..dont think it is swollen. Just some soreness. It does feel like hernia soreness i felt before some time back and then went away. The soreness is most pronouce when i sit and seems to be less when lay down.
My questions are
1) Why most info i got from internet says the risks are real in almost all STDs with unprotected oral sex? Which is more accurate? What are my chances?

2) When can i go for tests and get reliable results? What specific tests shld i be tested and for each of the STDs?
3) Is is too early to have any symptoms? If there are no symptoms after a week, it is safe to say i am not infected by STDs? or i will not know even then.
4) It is safe to have sex with my wife with condom of course? i worried i can get her infected with whatever i got from this even with condom on.. Any advise to minimize the risks.? She will know something is wrong if i not interested...
5) Know that this is forum for STD, but what are the chance that i might get HIV..? there might be cuts in her mouth and or some unnoticeable cuts on my penis for the blood to transmit..I did not notice any blood though. Does it have to be substantial bleeding for HIV to transmit..?

[H. Hunter Handsfield, M.D.]

Oral herpes recurrences (cold sores) are almost always on the outside, not inside the mouth.  Washing may help reduce STD risk, but only a little (and maybe not at all).  "Outside the US" covers too much of the world for me to comment on your risk.  If you are in an industrialized country (e.g., Europe, Australasia, etc) the risks probably are about the same as in this country.

Tests for gonorrhea and chlamydia are accurate with 2-3 days of exposure.  Syphilis and HIV, 6 weeks.  HSV blood tests, 6-12 weeks.  I repeat you don't need to be tested if you don't develop symptoms.  But if your anxieties force you to do it anyway, a single visit to a provider at about 6 weeks would be a good plan.

The risk after a single exposure is low, but I cannot put a number on it.

[H. Hunter Handsfield, M.D.]

First, relax.  Your original perception is more accurate than what you found by searching online.  By and large, oral sex is safe sex, especially in regard to HIV. For all other STDs, oral sex is much less efficient as a route of transmission than vaginal or anal sex.  These issues have been discussed frequently on this forum; with a little searching you can find a lot of information that should be quite reassuring.

To the direct questions:

1) There is a small but real risk of gonorrhea, herpes (due to HSV-1), and nongonococcal urethritis (NGU).  There is a theoretical risk of syphilis, but that STD is so rare in heterosexual women in the US that it's really not an issue.  There is no risk for chlamydia, which rarely infects the mouth and throat and therefore is not transmitted by oral sex.  As noted above, no practical risk for HIV, no more than one chance for 10-20,000 exposures, if the oral partner is infected.

2) See any STD-knowledgeable health care provider.  If you're not confident in the knowledge of your personal provider, visit your local health department STD clinic for expert, highly confidential, and low cost (perhaps free) care.  Don't go in asking for specific tests; accept the provider's judgment about what tests should be done.

3) Timing of symptoms varies from typically 2-5 days for gonorrhea, 3-10 days for herpes, 7-14 days for NGU, and 2-3 weeks for syphilis, That said, most STDs from oral sex cause symptoms; if no symptoms appear, you really don't need test at all, except for psychological reassurance.  The main symptoms to watch for are abnormal discharge from the penis (gonorrhea, NGU) or penile blisters or sores (herpes, syphilis).

4) For the reasons above, the chance you caught anything is low, but of course I cannot guarantee you aren't infected.  To be maximally safe, it is best to avoid sex with your wife for the next 2-3 weeks.  If you do have sex with her, of course condoms would markedly reduce the already low risk to her.

5) The near-zero risk for HIV from oral sex includes the fact that lots of people have oral lesions.  You really have no serious HIV concerns here, and anyway in most areas of the US, HIV is rare in commercial sex workers.  But for absolute reassurance, feel free to have an HIV test in about 6 weeks.

I hope this helps.  Best wishes--  HHH, MD

[kc26]

Dear Doc,
Thanks for your reply.
Sorry for not informing you realier. I am outside of US. Does it made the risk higher for syphilis and HIV? I have too
There are a few things that need your further clarications,
1) I did not notice cold sores in her outer lips and mouth. But not so sure about inside. Is it common to have only cold sores in the inside and not outside? Most Worried about this. Herpes in not curable.
2) Does washing your penis with soap and water after the oral lower the risk of STDs?
3) For peace of mind, i will go for test, With me not in US, very diffficult to get good expert advice. Can you pls recommend when the best time for accurate results to take the tests for each of the STDs? I can take the tests for specific STD each time it is the right time. I want to cancel out the possibility for each STD as soon as i can...
Thanks you so much. Appreciate it.

[H. Hunter Handsfield, M.D.]

I agree with whatisay; he said it as well as I can.  Time to end this thread.  I won't have any further comments.

[whatisay]

Calm down- You have no symptoms at 3 weeks- that is good news be happy- If you can't get tested for  gonorrhea and chlamydia as they can be tested now.  When those come back neg you will feel better.  If you can't wait 6 weeks get an HIV test at 4 weeks maybe 75% of anyone who  would be positive are positve by then.  So if you are neg that is good news.  Then test at 6 weeks this is 95% so given the low risk and the testig you would be in great shape.  The docotr cannot guarantee you are disease free.  Just make a p[lan with the information you are given here and you will feel better.  

[kc26]

Dear Doc,

Thanks for your help.

I am being counting the days and it has been very hard..Exactly 21 days have passed since the unprotected oral sex exposure...It has been a roller coaster up and down and the pass few days i being very anxious and worried sick of HIV and herpes infection..since they have with no cures..

Last 3 weeks i have no symptoms like abnormal discharge from the penis (gonorrhea, NGU) or penile blisters or sores (herpes, syphilis). Hope you can clear my mind.

1) With no symptoms for last 3 weeks.. Can you say that i am not infected with gonorrhea, NGU, herpes, syphilis?
2) You said that most STDs from oral sex cause symptoms. Why is that? So it is possible that i have STD and no symptom at all?
3) by how many weeks if i continue to have no symptoms can i say i am safe from herpes and HIV?
4) if infected by HIV, would i have symptoms by now.. what kind of symptoms and when?

Thanks again Doc..

[kc26]

Sorry Doc..1 last question
4) In all your vast experience, how likely is someone infected with multiple STDs with only 1 exposure with unprotected oral sex.??