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cunnilingus on a CSW
Dear Doctor,
33 days ago I had an intercourse with a CSW which involved protected vaginal intercourse, protected fellatio and UNPROTECTED cunnilingus. I do not recall having swallowed any blood or vaginal fluid, however later after we finished I noticed some blood on the blanket. It is therefore likely that she was menstruating. Moreover, I brushed my teeth 1-2 hrs before the exposure. After having made extensive reading recently, I am worried about having contracted HIV or any other STDs from this exposure. I read on internet that there were few "documented" cases of HIV transmission through cunnilingus. Furthermore last week (i.e. 4 weeks after the exposure) I had a light sore throat and a very mild fever reaching 37.1 C (98.8 F) at its highest.
1) How would you assess my risk of contracting HIV or any other STDs assuming that I could have swallowed little amount of menstrual blood/vaginal fluid?
2) Have you ever in your career encountered or read about a case where cunnilingus was the sole route through which HIV transmission to a man occurred? In this regard, how would you assess the trustworthiness of those very few allegedly documented cases? Is it likely that the patients did not tell or recall everything and that in reality cunnilingus was not the sole unprotected exposure involved?
3) As I understand from my reading, for cunnilingus to pose a realistic threat different aggravating circumstances have to coincide; e.g. swallowing profuse amounts of menstrual blood/vaginal fluid, sores and bleeding gums and no saliva in the mouth. Again in this regard, is it known whether any of these circumstances were present in those few "documented" cases?
4) Can my symptoms be attributed to ARS?
5) 26 days after the exposure I had a general screening for STDs the results of which I will learn in a couple of days. The tests included a combined HIV test for antibody and for p24 antigen. If the latter is negative is it a reliable sign that I am HIV-?
33 days ago I had an intercourse with a CSW which involved protected vaginal intercourse, protected fellatio and UNPROTECTED cunnilingus. I do not recall having swallowed any blood or vaginal fluid, however later after we finished I noticed some blood on the blanket. It is therefore likely that she was menstruating. Moreover, I brushed my teeth 1-2 hrs before the exposure. After having made extensive reading recently, I am worried about having contracted HIV or any other STDs from this exposure. I read on internet that there were few "documented" cases of HIV transmission through cunnilingus. Furthermore last week (i.e. 4 weeks after the exposure) I had a light sore throat and a very mild fever reaching 37.1 C (98.8 F) at its highest.
1) How would you assess my risk of contracting HIV or any other STDs assuming that I could have swallowed little amount of menstrual blood/vaginal fluid?
2) Have you ever in your career encountered or read about a case where cunnilingus was the sole route through which HIV transmission to a man occurred? In this regard, how would you assess the trustworthiness of those very few allegedly documented cases? Is it likely that the patients did not tell or recall everything and that in reality cunnilingus was not the sole unprotected exposure involved?
3) As I understand from my reading, for cunnilingus to pose a realistic threat different aggravating circumstances have to coincide; e.g. swallowing profuse amounts of menstrual blood/vaginal fluid, sores and bleeding gums and no saliva in the mouth. Again in this regard, is it known whether any of these circumstances were present in those few "documented" cases?
4) Can my symptoms be attributed to ARS?
5) 26 days after the exposure I had a general screening for STDs the results of which I will learn in a couple of days. The tests included a combined HIV test for antibody and for p24 antigen. If the latter is negative is it a reliable sign that I am HIV-?
MEDICAL PROFESSIONAL
Welcome to our Forum. I see that you have submitted the same question to our colleagues on the International Forum. I anticipate that you will get similar answers from each of us. As you have already learned, the risk of this infection is quite low. Condom protected sex is safe sex, most CSWs do not have HIV or other STIs, most exposure to infected partners do not lead to infection, and cunnilingus is a particularly inefficient means for transmission of infection. with this background, I'll go straight to your questions:
1) How would you assess my risk of contracting HIV or any other STDs assuming that I could have swallowed little amount of menstrual blood/vaginal fluid?
See above, very, very low, even if you swallowed vaginal secretions or blood. If you need the peace of mind that comes from negative tests, the most important test for you is a throat swab for gonorrhea and chlamydia.
2) Have you ever in your career encountered or read about a case where cunnilingus was the sole route through which HIV transmission to a man occurred? In this regard, how would you assess the trustworthiness of those very few allegedly documented cases? Is it likely that the patients did not tell or recall everything and that in reality cunnilingus was not the sole unprotected exposure involved?
In science one can never say never. It is, I suppose plausible that a few people have acquired HIV through cunnilingus but I consider them to be the "exceptions that prove the rule". The risk of infection, again, IF your partner was infected, is less than 1 in 10,000.
3) As I understand from my reading, for cunnilingus to pose a realistic threat different aggravating circumstances have to coincide; e.g. swallowing profuse amounts of menstrual blood/vaginal fluid, sores and bleeding gums and no saliva in the mouth. Again in this regard, is it known whether any of these circumstances were present in those few "documented" cases?
That would be my sense as well.
4) Can my symptoms be attributed to ARS?
Most unlikely. ARS is typically rather severe, flu-like illness.
5) 26 days after the exposure I had a general screening for STDs the results of which I will learn in a couple of days. The tests included a combined HIV test for antibody and for p24 antigen. If the latter is negative is it a reliable sign that I am HIV-?
If these tests are negative, you can be quite confident that you did not get HIV from the encounter that you describe. I anticipate that this will be the result (i.e. your tests will be negative) and hope that you will believe the results when you get them.
I hope these comments are helpful. Try not to worry. EWH
1) How would you assess my risk of contracting HIV or any other STDs assuming that I could have swallowed little amount of menstrual blood/vaginal fluid?
See above, very, very low, even if you swallowed vaginal secretions or blood. If you need the peace of mind that comes from negative tests, the most important test for you is a throat swab for gonorrhea and chlamydia.
2) Have you ever in your career encountered or read about a case where cunnilingus was the sole route through which HIV transmission to a man occurred? In this regard, how would you assess the trustworthiness of those very few allegedly documented cases? Is it likely that the patients did not tell or recall everything and that in reality cunnilingus was not the sole unprotected exposure involved?
In science one can never say never. It is, I suppose plausible that a few people have acquired HIV through cunnilingus but I consider them to be the "exceptions that prove the rule". The risk of infection, again, IF your partner was infected, is less than 1 in 10,000.
3) As I understand from my reading, for cunnilingus to pose a realistic threat different aggravating circumstances have to coincide; e.g. swallowing profuse amounts of menstrual blood/vaginal fluid, sores and bleeding gums and no saliva in the mouth. Again in this regard, is it known whether any of these circumstances were present in those few "documented" cases?
That would be my sense as well.
4) Can my symptoms be attributed to ARS?
Most unlikely. ARS is typically rather severe, flu-like illness.
5) 26 days after the exposure I had a general screening for STDs the results of which I will learn in a couple of days. The tests included a combined HIV test for antibody and for p24 antigen. If the latter is negative is it a reliable sign that I am HIV-?
If these tests are negative, you can be quite confident that you did not get HIV from the encounter that you describe. I anticipate that this will be the result (i.e. your tests will be negative) and hope that you will believe the results when you get them.
I hope these comments are helpful. Try not to worry. EWH
MEDICAL PROFESSIONAL
I'm pleased I could help. EWH
Dear Dr. Hook,
Thank you for your helpful and relieving reply.
Thank you for your helpful and relieving reply.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
