Risk Assesment

[Kumar642]

Hello Doctor,

                        I am 26 years old male living in Canada. I had protected  sex with a CSW from South Korea and she performed oral on me which is covered and I performed oral on her for about brief 3 minutes which consist of mainly kissing. After the encounter I have checked the condom if it has any holes and I even squeezed the used condom nothing came out of it. Is the condom break noticeable? or is it too small to noticeable? Also the brief oral I have performed on her put me at any risk? Do I need to get tested for hiv or any other STD?

[Edward W Hook, MD]

This is a new question.  I will provide a single response but if there are further questions, you should start a new thread.

A new HSV infection would not appear a day after exposure.  If you had a cold sore it was from an infection that you have acquired in the past.  

This will end this thread. EWH

[Kumar642]

Hello Doctor, I had an encounter in a massage parlour, she performed oral on me which is unprotected and we had protected vaginal sex. Next day morning I had burning sensation on my lower lip and it became a bump by evening. I saw the doctor today he examined and said its a cold sore (hsv1). How could one develop a cold sore next day after encounter? Or is it linked to my encounter that I had a month ago? Does this increase my risk of HIV?

[Kumar642]

Hello Doctor, you mean HIV? I don't have any other option than blood test.

[Edward W Hook, MD]

We recommend against blood tests for HSV. the results are all too often falsely positive. EWH

[Kumar642]

Hello Doctor, I want to get tested for HIV, just for reassurance. Is testing after 4 weeks is sufficient? since I had a very low risk exposure. Thanks.

[Edward W Hook, MD]

Neither your doctor, nor anyone else can tell if you have gonorrhea of te throat, or differentiate viral from bacterial sore throats from one aother by looking at them.  Certain appearances make some things more likely than others and he may have been speaking as a generality but testing is the only way to know for sure.

Nearly all gonorrhea of the throat however s asymptomatic. EWH

[Kumar642]

Hello Doctor,

     This is my last question here, I know I had a very very low risk event but I got sore throat on 10th day after the encounter. I saw the doctor yesterday he said thats a bacterial infection by looking at it. How can a doctor say bacterial or viral without a test? I wanted him to check for oral gonnorhea but he said I don't need any test since I don't have any symptoms such as burning etc while urinating. Also lymph nodes in neck do they swell both sides of neck if it is ARS? Why I am showing symptoms even though I have nothing to worry about? Thank you.

[Edward W Hook, MD]

No, no change in my assessment or adivce. EWH

[Kumar642]

Hello Doctor,

                     I have used the same condom for oral and vaginal sex does this cause condom to tear in small that I couldn't even notice?

[Edward W Hook, MD]

As I said above, there are one or perhaps two cases reported in whch men MAY have gotten HIV through cunnilingus.  that is all and I have NEVER sen such a ce myself.  EWH

[Kumar642]

Thanks for the reply doctor, has there been any cases you ever known or heard of men getting hiv through performing cunnilingus?

[Edward W Hook, MD]

Sorry, failed to note your question about other STIs.  The only other STI that you might be at risk for from the activities that you describe is oral gonorrhea. The risk for this is also quite small but if you wish to test, you could have a throat swab taken for testing at this time- it will give reliable results. EWH

[Edward W Hook, MD]

Welcome back to our Forum.  I will be pleased to comment.  This was a very, very low risk event.  Most CSWs do not have HIV. Further, condom protected sex is safe sex with no risk for HIV as long as the condom is worn throughout the encounter and does not break.  You can be confident that your condom did not break, When condoms break they break wide open leaving no doubt that they have failed.  If your condom appeared to be intact, it was.

As for the brief oral sex you performed on her, there is little risk.  There are a very few cases of HIV which may have been transmitted when men performed oral sex (cunnilingus) on infected partners but the estimates are that infection is transmitted less than once in every 10,000 exposures and probably less.  There is no risk for HIV form kissing, including deep kissing.  

My sincere advice is to not worry about this exposure.  If you wish to test in the future, you can do so but I am confident that when you do you will find that you did not get HIV form the exposure you describe.  EWH