Unprotected Oral Sex

Patient

Q: Dear Doctor, I (a male) have had unprotected oral sex (only) with a female prostitute about 6 weeks ago (she performed it on me twice). I do have some infrequent pain/throbbing sensation-on one of my testicles. There is no discharge, puss, chancres, sores, pain while urinating or any other normal STD symptoms. Is this testicle pain alone an STD symptom? Any chance of HIV infection from this incident? There was absolutely no contact with any part of genitals of this woman. Must I go for an STD/HIV tests? There is some practical difficulty for taking these tests for at least another 3 months. Very scared and would be grateful for your resposne/guidance.

Doctor

A:   Various research studies have shown that young adults tend to be at higher risk of being infected by HIV, mainly through high risk activities such as: unprotected casual sexual intercourse (especially receptive anal), large number of sexual partners, previous or current STDs (Gonorrhea, Chlamydia, Syphilis, Genital Herpes), sharing intravenous drugs paraphernalia, blood transfusions (before 1985 in US), mucosal contact with infected blood or needle-stick injuries, persons who exchange sex for money and/or drugs. HIV is transmitted when the virus enters the body, usually by injecting infected (needle stick) cells or semen. There are several possible ways in which the virus can enter: Most commonly, HIV infection is spread by having sex with an infected partner and the virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex. In the infected individuals the highest concentrations of the virus are in blood, less in the semen and vaginal secretion. The virus does not spread through casual contact such as preparing food, sharing towels and bedding, or via swimming pools, telephones, or toilet seats. The virus is also unlikely to be spread by contact with saliva, unless it is contaminated with blood. In the view of your exposure to a high risk activity, the suggested strategy is: Get Tested. Testing for HIV is a two-step process. First, an inexpensive screening test is done. If that test is positive, a second test (Western blot) is done to confirm the result.

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