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Does Oral Sex Lead To HIV?

Posted on Wed, 7 May 2014

Question: Dear Doctor, My best friend is a man has an oral sex ( Fellatio Only ) with sex worker girl one time only. After 3 days of the relation she performed the following tests : HBsAG : Negative HCV Ab ( XXXXXXX ) : Negative VDRL : Negative HIV 1&2 Ab/Ag ( Elisa ) : Negative 1- Is my friend has a risk of hepatitis B, hepatitis C, syphilis, aids, herpes simplex type 2 ? 2- Is my friend need any tests ? 3- In the day 12th after proposed infection he perform HSV-2 IgG & IgM test ( Negative ) so is this enough for herpes type 2 ? 4- in the day 14th after proposed infection he perform HIV PCR test ( If negative ) so is this enough for HIV ?

Answered by Dr. Sankaranantham Murugan (5 hours later)

Brief Answer: low risk with oral sex.STD/HIV ruled out by tests Detailed Answer: Hi XXXX, Welcome to HCM. Thanks for posting your query. Your friend had oral sex only. The chances of getting STD/HIV through oral sex is very low. When she was negative for HBV, HCV, VDRL.HIV1 and 2, then where is the question of risk for your friend? Nothing to worry. HSV 2 IgM also negative after 12 days (IgM indicates fresh infection). So the possibility of HSV 2 was also ruled out. If the girl had HSV 1 infection, which is so common for anybody, it might have been transmitted to your friend. If he had no other symptoms of herpes or an yeast infection you can ask your friend to simply forget about the incident and relax. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (3 hours later)

Thanks, - she is negative after 3 days of the act , but we read that she could be infected recently and the test not showing this, so is there any risk ? - Is any type of tests required ? If yes, what the right time for each type of STD's - No other symptoms around the mouth or in penil site , but there was in the past on lips before many years. - in the day 14th after proposed infection he perform HIV PCR test ( If negative ) so is this enough for HIV ? please your appreciated support.

Answered by Dr. Sankaranantham Murugan (41 minutes later)

Brief Answer: Oral sex carries low risk for HIV/STD. Detailed Answer: Hi, Welcome back. It depends upon the sexual activity of that girl. As you rightly pointed out that if the girl had her sexual activities well within 3 months of her tests, then there is every chance for her to have infection yet to be revealed and she may be infectious. But oral sex carries a low risk for HIV/STD. Test for Syphilis (VDRL) and HSV will become positive after 4-6 weeks of possible infection. HIV, HCV, HBV antibodies are likely to occur 8-12 weeks after possible infection. PCR tests for viral infection or P24 antigen test will become positive within a weeks time and becomes more conclusive after 4 weeks. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (1 hour later)

Thanks, Please doctor answer me directly for : - The 12th day herpes test ( HSV-2 IgG and HSV-2 IgM ) was negative for both without any symptoms, does my friend need to re-test again ? - The 14th day HIV PCR ( RNA ) conclusive or not ? - Is my friend need to test all STDs before he back again to his natural life ?

Answered by Dr. Sankaranantham Murugan (40 minutes later)

Brief Answer: HIV DNA PCR becomes conclusive after 4 weeks. Detailed Answer: Hi, Welcome back. Medicine is not Mathematics to have a fixed or constant values or answers. Here you may have probabilities and variations. If you want theoretical answer for your question, then my answer is DNA PCR becomes more conclusive after 4 weeks of possible infection. HSV need not to be checked routinely, need to be checked when there is doubt or to check about the sex partner who had no symptom. Diagnosis of Herpes mostly made with symptoms and there is no drug to prevent the recurrences. Moreover it is not a life threatening one. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (18 minutes later)

Thanks, We are talking about a specific case ( Fellatio during less than two minutes ) The man perform the blood test ( HSV-2 IgG and HSV-2 IgM ) after 12 days of the proposed infection and was negative for both ( IgG & IgM ) , Does he need to test again or the result conclusive that he is safe. The HIV test is RNA PCR and two weeks should be enough as per the lab , please confirm or reject ?

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer: DNA PCR becomes conclusive only after 4 weeks Detailed Answer: Hi, The timings two minutes or less is not at all that matters. Infection can occur within seconds if there is risk. Felatio once again, I told you, has low risk for HIV. If you want a conclusive result DNA PCR has to be repeated after 4 weeks. Dr Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar