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Had Oral Sex. Having Pimple Near Penis And Squeezed It. Washed The Blood And Pus. Any Risk Of HIV?

Posted on Sat, 14 Sep 2013

Question: Dear Dr.
I received a oral sex from a Sex worker in India. I was drunk at that moment however I can recall the situation
- She licked by testicles and there was sliva there
- She then put condom on my penis and gave me a oral. I came inside the condom. I then removed the condom.
- there was a pimple near my penis (at the pubic area). It was not bleeding. Girl's saliva touched the pimple
- next day I noticed another pimple at the same area which I squeezed and wash the blood and puss with soap.
I want to know:
1) What is my HIV risk from this incident?
2) Do I need to get tested?
3) Could these pimples be any other STD, in that case does it increase my chances of getting HIV?
4) Please let me know if there are slightest of chances of getting HIV by this exposure.

Answered by Dr. Sudarshan (7 hours later)

Brief Answer:
There is nothing to be worried about NO HIV RISK

Detailed Answer:
Hi XXXX,
Thanks for writing in.
Ive gone through your history and query.
To answer your queries-
1.There is no risk of HIV from this exposure.
2.There is no real need for testing HIV for this exposure.
3.The pimple appears to be folliculitis or bacterial infection.It does not appear to be STD.There is no increased risk of HIV.
4.There is no real risk of HIV by this type of exposure.Only few STDs like herpes genitalis or genital warts can be transmitted by such exposure.

Hope this clears your doubts.
There is nothing to be worried about.
Regards
DrSudarshan
MD HIV & STd specialist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudarshan (1 hour later)

Thank you for your reply. My anxiety levels have come down with your response. I just want to know if HIV can be transmitted by saliva. In my case, the pimple/lesion came in contact with the saliva. Also after removing the condom, I touched the pimple with the same wet hand.

Also though I checked the girl's mouth for any visible blood and I didnt saw any. Do not know if there were any microscopic cuts in her mouth and blood may have come out of that mixed with the saliva.

Though your response is very very assuring, I request you to elaborate a little as why there is no risk of HIV from this exposure.

Answered by Dr. Sudarshan (19 minutes later)

Brief Answer:
SALIVA DOES NOT TRANSMIT HIV VIRUS.

Detailed Answer:
Hi again,
Saliva contains antiviral substances naturally which neutralize the virus.Saliva is not known to transmit HIV virus .Unless there is major oral ulceration or active oral bleeding or saliva with visible blood staining there is no real transmission with salivary secretions.
As in your case it was protected exposure and no visible blood on lesion there is nothing to be worried about.
Hope this helps.
Regards
DrSudarshan

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudarshan (14 hours later)

Thank you for your reply. I read somewhere that virus levels are very high in saliva during initial stages of infection (window period). What if that girl was in her window period of infection. What are the chances of infection in that case. Her saliva touched my pimple on pubic area and also while removing condom my fingers touched the saliva and then I touched my penis and pimple. Please let me know if there is any risk.

Answered by Dr. Sudarshan (10 hours later)

Brief Answer:
HIV RNA PCR testing

Detailed Answer:
Hi again,
Even if the girl was in window period still the saliva is not able to transmit the virus.Actual fluid transfer is needed for HIV to be transmitted only blood /semen/ vaginal fluid can transmit the infection.Even if you had touched the lesion there is no need to worry as it is not able to transmit the infection.
If you are still worried you can undergo RNA PCR test for HIV .The negative test result will rule out the infection.
Hope this clears your doubt.
Dr Sudarshan

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudarshan (42 minutes later)

Thank you again for your reply. I completely trust your advise. One final question I am asking just out of my anxiety. Please tell me if I should go for PCR test or you have recommended this just to remove my anxiety. What would be your final advise. You are 100% sure that there is no risk with my exposure? I do not want to go for test unnecessarily and also I do not want to liive with doubt. Please tell me and I will then forget this incident and move on.

Answered by Dr. Sudarshan (25 hours later)

Brief Answer:
Move on

Detailed Answer:
Hi again,
In my opinion no testing is required and you should move on with life.
As no real exposure has occurred you should stop worrying and get on with routine.
Hope this helps.
Regards.

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Sudarshan (7 days later)

Dear Dr.

I missed to mention that while that sex worker licked my testicles there were few scratches and scabs on my testicles. It was not bleeding. The scratches/scabs may have come due to shaving or scratching due to itching. I could see girl's saliva on the scabs at the testicles. Does this increase my risk of HIV?

Also next day I saw a red spot at the rear side of my shirt. It looked like a blood spot. There was no other spot any where. Assuming that the spot was girl's blood and it also touched my pimple and testicles, is it a risk for HIV?

Answered by Dr. Sudarshan (2 days later)

Brief Answer:
No need to worry

Detailed Answer:
Hi Again,
Thanks for details.
Still I would say say there is no increased risk of HIV in your case.
HIV is unlikely to be transmitted by this kind of exposure.If large amount of blood is spilled over ulcerated area of skin or mucosa and remains as such for more than 30 minutes then there is a small chance of HIV exposure.
With the kind of exposure narrated by you there is hardly any risk of HIV.
Hope this calms your mind.
Regards
DrSudarshan

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sudarshan (9 hours later)

Thank you for your reply. If I understand correctly, hiv transfer do not happen so easily but still so many people are affected with this.
My only risk was exposure to saliva or may be blood on my testicles and pimple. There were some abrasions on testicles due to scratching/itching. Does hiv require lot of blood in direct contact with a wound for 30 mins to transfer? Request you to please explain this to me.
Please please let me know if tbere are slightest of chances of me catching hiv by thos exposure. I am too scared to for a hiv test and I do not want to go for test of there is no risk.

Answered by Dr. Sudarshan (52 minutes later)

Brief Answer:
No testing required

Detailed Answer:
HI again,
As you know already only way to spread HIV is by
-Unprotected penetrative sex
-Infected blood transfusion
-Mother to child
-Through needle pricks( occupational or drug user)

Most commonly it is transmitted by unprotected sex.It can spread if condom breaks down /ruptures during the act.Oral sex can transmit HIV in rare cases if there is active oral bleeding /ulcers in oral cavity and secretions are ejaculated into mouth.That too in very rare instances.
It does not transmit through saliva/scratches etc.
In my opinion you dont need any testing and have no risk so far.
Hope this helps.
Regards

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