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Dr. Andrew Rynne

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Does oral sex cause HIV infection? What test should I undergo?

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Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2766 Questions

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Posted on Tue, 10 Dec 2013 in Sexually Transmitted Diseases
Question: Hi, I believe my query needs to go to STD Sexual Disease specialist please.. ================================================================= I’m 32 yrs old male. I encountered an accident with a masseuse/prostitute on 3 May. We had a naked massage body to body, all over to my body, then something unplanned happened, she licked my anus, gave me oral sex- which was unprotected. We then had sex for 5 min but that was with condom. In about 3-4 days, I was starting to feel pain when urinating, burning sensation etc. somewhat whitish surface on top surface of penis, had unwanted smell on that surface area - no fluid discharge or blood though. I just relied on drinking plenty of water, lots of cranberry juice and did not see GP for about a 10 days. I realized that I might have some sort of infection as pain did not go away and then saw GP finally. She asked for urine test, STD blood test, ultrasound for kidney etc.. and gave me some sort of antibiotics for UTI. Reported attached. No STD infection was found. Kidney ultrasound report looked normal. My major complaint about pain did go away, however I still had some sort of strange tingling and somewhat urine burning feeling. My GP said, things are normal and it is just in my brain, but I still preferred to see a Urologist as I’d a strong feeling that something is not seeming right. And lucky that I saw him. Urologist physically examined me (entered his finger into my anus), on 21 XXXXXXX He suggested, I had some swelling in my prostate grand, he prescribed me Ciprosloxacin 500Mg 14 QTY (2 times/7 days) I did then felt normal and all remaining complaints, pain in urinating, was gone. I was asked to do urine test 7-10 days following the completion of my medicine, it came normal. 26 July, I saw him, he pointed, the Leucocytes got reduced down to 1 from 8 – in two urine tests that I’d done by this time, which he said is a good thing. He declared, I’m all good, also I’m safe to have sex with my wife. So this is the background… From about XXXXXXX I also had a strange tingling feeling in my anus, bit hard to describe but it catches my attention few times in a day. It is not going terrible but I feel like, never ever in my life it caught up my attention at anus. No itchiness, no pain, no burning, no blood evidence in tissue, I can feel skin appears to be normal, but feels like a worm coming out or something. I know it’s not worm but kind of tingling sensation. At early stage in XXXXXXX I’d thought it’s all related, so I did not mention to Urologist. But on 26th July, I mentioned him about this, he said, he can’t think of anything else, I’m all good. I let time go, no change in this anus sensation, I saw him again, 4 Nov, his response stays the same. The other thing is, I have a chronic sinus condition from many years, but in general sinus problem was ok up until, May. From about mid May, I noticed that I seem to continue get post nasal drip (sticky cough, sometimes yellow but generally white) and may be my sinuses are inflamed I think. I observe pain surrounding my eyes. I do have blockage in left frontal sinus from 2 yrs but despite, I did not have post nasal drip before May. I suspect that I’m still somewhat infected, somewhere, it’s just hasn’t been diagnosed properly. When I had flu or viral infection in winter season in past, that is when I used to get post nasal drip. This also makes me feel, some bacteria is still in my body because of this exposure. I don’t have discharge, no marks on penis, no burning pain when urinating but I observed, these days, if I wipe penis tip after urinating, it doesn’t smell so good. I still have a feeling that I might still have some sort of dormant or active bacteria in my body. Per my Urologist, it is just body’s natural bacteria smell, so nothing to worry. Per him, it got to be like a fish smell, with a discharge, etc., which I’m not experiencing so he reckons I don’t need to worry about, and I’m good. But I don’t recall even such smell before the exposure. From 26th July onwards, since Urologist gave me ok, I’ve been having sex with my wife and we don’t use condoms. Beginning Oct, my wife reported, she has been having pain above waist, very bad pain which lasted few days, she then did ultrasound for kidney and urine test per GP but it came normal. No possibility of kidney stone. She experienced warm body for few days, but wasn’t warm enough to be considered as fever. GP said, she is all ok. Currently, she is sort of ok but sometimes I can feel her body warm. Since there was no evidence in her urine, GP didn’t prescribe anything. I don’t know if this means anything to you? Any hint etc.? Note: I experienced warm body in first week of May following exposure but these days, I don’t feel warm and also no fever. No headache, no pain in throat. Based on my blood reports of 26 July, my GP suggested to take 3 injections of Hepatitis B vaccination (20mcg), I’ve already completed 2 so far, next one is due in few months. I’ve repeated HIV 3 times, all negative. Last test was 31 Oct. I've attached all reports that I've done so far. My questions are: 1. How do I find out I’m not still infected in any way with this exposure? What tests can I do? Is there anything should I repeat? What if any blood or urine tests you suggest comes normal? My GP and Urologist suggests that I’ve already had STD tests and they don’t think need of repeating it. I've attached all my reports here that I've done so far. 2. That strange tingling anus feeling, kind of bacterial smell on tissue after wiping the penis tip and my post nasal drip in sinus gives me warming signs, I feel, I should not keep ignoring this and do some tests. Basically eliminate any possibilities of any kind of infection present in body. Please suggest me, how do I eliminate this? 3. If I have any kind of STDs then shouldn’t I get fever? I don’t get fever. 4. I haven’t told my wife about my exposure, so I’m reluctant to tell her doing any STD tests. I feel, if all of my tests comes negative then how come she can get infection from me? 5. In next 3 months, we are also planning for a baby but I wanted to get back to my normal life and get well first. If any precautions that I need to take at this stage before we plan – Ie, doing specific blood test, urine test etc. either for me or for my wife then please advise. 6. Is that okay not to use condom during sexual intercourse with my wife just now ? In fact, I'm not using condom from past few months since Urologist gave me ok that I'm all good. I’m little bit concerned now. Should we also wait for baby planning until I sort out these things. Thanks !
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Answered by Dr. S. Murugan 3 hours later
Brief Answer: Oral sex,anal licking carries low risk for STD/HIV Detailed Answer: Hi, Welcome to XXXXXXX Thanks for posting your query. Oral sex has a low risk for STD/HIV when compared to penetrative anal and vaginal sex. Your vaginal sex is a protected one. Oro-anal contact also carries negligible risk for you. Licking the anus will not cause anything inside anus. So the feeling of worms and tingling sensations are not areal one but due to your fear for STD/HIV. Oral anal licking may be likely to cause problem for the licking person rather than you. All the blood and urine tests were within normal limits except that of ANA test which is not related to any of your problem. You mentioned that you had your tests for STD around 10th day after your high risk activity. Better repeat them once again and get things ruled out conclusively. Possibility of yeast infection is there with oral sex and over anus. It can be diagnosed by simple lab investigations and easily can be managed. Sinus problem is not related to your sexual activity. Your wife's abdominal pain also not likely to relate to your sexual encounter. After having tested once again for STD you can continue your relationship with your wife and you can try for your baby. Nothing to worry. Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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