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Gavin: HIV risk unprotected oral sex with sexual worker

Question: 

Hi, I had unprotected oral sex with a sexual worker 3 and a half weeks ago. I had a small sore on my penis during that time which is recovering. the whole process is like 1 minute and I did not ejaculate in her mouth. She is sucking and spiting the fluid in a bin. Before the oral I washed my penis and she washed her mouth with listerine mouth wash. I had a sore throat 2 weeks after that and it last only for a few days. Now I have this feeling of a lump under my jaw which is roughly 1-2 cm i think. It is not painful but I am worrying that I might contract HIV from the unprotected oral through my penis sore. I am feeling very anxious now and I don't know what can I do. Can you please give me some advice on my risk of contracting HIV through the sore and the timing that I have to do a screening test? Thank you.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV from receiving oral sex from an individual of unknown HIV status. From the information given, this scenario is determined to be of Negligible Risk. (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

Only certain bodily fluids, such as - blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk carry significant viral loads from a person who has HIV. These fluids must come in contact with a mucous membrane (mouth, vagina, penis, anus) or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur.

Although the risk of HIV transmission through oral sex is very low, several factors may increase that risk, including sores in the mouth or vagina or on the penis, bleeding gums, oral contact with menstrual blood, and the presence of other sexually transmitted diseases (STDs). In the future, using a barrier like a condom or dental dam during oral sex can further reduce the risk of transmitting HIV, other STDs.

It is important that you do not rely on acute HIV symptoms, or "ARS" in any way to indicate whether or not you have HIV. There are no clinically defined symptoms for acute HIV infection that can predict whether or not someone is HIV positive; the symptoms that are observed are only seen in some people, and are very similar to the flu and/or several other viruses that can cause similar presentations. The only way to be sure is through testing outside of the window period - 6 weeks and 3 months post-exposure for completely conclusive results.

Recommendation: There is no evidence or documented cases of transmission. Refer to a healthcare professional for more personalized answers.

All the best,

AIDS Vancouver Helpline, Jason