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Cunnilingus & STI's: Scared to death
Jul 10, 2005

Doc, you da man!!!! Feel good when I read your responses, unlike the other sites which paint doom's day scenarios. Anyway, here's my question. About 3 weeks back I did something that I am really ashamed of, I hooked up with a Prostitute in Dubai on a business trip. Had protected intercourse, but unprotected cunnilingus. Scared to death that I may have contracted some STI. HIV and Hep B in particular. I'm married w/ 2 kids and this thing has turned my life upside down. Never been unfaithful in the last decade of marriage, I think too much alcohol had something to do with it.

When should I get tested for HIV? and When to get tested for Hep B? No symptoms but anxiety is got me pretty sick.

Thanks Doc. Will definitely donate.

Response from Dr. Frascino

Hi,

Regarding HIV, oral sex carries a very low risk for HIV transmission. "Protected" sex should indeed be protected if the latex condom was used properly and did not fail. If you feel you've placed yourself at risk, get tested at the three-month mark. The odds are astronomically in your favor that you did not contract HIV from this single episode.

The story with Hepatitis B is a bit more complicated. The incubation or window period is usually only a few weeks, but in some cases it can be up to six months after exposure. Adding to this confusion is the fact that many adults who acquire HBV spontaneously clear the virus rapidly (within a few weeks). That means the immune system cures the infection and sets up a protective immunity all on its own. This, unfortunately, does not happen with HIV! Some folks who acquire HBV cannot immunologically clear the virus. They develop a chronic infection with Hepatitis B and the virus is always detectable in their blood. There are a variety of blood tests available that can help diagnose the exact stage of an HBV infection. Other tests show the development of protective immunity and clearance of the virus. The earliest test to become positive if someone is infected with HBV is the HBV PCR. Because this topic can be confusing, I suggest you review the information in the expert forum we have dedicated to hepatitis. From a sexual-risk standpoint, HBV would be difficult to transmit via oral sex. I do not know of any clinical studies scientifically estimating statistical risk of transmission of HBV through oral sex. About 10% of folks who acquire HBV become chronic carriers. A vaccine is available, which is safe and effective. I recommend all sexually active people be vaccinated.

Finally, for your anxiety, I recommend being honest with your wife. It's the best way to confront your guilt and stress over this incident. Counseling may also help.

I'll send you my best good-luck karma! Thank you for your donation. Helping others who are in desperate need is an excellent way to keep our problems in proper perspective.

Good luck.

Dr. Bob



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