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HIV/Other STD Risk from Giving Anilingus
Jul 16, 2011

I am a healthy male in my 30s with no history of any STDs. Last night while being very drunk, i had sex with 2 commercial sex workers. - I performed oral-anal sex on them (i licked their anus frequently inserting my tongue) for over an hour combined - I performed oral-vaginal sex on one (i licked her vagina) for a few minutes - I had condom protected intercourse with one of them with no condom breakage - One of them performed fellatio on me with a condom on.

I am now very concerned now about HIV and other STDs especially due to the oral-anal exposure. A lot of sites rate that exposure as high risk. I do have a small cut on the underside of my tongue and on my lip. The only symptom I have yet (15 hours later) is a dry throat and sloughing of skin inside my mouth on one side.

My questions are:

1. What is my risk of having acquired HIV?

2. Should I rush to any STD clinic for any preventive measures like PEP?

3. What is my risk of herpes, HPV, Chlamydia, Gonorrhea and Syphilis?

4. Should I continue to have protected or unprotected sex with my wife?

5. In general what should my course of action be -- at what point should I go to the doctor, if at all?

Your responses are eagerly awaited and will be highly appreciated.

Response from Dr. Frascino

Hi.

1. Your combined HIV-acquisition risk from your walk on the wild side last night is extremely low. Rimming (oral-anal) and cunnilingus (oral-vaginal) carry an extremely low risk for HIV acquisition, barring unusual extenuating circumstances. Protected sex (oral, vaginal or anal) would be "protected," assuming the latex condom was used properly and didn't fail (break).

2. PEP would not be warranted for such a minimal level of risk.

3. Many STDs, including the ones you listed, are much easier to contract than HIV. HPV, for instance, can be transmitted by skin-to-skin contact. Routine STD screening is recommended for sexually active folks with multiple partners.

4. I would advise you level with your wife and then decide together. Your HIV risk is extremely low; however, you both may feel more comfortable using latex condoms until your HIV-negative status can be confirmed with a definitive three-month HIV-antibody test.

5. I'd recommend routine STD screening. Your general medicine doctor or an STD clinic can do this for you.

Good luck.

Dr. Bob



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