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Please Help!!! I'm So Stressed and Don't Understand...
May 27, 2013

I had condom-protected sex (I was insertive partner) with another man who is HIV +. He is on meds. He also gave me oral sex for a minute or two. I'm concerned about a small bump on my penis (very small) that it may be a syphilis chancre. Assuming it is, am I still at little to no risk?

As far as I know, receiving oral sex is thought be nonexistent risk while giving oral sex is slightly higher, but still low.

My concern is, if syphilis was present in him when he gave oral sex, would this increase my risk of HIV from receiving oral sex? I was under the impression the presence of syphilis increases the risk if I were to have given him oral sex or if, perhaps, I had a chancre in my anus and he had unprotected anal sex with me.

Please help. I'm so stressed out I can't handle it.

Response from Dr. Wohl

There is a theoretical risk that an ulcerative lesion could act as a portal for HIV transmission. But, this requires the ulcer to be there at the time of potential exposure to HIV. If it pops up later, that does not count. Also, it is unclear that this risk is that appreciable as studies that look at preventing herpes lesions have not found reductions in HIV acquisition.

Syphilis does not typically cause a pimple.

Overall, I would say that the risk of HIV here is nil if condoms were used - no matter what.

DW



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