Concerns About Oral Sex and Infection Risks: A Medical Perspective

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On July 2, 2023, I received oral sex without a condom from a female massage therapist, but there was no penetrative intercourse.
A few months ago, I had a tooth extraction, and I'm concerned if the wound could be infected.
After the oral sex, I've been experiencing inflammation of the scalp hair follicles, and my weight has dropped from 128 lbs to around 115-116 lbs.
I'm wondering if I might have contracted an infection.
I've been considering going to a small clinic to get tested for HIV, but I'm worried about the accuracy of the results since it hasn't been a week yet.

123, 30~39 year old female. Ask Date: 2023/07/07

Dr. Liao Zhongxin reply Internal Medicine

According to the Centers for Disease Control (CDC) data, there are three main routes of HIV transmission: 1.
Sexual transmission: Engaging in oral, anal, or vaginal intercourse or other exchanges of bodily fluids with an HIV-infected individual carries a risk of infection.
2.
Blood transmission: (1) Receiving or coming into contact with blood or blood products contaminated with HIV.
(2) Sharing needles, syringes, or diluents with individuals who are HIV-positive and use injectable drugs.
(3) Receiving an organ transplant from an HIV-infected donor.
3.
Vertical transmission from mother to child: Infants can acquire HIV from their infected mothers during pregnancy, childbirth, or breastfeeding.

The incubation period after HIV infection has two interpretations: 1.
Symptoms resembling a cold may appear approximately 2-6 weeks after infection, indicating primary infection.
2.
The period from HIV infection to the onset of clinical symptoms typically ranges from 5-10 years (currently referred to as the asymptomatic phase or subclinical phase).
However, as mentioned, the progression of HIV infection can vary significantly among individuals.
During the window period or asymptomatic phase, many patients may not exhibit symptoms, which can lead to continued engagement in high-risk behaviors, creating gaps in HIV prevention and control.

From the above, it can be inferred that the likelihood of contracting HIV is not very high; however, it is still recommended to seek follow-up and consultation at nearby medical facilities.

Reply Date: 2023/07/07

More Info

When it comes to concerns about oral sex and the associated risks of sexually transmitted infections (STIs), it's essential to understand the nuances of transmission routes, the nature of the infections, and the implications of any potential exposure.
Oral sex, while generally considered to be a lower-risk sexual activity compared to vaginal or anal intercourse, is not without its risks. The transmission of STIs through oral sex can occur, particularly if there are open sores, cuts, or bleeding gums in the mouth, which can facilitate the entry of pathogens. In your case, having undergone dental procedures such as tooth extraction could potentially increase the risk if there were any open wounds or healing sites in your mouth during the encounter.

Regarding your specific concerns about the potential for HIV transmission, it's important to note that while the risk of acquiring HIV through oral sex is significantly lower than through anal or vaginal intercourse, it is not zero. Factors that can increase the risk include the presence of other STIs, oral health issues (like bleeding gums), and the viral load of the HIV-positive partner if they are infected.
Your symptoms of scalp folliculitis and weight loss could be concerning, but they are not definitive indicators of an HIV infection. Folliculitis can arise from various causes, including bacterial infections, irritation, or even stress. Weight loss can also be attributed to numerous factors, including anxiety, dietary changes, or underlying health issues.
If you are feeling anxious about the possibility of having contracted an STI, including HIV, it is advisable to seek testing. The timing of testing is crucial; for HIV, testing is typically recommended at three months post-exposure for the most accurate results, as it allows enough time for antibodies to develop. Rapid tests can provide results as early as three weeks, but they may not be as reliable as tests done at the three-month mark.

In terms of your concerns about the accuracy of testing at smaller clinics, it is generally advisable to seek testing from reputable healthcare providers or specialized clinics that focus on sexual health. These facilities often have more experience and resources to provide accurate testing and counseling.

To manage your anxiety during this waiting period, consider engaging in stress-reducing activities such as exercise, mindfulness, or talking to a mental health professional. It's also helpful to educate yourself about STIs and their transmission to alleviate fears based on misinformation.

In summary, while the risk of contracting an STI through oral sex is lower than other forms of sexual activity, it is not negligible, especially with factors such as open wounds in the mouth. If you have concerns about potential exposure, seeking testing and professional medical advice is the best course of action. Remember, early detection and treatment can significantly improve health outcomes, and addressing your mental health is just as important as your physical health.

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