
Does Oral Sex Lead To STD?

I received unprotected oral sex and we also engaged in protected penetrative sex (using condom) And only for 5 minutes. Obviously I don't know whether this woman has HIV but I'm scared since she is a sex worker. What's worse is that I have a minuscule cut/nick on the base of my penis from shaving 2 hours previous to the episode which I'm not sure if the condom covered. One on my penis can barely even be classed as a cut, think i just nipped the skin and made a red mark as I dont remember any blood and it doesn't even appear to have any 'scab-like' appearance....however there is a small cut that is located on my scrotom, very close (basically beside) the base of my penis which obviously wouldn't have been inside the vagina but may have touched it, I'm not entirely sure, would this count as risk?
Also because these cuts are small like I said, would 2 hours provide enough time for them to 'heal' enough to form a barrier against infection if I was exposed? As I said i have no recollection of any bleeding etc but they are still present which is a worry.
Also today (the next day) I've awoken to feeling lethargic and I have a sore throat...could these be early symptoms?
Basically I'm finding every reason to panic.
What is my likelihood of hiv transmission? Again this is hypothetical because the lady may not have HIV but being a sex worker the worry is always there. The lady clearly stated she never had penetrative sex without using 'protection'. Furthermore, I know you can't really tell if someone has HIV by appearance but from what I remember she seemed well, e.g. no obvious symptoms such as fever or rash.
Also I'm within 48 hours, is there enough of a case for me to get PEP or am I just being overly paranoid? I heard PEP can have pretty dire side affects.
Basically after this dreadful episode, I'd like reassurance as to whether I'm panicking over nothing or whether I have genuine concerns over a 'high risk exposure'
HIV
Detailed Answer:
Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query very patiently and I have understood it
First thing first, Oral sex carries a very low risk, if at all, due to the anti-HIV properties of saliva, provided the person giving oral sex does'nt has any oral lesions/sores in the mouth. So we can assume that the oral sex that you had with the sex worker is safe.
Regarding the protected vaginal sex, the only concerning thing is the nick/cut at the base of the penis and possibly also the one present at the base of the scrotum, which may not have been properly covered by the condom and thus may have come into contact with the genital secretions. An abrasion OR break in the skin, is good enough risk. It does'nt have to be a XXXXXXX bleeding wound to qualify as a break in the skin.
Therefore this particular exposure of yours, would qualify as carrying potential risk for HIV transmission.
I think you do qualify for PEP Prophylaxis. The guideline is simple: PEP should be provided following exposure of non-intact skin (through percutaneous sharps injury or skin abrasion) or mucous membranes (through sexual exposure or splashes to the eyes, nose or oral cavity) to a potentially infected body fluid
from a source that is HIV-positive or has unknown HIV status. Body fluids that may transmit HIV include blood, genital secretions and cerebrospinal, amniotic, peritoneal or pleural fluids.
regards


Does the fact that the cut is on my scrotum make the risk of infection less, as it obviously does not enter/go inside the vagina?
And also, with minuscule cuts, would 2 hours provide sufficient time for the wound to 'heal' to a level which would act as an impermeable barrier to infection? Like I said, I cannot remember the cuts bleeding at all, I think i may have just nipped the skin, creating what would appear to be a cut but not essentially an open wound, does this play a role in my risk of exposure?
I am going to a sexual health clinic in the morning (around 40 hours after exposure)....is PEP still a viable/successful option after this time?
Regards,XXXX
HIV
Detailed Answer:
Hi.
By defination, Non-Intact skin is the skin that is chapped, abraded, or with dermatitis. A miniscule cut or nip on penis after shaving would qualify as non-intact skin even though it did'nt bleed.
Regarding the cut on the base of scrotum, though, it is unlikely, that portion of the genitalia may have entered vagina but it may have potentially come in contact with the genital secretions just because of its proximity to the vaginal opening.
A break in the skin, would not have sufficiently healed in just 2 hours.
PEP can be initiated in you. Whenever there is a risk of HIV transmission PEP should be initiated as soon as possible, within hours and no later than 72 hours following the potential exposure.
regards

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