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Dear docror(s), My question is not related to his field of expertiece though. It is again connected to the plague of the 20th century (or the 21st one as we will see): HIV/AIDS. Here we go..... I had had a swab sample taken from my urethra for general check-up purposes. Prior to that I had no complaints or clinical findings of any active STDs. This was a sort of real trauma to my urethra (being hurt too much at the time when the sample was taken; ouch!). On my fourth day after the swab I got engaged in insertive fellatio from a sex worker. And I felt some uncomfortableness at the opening of my urethra the next morning. My question is: Should I be concerned about contracting HIV? Is any testing indicated for a situation like mine after the window period? Would the irritation in the urethra end up in 4 days and pose no additional risk of transmission after a swab was taken? Can you -based on the clinical data(please see "P.S.")- state that it is safe for me to believe that I had only negligible risk and I can continue to practice sex with no worries of infecting anybody? This is important for me to arrive at an ease of mind and restart a normal life. P.S. I know that most experts do not recommend testing for HIV after insertive fellatio as there are no documented cases of infection due to insertive fellatio and the risk is only theoretical. Thanks.
Thank you for your inquiry. In brief, testing and protective behaviors are both recommended; oral sex is not as safe as once believed and still perceived; the infection rate MAY be as high as 7% and has been shown to be as low as 0.3%. Several epidemiological studies have examined the risk of HIV infection through unprotected receptive oral intercourse (receptive fellatio) and through unprotected insertive orogenital intercourse (insertive fellatio) or insertive oral-anal sex (insertive anilingus): other studies, while not distinguishing the type of oral sex between homosexual men, further suggest the possibility of HIV transmission through oral-penile/oral-anal contact. In the UK for example, 13 cases of HIV transmission through oro-genital contact had been reported to the public health authorities up to December 1998 (though in 2 of these cases, the reporting physician was not convinced that oro-geniral contact was the only risk); and in a study to describe the clinical and epidemiologic features of primary HIV infection, four of 46 patients reported having had only unprotected orogenital contact during the suspected sexual encounter that led to their seroconversion. These and other figures are available in the public domain for example, from which the above statistics were taken.
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