Anonymous on August 12, 2011

I had unprotected oral sex with a prostitute...could I have gotten HIV or an STD?

I’m very scared because, in the last two or three months, I’ve had sex with different prostitutes. I used a condom, except when I had unprotected oral sex (mouth to vagina). Two days ago, I suddenly got a skin rash and fever. I thought it was just an allergy, but the anti-allergy pills haven’t made the fevers go away. Could I have gotten HIV or an STD? Please help!

answered by Daniel Perlman, MD, MBA on August 12, 2011

 I’m sorry to hear that you’ve been experiencing a rash and fever. I encourage you to talk with your doctor about your symptoms and the best way to deal with them, but I’m happy to offer some thoughts on the matter to get your started...

Can you get an STD from unprotected oral sex? Yes. Most STDs (including HIV) can be spread through oral sex. Specifically, HIV is transmitted through unprotected vaginal, anal or oral sex when the blood, semen or vaginal secretions of an infected partner enter your body. Transmission of HIV by giving a woman oral sex is more likely if you have any cuts or sores in your mouth. You can learn more about HIV risk factors, symptoms, testing and treatment in our Expert Guide to HIV.

Since you’ve had unprotected oral sex, getting tested not only for HIV, but for other common STDs may be a good idea. If you’re at risk for HIV, it’s also likely that you’re at risk for other STDs, like chlamydia, gonorrhea, herpes, hepatitis or syphilis.

Sex with prostitutes may increase your risk of catching HIV and other STDs. Why? Sex workers are at higher risk for STDs, including HIV, because they have multiple sex partners and are more likely to use intravenous drugs. When you have sex with a high-risk partner, your risk increases, too. While condoms and dental dams reduce your chances of contracting HIV or other STDs from an infected person, they’re not perfect. A study by the National Institute of Allergy and Infectious Diseases found that always using a condom with an HIV-infected partner reduces the risk of the virus spreading by 85%...but 85% is not 100%.

Are a fever and skin rash symptoms of HIV? Possibly, but not necessarily. Flu-like symptoms (including a fever) and a rash on the stomach, arms, legs or face may be symptoms of HIV, or another STD. Or you might just have a cold or the flu.

The only way to know if you have an STD like HIV is to get tested. And if you do test positive for an STD, you’ll be better informed and prepared to take the necessary next steps for treatment and to stay healthy. Identifying STDs, especially HIV, early and getting treatment, if needed, will help slow negative effects on your body and minimize the risk of future complications.

Again, I’m sorry to hear about your discomfort. I encourage you to visit your doctor for an exam of the rash and fever you have. And talk with your doctor about STD testing, including testing for HIV. Your doctor can help you get the tests you need or you can seek out confidential online testing services if that makes you more comfortable.

I wish you good news and good health as you take control of your health by getting tested.


Daniel Perlman, MD, MBA

Dr. Perlman is a Colorado-based infectious disease specialist (including HIV and other STDs) in private practice at Greater Denver Infectious Diseases. Additionally, he is Assistant Clinical Professor in the Division of Infectious Diseases at the University of Colorado School of Medicine. Dr. Perlman was educated at theUniversity of Maryland School of Medicine, and completed his residency in internal medicine at the Johns Hopkins University School of Medicine.

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