[Question #11071] Unprotected oral concerns
17 months ago
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Hi there
Im a male and I recently received unprotected oral sex on my penis from an independent sex worker in Australia yesterday. Im really worried this has given me something as she didn’t really check my penis before hand. I plan on having unprotected sex with a partner in 3 weeks and i dont want to tell them about my encounter if possible. Is it safe to have sex 3 weeks from yesterday if I make sure I have a test done right before? Im scared it wont be enough time to pick up on diseases such as syphilis which can lay dormant. Thanks
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H. Hunter Handsfield, MD
17 months ago
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Welcome to the forum. Thanks for your confidence in our services.
You describe a very low risk exposure in regard to all STDs, zero risk for some of them. Transmissible oral STDs are quite uncommon -- much less common than genital infections -- and when present are less readily transmitted than genital. Assuming your partner is female, the main STDs with any measurable frequency after a single episode of unprotected oral sex (i.e. looking at mouth to penis transmission) are gonorrhea, nongonococcal urethritis (NGU) often due to normal oral bacteria, and herpes due to HSV type 1. All three of these usually would cause obvious symptoms (penile discharge, painful urination, obvious penile blisters/sores) within 10 days or so. So absence of symptoms at that point would be very reassuring. If you would like additional reassurance, you could have a urine test for gonorrhea, which is valid any time more than 3-4 days after exposure. There are no early tests for NGU or herpes.
Syphilis is theoretically possible, but it's so rare in heterosexual women in most settings (in the US) that it's usually not a serious consideration. Usually a chancre -- the initial sore of syphilis -- appears 10-20 days after exposure, so that's also within your hopped-for time frame. However, there is no test to detect syphilis before a chancre develops; the syphilis blood tests pick up many infections at 4 weeks but require 6 weeks for conclusive results. However, given both the rarity of syphilis in most sexually active women plus absence of a chancre within 3 weeks would be strong evidence you didn't get it.
A possible option is to see an STD knowledgeable provider and discuss the possibility of preventive treatment, such as a shot of ceftriaxone to abort incubating gonorrhea and doxycycline to cover NGU and syphilis. However, I'm really not sure this is necessary; if somehow I were in your situation, I wouldn't feel the need. However, this might depend in part on more information about your partner. (If your partner were male, or if were otherwise a higher risk scenario it might alter this advice.)
I hope these comments are helpful as a start. Let me know if anything isn't clear.
HHH, MD
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17 months ago
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Thankyou so much for your response: i will look into preventative treatment for sure just in case. If I end up not doing the preventative treatment, if I dont have a chacre, can I assume its safe to have sex, or can I pass on syphilis while it’s asymptomatic.
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H. Hunter Handsfield, MD
17 months ago
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You cannot transmit syphilis until and unless a chancre has appeared; or after 6 weeks at the earliest. In other words, if no penile sore before your anticipated contact with your partner in three weeks, there will be no possibility of infecting him with syphilis.
If I were in your situation, if no symptoms had shown up by ten days, I would not have preventive treatment and would continue unprotected sex with my wife without worry I could infect her with anything.
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17 months ago
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So after 6 weeks, theres a chance I can pass on syphilis without any symptoms? Sorry just really worried about giving my partner something. Also do you have any reassuring stats about how rare syphilis is via receiving oral, if its specific to Australia that would be amazing too. Thanks!
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H. Hunter Handsfield, MD
17 months ago
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After 6 weeks, if you had syphilis, you might be able to pass it on. But there is almost no chance of it from this kind of exposure, and of all STDs, syphilis is the least likely. And syphilis is rare in Australia except in men who have sex with men and in some native (aboriginal) populations in parts of the country. And at 6 weeks you can be tested if you wish.
Australia's government funded sexual health centres are the world's best network of STD/HIV clinics. There are SHC's in all major metropolitan areas -- one in most cities and I think two in Sydney. They have excellent service both by phone and online. If you want further reassurance, you can't go wrong by contacting your local SHC. Good luck.
That completes the two follow-up comments and questions included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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