Hello, I had oral performed on me for 1-2 minutes and finished. It was at a massage parlor in the United States and a saran wrap style baggie was used as protection. This event/exposure occurred on 4/5/24 and I have no reason for believing the saran wrap baggie broke or failed to cover the area of my penis that was exposed. However, I have a regular partner who I cannot pass anything off to, so I decided to postpone any sexual activity (other than kissing) with her until I could be tested, which I just visited a clinic and was tested for Chlamydia, Gonorrhea, and Syphilis on 4/26. I understand that Syphilis cannot be confirmed as negative until 6 weeks after exposure and ideally longer, but decided to test anyways. I did not test for HIV as I understood it to be a zero risk exposure. I've also thought the entire event was "protected" but was advised by the nurse at the clinic that saran wrap provides no protection and this should be considered an unprotected exposure, which doesn't align with things I've read on this forum, and ultimately led me to ask this question. Therefore, if you could clarify the following I'd be very thankful:1. Was this a protected exposure? Why did the nurse say it should be considered unprotected and that I'd have no way of actually knowing if the baggie broke but I didn't see how it could have?2. Based on the tests I've had, if everything is negative can I continue to have sex with my regular partner? 3. Similar to above, but should I be retested for Syphilis after another 3 weeks pass (6 weeks total), or am I okay to continue with a negative test from my recent tests? 4. I know that I mentioned that I wasn't tested for HIV, but should I be tested? Or no reason to bother and can resume sex with regular partner. Important note, I've had no symptoms resembling any STI and have HSV1 already.

For some reason, I chose not to be tested for HIV and no it's a zero risk exposure for that but keep returning to the "what-if". However, if you say it's no bother in testing for then I will trust your expertise. I also keep returning to the though about Syphilis and if I should postpone any further sex with regular partner until I can be tested at 4-6 weeks. Please put my mind at ease and let me know that everything is alright. I think the nurse mentioning that this is an unprotected event got into my head when I originally had very little concern due to my thinking that it was protected oral which is considered very safe. 

Welcome to the Forum.  Thanks for your questions.  I'll be glad to comment. This was a protected, virtually no risk exposure.  Sarah wrap, while not elegant, is not permeable and would not allow infection to be transmitted.  Even if the event was unprotected, it would still be very low risk.  Most people, even most commercial sex workers do not have STIs, including HIV and when they do, transmission of infection rarely occurs following a single exposure.  ---

Thank you, Dr. Hook. This is much appreciated and I agree that it was almost certainly protected but wasn't sure after my recent visit to the clinic. Can you provide the potential "ballpark" estimate for how accurate the Syphilis test would be after 3 weeks from the exposure? And, another "ballpark" estimate for the likelihood of getting Syphilis? Less than 1%? Also, why does HIV not pass effectively through the receiving of oral? These are my last questions and I'm thankful for your service. I believe my anxiety has been put to rest now and I will move forward upon the receival of my negative results. Many thanks. 

The "ball park estimates you describe are of little use.  Certainly your risk of syphilis from the contact that you describe is no more than a small proportion of 1%.  As for the proportion of syphilis cases which would have positive tests at 3 weeks, there are no data.  Sorry.  The available data indicate that blood tests become positive a few days after a syphilis lesion becomes clinically apparent. The fact that you have not seen lesions yet is further strong evidence that you did not acquire syphilis.   EWH---

Great, thanks for your response. Take care!

So you would say with 100% confidence that I can resume unprotected sex with my partner?  

Yes.---