[Question #11766] STI risk from unprotected oral sex - risk, treatment
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12 months ago
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Received unprotected oral sex from a Thai female masseuse on 3 Aug. Light kissing, no ejaculation in mouth. Gave oral sex to LT partner on 4 Aug. Cleaned my penis with Listerine daily since 3 Aug. At day 5, no symptoms.
Took 200mg Doxycycline on 5 Aug. Saw GP who prescribed 7 day course of Vibramycin. Urine / blood test booked in 2 weeks. Qs:
1. Is my case low risk? Will the Vibramycin eliminate chances of STI?
3. Is my LT partner at risk due oral sex on 4 Aug?
4. How many days, symptom free, before I am ‘all clear’?
5. Is further testing necessary?
6. When Is it safe/low risk to resume sex with my regular partner?
Thank you.
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Edward W. Hook M.D.
12 months ago
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Welcome to the Forum. Thanks for your questions. I'll go straight to your questions:
1. Is my case low risk? Will the Vibramycin eliminate chances of STI?
Yes, your encounter was relatively low risk. Few STIs are acquired through oral sex and most single exposures to persons with oral infections do not result in infection. The doxycycline (Vibramycin) eliminates the risk for chlamydia and syphilis and there are no proven cases of HIV acquired through receipt of oral sex. Your risk for gonorrhea is reduced but not entirely eliminated.
3. Is my LT partner at risk due oral sex on 4 Aug?
You received oral sex with your penis but did not expose your LT partner by performing oral sex.
4. How many days, symptom free, before I am ‘all clear’?
As mentioned above, the major risk, if any if for gonorrhea. Most (90%) people who acquire gonorrhea develop symptoms within 3-5 days. If you want to be 100% sure a urine test for gonorrhea will be conclusive at this time.
5. Is further testing necessary?
See above. If you were going to test, the only thing I would recommend is a urine test for gonorrhea. In the absence of symptoms, if I were you I would not feel the need to test strongly.
6. When Is it safe/low risk to resume sex with my regular partner?
Now
I hope this information is helpful. EWH
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12 months ago
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Thank you Dr. Hook. Appreciate the quick response.
Two follow up questions. What is my risks of catching Herpes HV1 or HV2 from my oral encounter? I am worried of infecting my LT partner.
Separately, what time frame would I be looking at, should I not develop any symptoms, could I expect to be 'all clear'?
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12 months ago
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Just to clarify my all clear follow up is in relation to Herpes.
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Edward W. Hook M.D.
12 months ago
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Overall, your risk of acquiring herpes from giving or receiving oral sex is low. HSV-2 almost never infects the oral cavity, and as a result, it is extraordinarily rare for someone to acquire HSV-2 from receipt of oral sex. In addition, HSV2 very rarely infects the mouth. I would have no concerns about HSV two from the encounter you describe.
Persons occasionally acquire genital HSV-1, if they do not already have it, from receiving oral sex. This is quite uncommon both because the transmission is rare and equally or perhaps more importantly because 60% of adults have HSV-1 which they have acquired in childhood whether they know it or not. Not everyone with HSV-1 experiences cold sores, but once a person has HSV-1, whether or not they get cold sore, they cannot acquire again.
If you are going to develop herpes lesions as a result of this encounter, that will occur within 10 days of the encounter.
EWH
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12 months ago
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Thank you Dr. Hook.
My blood/urine test on day 14 have come back (see below). I have not had any symptoms.
Blood test: RPR (non-reactive), Syphilis TP Antibodies (by CMIA) (non-reactive Index: <1.0), HIV-1 & 2 Ab/pg24 Ag (by CMIA) Negative.
Urine test: (Sexual Health Multiplex PCR 7 NDA Tests) all Negative for Chlamydia trachomatis, Neisseria Gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, Trichomonas vaginalis.
Are these tests conclusive and am I sufficiently ‘all clear’? I understand HIV, HSV, Syphilis may not show up in blood test so soon, but do you think, given my risk level that a follow up blood test is required at 6 or 12 weeks?
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Edward W. Hook M.D.
12 months ago
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Given the nature of your test results, the antibiotics you took and your test results I urge you to consider yourself "all clear" and move forward without concern.
This completes this thread. Please don't worry. EWH
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