[Question #12075] Blowjob questions
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10 months ago
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Hi Doctors,
Thanks for the services you provide. I have a question and am looking for advice.
About a week ago I performed unprotected oral sex on a co- worker friend ( I am female, friend is male). I have read here that oral sex is pretty safe sex - but I am now regretting my choices, because it was just dumb. I have a regular partner that I will be seeing in 6 weeks who will expect blowjobs.
What are the chances of my friend transmitting chlamydia to my throat if this was a brief encounter with no ejaculation.
I have a Z-pack, should I just go ahead a take 1g to be safe, or would the oral chlamydia most likely clear by 6 weeks without intervention?
I have seen on the site that cdc does not recommend testing, and that most positives are transient.
I would like to make the best decision with your expert guidance
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H. Hunter Handsfield, MD
10 months ago
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Welcome to the forum and thanks for your question.
First congratulations on a responsible approach to sexual safety. Don't beat yourself over the head for the occasional lapse -- and as you already seem to know, this probably was a near-zero risk event.
---Once in a while I respond with a more comprehensive reply than usual, which I call my blog-like replies. It so happens I did exactly that just two days ago, in response to another question about oral chlamydia. Please read it -- question #12064. But I have to say your own research has been good; your questions indicate you have learned quite a bit. But to address your questions explicitly:
"What are the chances of my friend transmitting chlamydia to my throat...?" First, how likely is your partner to have had a urethral chlamydial infection? Probably under 1% chance; perhaps higher if he has been highly sexually active recently but still research shows that even among men at highest risk (e.g. attending STD clinics) well under 2-3% are infected. So most likely you weren't exposed. If exposed by performing fellatio (BJ), a good guess is that infection takes hold in the throat under 1% of the time. 1% x 1% = one chance in 10,000 you have pharyngeal (throat) chlamydia now.
"I have a Z-pack...?" Don't take azithromycin. It's too unlikely you are infected but equally important, azithro is not reliable against pharyngeal chlamydia. (Or rectal infection, for that matter.) If infected, you would need doxycycline for a week.
"I have seen on the site...." Correct about CDC advice. Actually, it's not all that clear and the CDC statements have wiggle room about it. But all the major academically oriented STD clinics do not routinely test patients for pharyngeal chlamydia.
"...would oral chlamydia most likely clear by 6 weeks without intervention?" Yes -- usually sooner than that.
"I would like to make the best decision...." Thanks for your comment about our expert guidance. Honestly, we rarely advise STD testing at all after single exposures, unless the risk is especially high -- like a known infected partner, symptoms, etc. And certainly not when the only exposure is like yours. Of course you are free to visit one of the many labs that offer STD testing directly to consumers and request a pharyngeal swab test for chlamydia. But I really don't recommend it.
I hope these comments are helpful; and that you'll take the time to read the other thread. Then feel free to let me know if anything needs further clarification.
HHH, MD
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10 months ago
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Thanks for the reply. Friend is a 46 y/o married male nurse if that helps.
If he had chlamydia, would he more than likely have symptoms?
I have also read where the infection takes place is in the back of the throat- so if there was no contact with back of throat would that make it even less likely?
Lastly what is the transmission rate of mouth to penis if said infection took place?
Lastly I am allergic to doxy- what would be the second line defense?
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H. Hunter Handsfield, MD
10 months ago
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Chlamydia is basically an STD of youth. Its frequency at any anatomic site is extremely low beyond age 30. The reasons are not entirely clear, but probably it has to do with previous infection, both with sexually transmitted chlamydia and related bacteria that cause respiratory infections.
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There are no data oral sex STD risk with the details of exposure, like contact with the back of the throat. I doubt it makes any difference.
Transmission oral to penis? Probably way under 1% even if oral infection is present.
You don't need doxycycline or any other treatment; my comments above did not encourage or imply that you do. In any case, true allergy to the tetracyclines (doxy and related drugs) is rare. Was that a professional diagnosis, e.g. with skin rash? Or stomach upset? Or what? But if chlamydia treatment really is needed and doxycycline isn't feasible, the choices are azithromycin with test of cure to check the result; or the antibiotic levofloxacin.
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10 months ago
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Thank you again for the timely response. The reaction was a full body rash as a child. I’m going place my trust in you and believe I was not infected- plus by six weeks you said it would be gone any way. Thank you again for you words of encouragement and understanding.
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H. Hunter Handsfield, MD
10 months ago
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Hmm... Are you sure it was doxycycline? Common wisdom for decades was that the tetracyclines, including doxycycline, are never prescribed for children because of safety concerns related to tooth development. New knowledge suggests the problems are neither common nor serious. But very few children have been treated with doxycycline -- and then only for quite serious infections with few good alternatives (like rocky mount spotted fever, perhaps the most common example). Were you by chance treated for RMSF?
Threads normally are closed after two follow-up comments and replies, but I'm interested your response!
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10 months ago
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I dont actually know- my mom told me it was docxy and I might have been early teens? I don’t think it was a serious illness. Maybe acne? I’m not sure to be honest.
But I’m going to trust you- as the expert!
I won’t be having any type of sex for the next 6 weeks so hopefully in that very less then 1% that I contracted oral chlamydia- it will have self cleared by then .
Thank you for keeping the thread open
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H. Hunter Handsfield, MD
10 months ago
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Maybe it was something other than doxycycline. Many other antibiotics are far more prone to cause allergic rash than doxy is.
That concludes this thread. I have enjoyed the discussion. Stay well.
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