[Question #12377] kissing/rimming risks – very concerned about gonorrhoea
8 months ago
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gay male. two recent exposures. first exposure was kissing, no sexual contact. second exposure was a new partner where we had deeping kissing and rimming (i was the receptive partner). cannot remember if there was any fellatio or fingering (i was very drunk).
I do not know the status of the first person but the second person reassured me they were recently tested, all clear and haven't had sex with anybody since their past two test.
what are the risks? also concerned I could have caught oral gonnorhea from the first person, the engaged in deep kissing with the second who then rimmed me, then given myself rectal gonorrhoea.
8 months ago
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it's worth noting that since the second exposure (which happened on wednesday), I have experienced anal itching and redness, slight blood in stool but no discharge/mucus on stool, slight penile pain but no discharge. are these consistent with gonorrhoea?
I also have a regularly partner with whom i have slept naked with. if he spooned me, could he catch gonnorhoea but touching my anus with his penis? Is it worth me testing?
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H. Hunter Handsfield, MD
8 months ago
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Welcome back to the forum. Thank you for your continued confidence in our services, a few years since your previous questions.
The bottom line (pun intended!) is that while I cannot guarantee you don't have rectal or pharyngeal (oral) gonorrhea, it is very unlikely from the new partnerships described here. A major unknown is whether your regular partner might be at risk for exposure and infection: as you undoubtedly understand, when one partner in a usually monogamous relationship has external partners, often the other has done so as well. (At least one of your older questions concerned a known HIV infected housemate. Are you and he still together?)
There's been a lot of online buzz about kissing and gonorrhea, but it's uncommon. Even among the most sexually active MSM, at any point in time no more than 5-10% have oral gonorrhea; and when present, it's probably transmitted during no more than a few percent of kissing events. Therefore the risk from any one exposure is probably under one chance in hundreds if not thousands. Second, oral to anal gonorrhea transmission by rimming certainly is possible, but the risk for any single event probably is similar to that from kissing. Having said that, your anal symptoms certainly could be gonorrhea -- or chlamydia, or herpes (unlikely), or even syphilis (also unlikely). I won't try to speculate further on which partner and exposure might have been responsible: the main thing is to get seen professionally for exam and testing, including all potentially exposed sites (urethra, rectum, pharynx). If anything turns up, you can then advise any and all these partners (and any others in the last few weeks) to also be examined, tested and possibly treated.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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8 months ago
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Hey doc,
Thanks for coming back to me. To clarify, the partner mentioned is a new regular partner – hence the concern and why I'm ruling out past concerns of the other person bringing STD's into the relationship (does this change things?). Nevertheless, I must say your reply is not what I was hoping for... one of the reasons being that previous posts have stated that anal itching and lack of discharge do not indicate an std so why is it now that these symptoms could indicate this? Not to mention the possibility of other std's you mention.
As you can tell I'm incredibly worried, so I'm wondering whether you think these symptoms are indicative of an STD? I should mention that these have subsided in the past day or so. Also:
should i take solace in the fact my previous contact was tested negative the past two times?
can you clarify whether it's likely that (if i had oral gonorrhoea) i can kiss him and then has pass it to my anus?
I'm anxious I've read previous posts of this nature whereby testing hasn't even been recommended on these accounts so I'm a tad confused.
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H. Hunter Handsfield, MD
8 months ago
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Hmm... I don't know what "previous posts have stated that anal itching and lack of discharge do not indicate an std." You certainly didn't hear that from me or Dr. Hook. These are quite typical symptoms of anorectal STDs like gonorrhea, chlamydia, and -- less often -- herpes. Many (maybe most) people with such anal infections do not experience discharge. STDs are by no means the only causes of these symptoms; you might have simple pruritus ani (Latin for itchy anus, which all humans experience from time to time), yeast or other non STD infections, etc. But in view of your exposure history, it makes sense for you to be tested.
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I can't tell what to make of your previous contact recently tested and negative. It depends on what anatomic sites were tested, and for which STDs.
Yes it would be unlikely to transmit oral gonorrhea to your partner by kissing, and then acquire anal infection yourself by analingus (rimming) -- but it's possible.
As for "I've read previous posts" that gave you other impressions, all I can suggest is that those specific situations were different than this one or that you misunderstood something. In any case, you came here for our professional assessment and advice. Do with it as you will.
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8 months ago
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Thanks for replying doctor. In no means am I questioning your work. I think I've just been browsing the previously answered questions too long. Nevertheless, I've secured an appointment at the clinic today – it's day 5 after the last exposure. Would this be conclusive? UK clinics typically say 2 weeks for chlamydia and gonorrhoea but is this conservative?
Also, since the last exposure I've not had sex with my partner so, say it was positive for rectal gonnorhoea but not oral, he wouldn't be at risk from just sharing a bed with me naked and just kissing?
Many thanks for your help here!
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H. Hunter Handsfield, MD
8 months ago
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Gonorrhea/chlamydia testing for gonorrhea definitely is valid any time more than 4-5 days after exposure. It's less certain for chlamydia, but in the US there is broad consensus that 4-5 days also is fine.
In that circumstance, your partner would not be at risk. But follow the advice you ge at the clinic. (I hope you're being seen at one of UK's excellent NHS GUM clinics; although there also are excellent private sexual health clinics. Either way, you can rely on their advice.
That concludes this thread. I hope the discussion has been helpful.
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