[Question #13089] Oral syphilis
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2 months ago
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I gave unprotected oral sex to someone I met last night. I noticed no sores on the penis but could have missed something. I am currently freaking out about my risk of contracting an sti, mostly syphilis. Should I be concerned and should I stay away from other partners for some time?
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H. Hunter Handsfield, MD
2 months ago
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Greetings and welcome to the forum.
More information is needed to judge the risk of syphilis. The chance probably is very low; oral sex is a relatively infrequent transmission event for syphilis but there are exceptions. The risk of other STIs probably is a lot higher than syphilis. What sex(es) are you and this partner? What do you know about their sexual or health history and lifestyle? Was this a sex worker, a bar pick-up, or what? Where did this happen (e.g. country and city)? What is your own usual sexual lifestyle? Was this a common or unusual sort of event for you?
I'll be happy to speculate if you can fill in some of these details.
HHH, MD
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2 months ago
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Just a random person at a bar I met. We are both male. This is out of the ordinary for me as I never do it but I’m not sure as for them. I know nothing of them besides a claim that they have a clean panel in April. This happened in north Chicago.
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H. Hunter Handsfield, MD
2 months ago
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Thanks for the additional info. People rarely lie about HIV/STI status when asked directly, so it seems likely he doesn't have transmissible syphilis ("clean panel"). Your risk probably is very low for all STIs, including syphilis, and I would view STI testing entirely optional in this setting. On the other hand, it would still be reasonable for you to have basic testing if only for reassurance. If you do so, I would advise a throat swab for gonorrhea (which automatically includes chlamydia even though not needed). However, that's all that can be done in the short term. Assuming you don't develop a chancre (syphilitic sore) of the penis in the next coulple of weeks syphilis will become even less likely, but you also could have a blood test 6 weeks after the event. HIV is so rare it can be ignored, but you might also be reassured by a negative HIV test.
Another option to consider is to contact the Chicago public health STI program or clinic (which is highly respected) and discuss the event -- including whether this particular bar has been frequently implicated in HIV/STI transmission. If they consider the risk especially high, conceivably they would advise prophylactic penicillin to prevent syphilis or other measures. In the meantime, if somehow I wherein your situation, I would continue unprotected sex with my wife once I had a negative gonorrhea test result and if no penile sore appeared within 10 days or so.
I hope these comments are helpful. Let me know if anything isn't clear.
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2 months ago
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Just one last little thought you may be able to help me with. I contacted the person and was told they test after every partner and their last one was clean so that was a relief. I did a little research and decided to get a dose of doxypep. Will this benefit me at all or have I just taken it for no reason?
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H. Hunter Handsfield, MD
2 months ago
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This exposure didn't warrant doxypep, which at this time is advised only after unprotected anal sex. That might change, but I doubt CDC or any similar authority ever will advise after a single episode of oral sex, except perhaps when the other partner is known to be infected. And the expanded information about your partner makes it almost impossible he had chlamydia, syphilis or gonorrhea, the STIs prevented by doxycycline. It will not have done harm but it did no good either.
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That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.