Fantastic forum!

My question pertains to the risks associated with receiving unprotected oral sex from a highly promiscuous woman (i.e., my penis in her mouth). My first encounter was 3 days ago. I received vigorous unprotected oral sex from her for 5 minutes and ejaculated in her mouth. So far, I have not experienced any STI symptoms.

The woman is a married, US-based healthcare worker who has a kink for providing anonymous, unprotected BJs to men when her husband is out of town. Specifically, she solicits inquiries from men online to visit her home and use her private ‘glory hole’. Based on my experience, as part of the applicant screening process, she requires photographs of the men’s body and genitals and emphasizes the importance of DDF (i.e., drug and disease free). Her stated goal is to build a roster of regulars who she can solicit to visit her glory hole periodically. My best guess based on her account activity is that she gives unprotected BJs to 3-5 men over the course of 2 days every 2-3 weeks.

Should I be worried about my one encounter? For how long do I need to be asymptomatic to be sure I won’t transmit an STD to my regular penetrative vaginal sex partner (I assume testing isn't necessary)?

Additionally, can I incorporate oral sex from this woman into my routine in a low-risk way? For instance, could I receive unprotected oral sex from her 2x per month, wait 3 days to confirm no symptoms, then resume penetrative sex with my normal partner without worry?

Thank you!

Receipt of oral sex is a relatively low risk activity.  HIV is NOT acquired from receipt of oral sex and the major STIs acquired from receipt of unprotected oral sex are gonorrhea and non-chlamydial NGU, both of which are typically symptomatic (3-5 days for gonorrhea, perhaps a week for NGU).  There is also a still smaller risk of syphilis but in the case you describe, this risk is probably negligible.  If you remain asymptomatic follow your exposure the risk of having acquired an STI becomes very, very low but not zero.  The only way to be entirely sure is to test with a urine test for gonorrhea at more than 3-5 days after the exposure.  (I would not worry about non-chlamydial NGU unless you develop symptoms

I hope this perspective is helpful.  EWH

Dr. Hook, thank you for the speedy and helpful reply! A couple quick follow up questions followed by a longer one:

Based on your response, I don’t plan to test and will resume unprotected vaginal sex with my partner since I’ve continued to be asymptomatic 5 days after the encounter (let me know if you think this is irresponsible). However, I would like to better understand the risk of continuing to receive unprotected oral sex from casual partners in the future, so I can enjoy it without wigging out afterwards.

For instance, I was surprised you didn’t consider my recent ‘glory hole’ partner to be high risk given the number of partners she maintains. Similarly, in other posts pertaining to unprotected oral sex with CSWs / escorts, you and Dr. Handsfield often describe these encounters as low risk. This begs the question: from the perspective of a male recipient, what factors influence the risk of catching an STI the most? From what I can tell, testing frequency seems to outweigh all other factors, even partner quantity. Is this accurate?

2.  No

3.  Nothing beyond what you are doing.  There is no evidence in men that urination or washing after sex reduces STI rates.

I think your plan is fine.  Sex with multiple partners is typically low but not no risk.  They may have STIs they are unaware of.  More partners, more risk.  EWH