However I made the mistake and decided to give her unprotected cunnilingus oral sex for about 2min or so licking only her clitoris , I did not insert my tongue inside her vagina,  she also gave me condom protected oral sex we then had condom protected sex. This was outside my marriage and I really regret this.  And afraid I could pass something on to my partner, 25hours after the event I did take Doxy pep , which was 2 100mg pills. How effective is this? How often does the pep fail? 

What are the chances I could have got syphillis from this exposure ? 

Also do you think I could get hiv  or heptatitis B  from this exposure ? 

How common is oral gonorrhea from cunnilingus ? 

You were wise to use a condom for vaginal sex -- as well as (unnecessarily) when she performed oral sex on you. Fellatio is safe sex, and your escort partner apparently knows it:  there is very little STI risk (and zero for HIV) from mouth to penis, even without condom protection. There has never been a proved case of HIV transmitted by such contact. And saliva rarely transmits HIV or other STIs. As for the cunnilingus event, I do not see that it was a "mistake"; that also is a near zero risk exposure for all STIs, and here too there has never been a known HIV transmission. The chance you have any STI at all, or that you could transmit an STI to your partner on account of this event, is exceedingly low.

I definitely would have advised against doxy-Pep, which is recommended only for far higher risk exposures than this one. However, it protected you very well against chlamydia (the most common bacterial STI) and syphilis, and reduced the already miniscule chance of gonorrhea by about half.

"Chance of syphilis...? Zero for all practical purposes. A partner like yours is exceedingly unlikely to have it; the exposure events themselves were very low risk; and the doxy-pep was effective prevention.

"HIV or hepatitis B virus...?" Also exceedingly low risk. I do not advise testing for them. (And making an assumption about your age, it seems likely you were vaccinated against HBV in childhood.)

"...oral gonorrhea from cunnilingus?" Exceedingly rare. My forum colleague Dr. Hook was the senior researcher on the best study on this, finding no oral gonorrhea in a substantial number of persons likely exposed to it by performing cunnilingus.

So all is well. I advise against testing and if somehow I were in your situation, I would continue unprotected sex with my wife without any fear of infecting her.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Your wife was not at risk.

Since I took doxy pep 25hrs after exposure, would it be a waste of time to test for syphillis at 6 weeks? 

About a hour after taking doxypep I had some ranch dressing with my food and a cheese stick I heard dairy would make doxy not effective is this true ? 

Also do you think the slight underwear stain in morning is normal I usually have like a pea size stain these past two days ? Throughout the day I don’t have any stains or discharge or any burn with urination. 

Would hiv testing from cunnilingus be a waste of time ? 

That amount of dairy intake soon after doxycycline is not likely to interfere.

I don't see how "tight underwear" would cause staining. But keep an eye out for other evidence of actual discharge. (In which case you would have to look for causes other than your recent exposure.)