[Question #13684] STI from unprotected oral
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1 months ago
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Hello doctors,
I have had unprotected oral sex a few times from a provider, it has been 4 months since the last time. I have went down a rabbit hole on STIs, even though I don’t have symptoms at all. I keep reading that syphilis is on the rise, gonorrhea and chlamydia could be likely but also that even if you don’t have symptoms you could be asymptomatic. AI also does not help as it seems they are getting information directly from the CDC.
I don’t have any symptoms, never seen a sore, no discharge, no rash. Am I at risk here? Is testing needed? I do have a partner and they don’t have any symptoms either.
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Edward W. Hook M.D.
1 months ago
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Welcome to the Forum. Thanks for your questions. I'll e glad to comment.
STIs following receipt of oral sex an the exposure is lower risk than genital-genital exposures. Most persons, including most commercial sex workers do not have STIs, including HIV and most exposures do to lead to transmission of infection. Of the STIs acquired from receipt of oral sex, gonorrhea is most common and is symptomatic in over 90% of cases but is rarely asymptomatic. The absence of symptoms at this time, 4 months is strong evidence that you were not infected but there is a very small possibility that you have an asymptomatic infection. This is not something that I would worry. The chance that you have an STI from your prior encounters is less than 1% but if you wish to be 100% sure, testing would prove that. (I would not bother but as I said, this is a personal choice). If you choose to test, the most important test you can have is a urine test for gonorrhea (chlamydial testing is typically done at the same time).
I hope this information is helpful. Please don't worry. EWH
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1 months ago
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Thank you, Dr. Hook.
As you mentioned gonorrhea would be likely candidate, but with no symptoms I am probably fine. How about syphilis? I am reading that it is on the rise in the US, but looking at the numbers it still seems small. I guess I am just worried from what I read online, and the resources mentioning being “asymptomatic.”
Not sure if it makes a difference or not, the oral sessions last a maximum of 1-2 minutes before a condom goes on followed by more oral and penetration.
Appreciate your advice.
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Edward W. Hook M.D.
1 months ago
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Thanks for your thoughtful follow up. You are correct that the risk of syphilis is far lower than for other STIs. Further, had you acquired syphilis you would have developed a sore ( a chancre) on your penis. That you have not is strong evidence that you have not acquired syphilis.
The internet tends to be an unreliable source of information on STI risk.
Again I urge you not to worry. EWH
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1 months ago
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Thank you again. This is my last reply and had another question.
I think based on what you have told me I am not infected. The part that got my attention was the probability of chlamydia because you mentioned they would be asymptomatic. Is it rare to get chlamydia from oral? I’m assuming if I had it, either myself or my partner would have had some sort of symptom.
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Edward W. Hook M.D.
1 months ago
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You are correct. Getting chlamydia from receipt of oral sex is about ten times less common than getting gonorrhea. Syphilis from oral sex is even less common. I agree that it is reasonable to presume that you were not infected.
Take care. EWH
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