[Question #13712] Protected Oral
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1 months ago
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Hello Drs it has been almost 2 years since my last encounter and unfortunately I am back with a somewhat similar experience. I have extensively read a lot of replies of yours and I can already anticipate what your answers will be. After reading a lot of the responses that are in the same category of oral I can safely assume that your answer will be that I had a minuscule to damn near zero risk encounter. The encounter I am here for was a protected oral from a street walker on Sunday, January 11th She took out the condom from her bra and used her mouth to hold the condom on my head and used her hands to pull the condom down my shaft. The encounter lasted no longer than 7 to 10 minutes and afterward I took the condom off and discarded it. I mistakenly forgot to ask her what was the last time she got tested and unfortunately I won’t be able to ask her. But based off a lot of your responses to unprotected oral and also protected oral questions that I’ve seen on here like I said I can anticipate your answer.
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1 months ago
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1. What are the chances of me getting anything from the encounter? I realise that the only real possibility from oral is gonorrhoea and NGU but that is with unprotected oral as I understand it with oral it’s almost no risk.
2. As I’ve explained to my last encounter, I do have a Wife and would hate to cause any harm to her because of my dumb mistake. Is there a chance that I can give her anything? And is it safe to continue regular sex with her?
3.I am on day three and have not noticed any symptoms whatsoever. I’ve read on some of your post that if you don’t get any symptoms within 3 to 5 days it is safe to assume that you are in the clear. Does that mean essentially that if a week goes by and I have no symptoms. It is safe for me to assume that nothing will happen and I am in the clear.
4. This question kind of ties into the 3rd question I’ve noticed that in past responses the percentage has changed when it comes to symptomatic gonorrhoea. I noticed before the percentage was 99% of males have symptoms of gonorrhoea within 3 to 5 days and I realise that it has now changed to 90% my question is was there a new study that changed the response or was it just a guesstimate when you would answer 99% with all respect to your guises work I was just curious thank you guys so much.
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H. Hunter Handsfield, MD
1 months ago
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Welcome back. My initial response is succinct, based only on the title you chose for your question. Even unprotected, receiving oral sex is low risk for all STIs and zero risk (or virtually zero) for HIV. For condom protected oral -- the title you chose -- and assuming no obvious condom breakage, the risk is truly zero for all infections.
1. What are the chances....? I would say zero and that you should not be tested for anything.
2. Since you could not have been infected, you cannot have any STI to transmit to your wife.
3. No symptoms after 5 days is strong evidence against gonorrhea, but that's all. Most other STIs take longer for symptoms to begin. But still since the risk was zero you really shouldn't be worried.
4. I don't know where you saw only 90%. I would continue to estimate that 99% of males have symptoms within 5 days. And this is something I know about; here's a link to an old study but still the single most important and comprehensive analysis of asymptomatic urethral (penile) gonorrhea in males. Note the first author: https://pubmed.ncbi.nlm.nih.gov/4202519/
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD
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1 months ago
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3. I know u said that other STDs take longer to develop how long would u say that enough time has passed for me to feel like im fully in the clear. Since I won’t be taking any test to make sure.
The unfortunate part is that I’m feeling the same feeling I got last time where I feel something coming out of my urethra but when I gently squeeze on the head, nothing comes out. I know this is nothing more than anxiety, but it took awhile before the sensation went away in the previous encounter. Even after negative test of the last encounter and all of your advice I still talk Doxy for seven days and azithromycin 500mg nd after that the feeling went away. Closing that chapter. I don’t wanna do the same any advice. I understand that is out of ur expertise just thought I’d ask. Just for reassurance this ain’t a std symptoms correct.
All in all I should be in the clear by this Friday and just put this behind me and never do this again. I can very much tell this type of lifestyle just isn’t for me based off the chance of hurting my wife with an impulsive decision that I regret.
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H. Hunter Handsfield, MD
1 months ago
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There is no time at which you can be 100% certain you aren't infected just on account of symptoms. All important STIs sometimes cause no symptoms at all. Most cases of chlamydia cause symptoms within 2 weeks and most syphilis within 4 weeks. But the only way to know for sure is to be tested. On the other hand, the sexual event you describe was not an exposure at all; there was no possibility of any infection. Therefore testing isn't necessary.
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The symptoms you describe for your penis/urethra indeed sound like the originate with anxiety, nothing more. If the doxycycline helped, it probably was also psychological, not because you actually needed treatment.
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1 months ago
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Last question/statement.
All in all I should be fine and don’t need treatment or to get tested.
1. Am I to understand that chlamydia is rarely transmitted through oral and syphilis is also rare to get from Oral? If u would be so kind in telling me those chances of these I know u said it was pretty much a NO RISK. But if this would have been unprotected what would be the chances are we talking 1 in 20000 or winning the lottery type numbers.
2. For this small minuscule chances I could have caught have something else what would it be and how soon would symptoms show?
3. In your years of medicine in this subject have u ever seen someone get diagnosed with any STD When condom protected oral was the only encounter.
I appreciate all you do Dr. If their is a way I can donate more I would love to know. Your knowledge sharing has helped a lot of people with problems and this site that you and Dr Hook created is heaven sent.
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H. Hunter Handsfield, MD
1 months ago
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1. That the correct perspective on oral chlamydia and its transmission by oral sex: both are very rare. Moreover, when chlamydia does infect the oral cavity, it causes no symptoms, is rarely transmitted to partners, and is cleared by the immune system without treatment. Syphilis is different; although not commonly transmitted by oral sex, that definitely happens -- much more commonly than for chlamydia. Indeed your exposure was NO RISK (to use your own all-caps emphasis) for all STIs, because of the condom.
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2. Irrelevant because of the impossibility of infection from this event.
3. No I have never seen such a case and neither has anyone else, since it cannot occur -- if the condom is in place for the entire exposure and does not break. No infection of any kind can pass through intact latex: there is no such thing as microscopic defects that allow viruses or bacteria to pass.
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.