[Question #13822] oral sex and sti

6 days ago

hi doctor i am male and i received unprotected oral sex(blowjob) from a woman yesterday also i kissed her deeply and now i am having severe anxiety on sti mainly hiv and syphilis and also other sti, activity was for maximum 10 minutes and my penis is circumcised. also this is my first and single exposure from her. (i do not frequently have sex from strangers previously i had sex 18 months before). please tell me real world situation regarding transmission of sti from this exposure (mouth to penis) and which test i have to do or if no test is required. your reply will decrease my anxiety. please tell me in case of all sti (hiv,syphilis,hpv,hsv1&2, chlamydia,gonorhea,ngu). i am working in oman i heard in oman syphilis and hiv is increasing thats why i am afraid mainly of this two. also doctor please tell if i can forget everything and move on without looking for any symptoms and test also can i have sex with my wife? i have sore throat from today morning but exposure was yesterday.

i read mixed things online some place they say hiv does not spread in my scenario some place they say it can spread if blood is present in givers mouth. i am confused. syphilis also they said similarly some does not and some it spread easily if sore is present.

imagining if she has hiv and syphilis sore or other sti present how safe am i? do i need test?

doctor please give me a detailed reply so i can be free from anxiety.

H. Hunter Handsfield, MD

6 days ago

Welcome to the forum. Thank you for your confidence in our services.

As I suspect you know, all our replies always are frank, direct, and science based -- that is, the "real world situation."

You had a very low risk exposure, almost certainly zero for HIV. Kissing can be disregarded entirely, with no significant risk of any STI. As for oral sex, it might be theoretically true that blood in a partner's mouth elevates the risk. However, in the entire 4+ decades of the worldwide HIV/AIDS epidemic, to my knowledge there has never been a scientifically documented case of oral to penis transmission of HIV -- and obviously there must have been millions or even billions of such events in which there was some blood in the oral partner's mouth. Syphilis is rare from oral sex as well. The most common important STI in this situation is gonorrhea, but even that probably occurs in under one in thousands of exposures. Chlamydia is zero risk or close to zero. Herpes due to HSV1 is possible but rare. Nongonoccal urethritis (NGU) can occur, often suspected to be caused by normal oral bacteria and generally harmless.

At this juncture, I would advise you to just be on the lookout for symptoms like discharge (pus or mucus) from your penis and penile sores. If these don't happen within ~2 weeks, you can be confident you were not infected. In this situation, I would not recommend testing for anything. However, some persons in your situation decide to be tested even if the risk is very low; reassurance alone is a valid reason for testing even if there is little chance of any infection. In that case, I would advise a urine gonorrhea/chlamydia test, which would be valid any time more than 4-5 days after exposure; and blood tests for HIV and syphilis, which can be done 6 weeks or more after exposure. Definitely do not test for anything else: the available tests for herpes, for example, are not reliable in this situation and often give misleading results.

In the meantime, say relaxed: it is very unlikely you have any infection and any tests you do almost certainly will be negative.

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

HHH, MD

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6 days ago

Thanks for replying doctor

Doctor you said mine is low risk and no chance of hiv and syphilis is rare but at the end you asked me to test after 6 weeks… is this 2 test really necessary? Or is it just to clear my anxiety? Can i move on with my life without testing? Also doctor which sti should i be worried or looking mainly for or need testing? Regarding syphilis should i be worried in my scenario? Also doctor can i have unprotected sex with my wife? Since i am in oman i cannot test for hiv and syphilis easily that is why i asked if its really necessary in my case? When i read your other answers similar to mine i saw you reply most of them no need to test for any sti for this exposure.

If you are in my situation what will you do doctor?

6 days ago

Also doctor you said to look for discharge from penis and penile sore these are symptoms for which sti and after 2 weeks if no symptoms happens its over right? From your advice hiv is deleted from my mind now i want to know about syphilis doctor… also i checked her mouth photos inside i asked her to send me there was no visible sore or anything

H. Hunter Handsfield, MD

6 days ago

I did not "ask you to test" at 6 weeks or any other time. I suggested that you might consider it if you are anxious and would like the additional reassurance from the negative results. You can look at it as "just to clear [your] anxiety" if you wish! I already told you which STI tests you might consider for these reasons: urine for gonorrhea/chlamydia in a few days, syphilis and HIV blood tests after a few weeks. I do not advise any other tests. My advice to you is exactly the same as I have given the large majority of forum users who asked similar questions. If I were in your situation, in absence of symptoms I would not be tested for anything.

Looking in your partner's mouth is meaningless. If she has no symptoms she hasn't noticed herself, looking yourself won't tell you anything useful.

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6 days ago

Thanks doctor i was confused.. just some more doubts doctor

1. Hiv i can remove from my list without testing right doctor?

2. Gonorrhea how many days after exposure i should look for symptoms and if no dicharge is present i can forget that also right?

3. Syphilis should i be worried? Since it is rare… can i forget this also without testing ?

4. Doctor i read for syphilis to transmit there should be direct contact with sore and in primary stage…is it true?

5. What are the chances of syphilis in my condition?

6. Mainly which sti should i look for?

7. Can i have sex with my wife and move on with my life?

I know this is my last chance so thanks for your help doctor…your replies helped me a lot doctor mainly it reduced my anxiety… thank you

5 days ago

Doctor one more doubt, my only main fear now is syphilis

How common is the possibility of getting syphilis from recieving oral sex if penis touches sore in mouth and if it does not touch? Also doctor i have visa medical test at end of this so should i take doxycycline 100mg twice daily for two weeks because i vdrl is positive i will loose my job and visa

H. Hunter Handsfield, MD

5 days ago

These are repeat questions; all are directly addressed above or the replies are obvious from those remarks. I commented on your near zero risk for syphilis in my opening reply above. The chance you acquired syphilis is under one chance in many thousand. I would strongly advise against doxycycline prior to your blood test. However if you wish that extra level of insurance, you definitely do not need two weeks treatment. The standard recommendation for post exposure prophylaxis with doxycycline (doxyPEP) is a single dose of 200 mg taken within 3-4 days of exposure; it is 100% protective against syphilis.

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.

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