[Question #14063] STD

1 months ago

Married male here. Yesterday I received Oral sex and brief unprotected vaginal exposure. Is chlamydia/gonorrhea NAAT accurate at 5 days? Is there risk of gonorrhea if she was asymptomatic?

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum. Thanks for your confidence in our services.

You say nothing at all about your non-marital partner yesterday, which makes it difficult to evaluate your STD risk. But the answer to the first question is yes: a negative gonorrhea/chlamydia NAAT at 5 days will be conclusive.

In women, symptoms are pretty much useless in judging the likelihood of chlamydia or gonorrhea. Many women have increased vaginal discharge but judging normal vs abnormal vaginal discharge can be difficult; and the majority of cases cause no symptoms. If your partner did report she has been experiencing increased discharge or painful urination, it would increase the chance she was infected. But absence of symptoms is no guarantee at all. In terms of gonorrhea/chlamydia risk, just rely on your own test results.

If your partner was particularly high risk -- like a sex worker or bar pick-up -- you might want to also consider blood tests for HIV and syphilis after a couple of risks.

I hope these comments are helpful. Let me know if anything is unclear.

HHH, MD

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1 months ago

I'm a married. The other woman e is promiscuous and has casual sex, when I asked, she mentioned she tests for STDs at least once a year through blood and urine tests recommended by her family doctor. She has never performed a swab test though. She told me she had chlamydia twice, once in high school ( 20 + years ago) and when she was pregnant another one was found ( 15 years ago). She says ever since she has been clean proven by tests. I have no reason to think this is a lie. Last test was around March April this year.

My concern is about my risk and to pass it to my wife

1) scanning through some questions I see chlamydia is not commonly transfered through oral sex but gonorrhea is, if her throat was infected, what is the likely hood that I could get gonorrhea and be asymptomatic?

3) if I decide to continue seeing her, if I usecondoms rolled all the way to the base all the time, would it prevent any skin STDs?

4) If I choose to continue to receive fellatio and ask her not to Deep throat, would that reduce the risk of potential infection since it lives in the throat?

What do you recommend me to do in this case and is there something else Im missing to test for?

Thanks

Frank Dux

1 months ago

I forgot to mention about my non marital partner. 34 year old divorced. She casually sees people and sleeps with them once in a while. She seems very knowledgeable about stds and assures me she has tested and that she is clean. She tells me I can test for my peace of mind but she is safe. I don't know about her throat though but if she had gonorrea I most likely would have develop syntomps? She also said she had an abnormal pap that was treated and it's been clear ever since. I'm not sure about warts since it can take months to appear. What would you do if you were in my position?

H. Hunter Handsfield, MD

1 months ago

Thanks for the information about your partner. Based on what she says, she is obviously at moderate to high risk of STDs. OTOH, that she tests regularly and was apparently honest makes it unlikely she has active, transmissible gonorrhea, chlamydia, HIV or syphilis. Your most recent statement indicates she's a wise person with good understanding about STIs and their prevention. The idea of you testing "for peace mind" makes sense.

1) When oral gonorrhea is present, probably it is transmitted to partners by oral sex under 10% of the time, maybe closer to 1% (one chance in a hundred). If you were infected, there's a 99% probability you would not have obvious symptoms within 5 days. (Asymptomatic urethral gonorrhea is very rare in recent years.)

3) Condoms are generally very good in preventing skin-skin contact (herpes, syphilis, HPV) but not perfect. Whether or not rolled all the way up probably makes no significant difference.

4) There are no data on whether "deeper" fellatio or less deep penetration changes the risk of any STD. I suggest you consider all such unprotected contact to be fairly low risk for most STDs and virtually zero risk for some (such as herpes due to HSV2 and HIV).

"What would you do if you were in my position?" If your non-marital relationship continues, you'll be reasonably safe doing what you are now -- condoms for vaginal or anal sex, but unprotected oral sex OK -- and might be tested for common STDs every few months -- urine gon/chl, blood tests for syphilis and HIV.

My advice is to ignore HPV and warts. Almost everybody gets genital HPV -- it's a normal, expected, unavoidable aspect of human sexuality. You could consider immunization to reliably prevent infection with the 9 HPV types that cause most health problems (warts, cancers).

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1 months ago

Thank you.

I did some late night thinking and decided this morning to stop seeing my affair which I communicated by texts.

There is two pieces of information I ommited. The penetration that happened 2 days ago lasted for no less than 5 seconds. In and out once although It was deep. Not sure if this reduces risks, I havent had sex with my wife since.

Also, . There was another encounter with this same Person last Tuesday but only involved me giving and receiving oral sex. 5 days later ( Saturday night) I had unprotected sex with my wife and I'm worried I may have given her something

My plan was to test and if positive I can take antibiotics before I have to disclose my indiscretion but since I had sex with my wife after just oral sex, could she be at risk?

Also to clarify. You mentioned.

"). If you were infected, there's a 99% probability you would not have obvious symptoms within 5 days. (Asymptomatic urethral gonorrhea is very rare in recent years.)" did you mean there's 99% I will not or I will have symptoms? You mention it is rare so I'm confused by the wording.

I'm not worried about skin stds because if it's herpes, my wife has hsv 1 and I can blame it on it and it it's a wart I can say it was re activated from years ago type of thing. So, in the absense of symptoms should I be mostly in the clear? If I had chlamydia it would have been from vagina sex and my wife wouldn't be exposed to it since I didn't have sex after that just after the only oral encounter.

And finally at the risk of writing a too long question. I can book an appointment to test for gono and chlamydia this Friday but that would be only 4 days post exposure. Would that be enough time for conclusive results? Are fasle positive/negative tests common for urine? Should I release the fist urine of the morning?

H. Hunter Handsfield, MD

1 months ago

Excuse the confusing wording. 99% of men with urethral gonorrhea develop obvious symptoms within 5 days. In other words, absence of symptoms within that time is nearly 100% proof you did not catch gonorrhea.

I'm not sure I fully understand the paragraph starting "I'm not worried...." If I correctly understand, you're right about no worries in the event you acquire HSV1. But this doesn't apply for HSV2.

The data on time to conclusive testing are not very strong. 4 days surely is OK for gonorrhea but maybe not for chlamydia. I suggest waiting til day 5.

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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