[Question #1530] Married Mistake

45 months ago
I am a 43 year old married male who despite better judgment on 11/29/16 chose to connect with a like minded male for oral sex in the burbs of Boston. He was 27 and said he had only performed oral sex one other time and received once. Both with other men. He was a very clean cut white male and did not seem the type to visit bathhouses or glory holes.  He also has a girlfriend that lives with him. This alone made him nervous to continue and stopped performing on me after about a minute without completion.

Guilt has me feeling a lot of “What is that?” symptoms. Odd pressure in the groin area until I stand up and an occasional itch that is solved by an adjustment of underwear.  About two weeks after I had a mild sore throat with post nasal drip runniness and a stuffy nose which lasted about two days with allergy pills. Two days ago I had a very small sore inside my lip but feel it was from being chapped and it is going away already. No other symptoms I am aware of.

Based on what I have read read on this forum I felt confident enough to avoid testing and resume unprotected sex with my wife on 12/17/16.

All seemed fine but there was a slight odd feeling during ejaculation. My first in three weeks. Yesterday, she developed a sore throat and and is tired but no other symptoms. Now the fear sets in. 

So, I ask:
1) What is MY risk based on the situation I describe and more importantly, to my wife.
2) Are OUR symptoms aligned with anything that would require testing?
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

Welcome to our Forum.  I'll be glad to comment.  The exposure you describe was very low risk.  Most people do not have STIs of any sort (including HIV) and your partner sounds to be lower risk than average.  Even in high risk populations, oral STIs are rare, gonorrhea being probably the most common and that is present in less than 5% of persons attending STD clinics (who, I would think are at somewhat higher risk than your partner).  Even if your partner did have an STI, most exposures do not lead to infection. 

From the sounds of things you received but did not give oral sex.  If this is the case, oral sex only relatively rarely leads to infection.  When it does, the most common problems are either symptomatic (causing burning on urination or penile discharge) gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  This sort of non-chlamydial NGU is not clearly and STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications.  In the Unitized Kingdom, many specialists do not treat NGU associated with oral sex.  When treated, oral sex-related NGU typically resolves quickly.

As for your symptoms, the symptoms you describe are more characteristic of the sensations an anxious person might experience if they were on the "lookout" for possible STI symptoms than true STI symptoms.  They do not suggest STI.  Similarly your wife's symptoms are not suggestive of STI either.

If I were you, I would not worry in the least and I see no need for testing related to the exposure you describe unless you want the peace of mind that a negative test would should. If you decide to test, testing for gonorrhea and NGU would be most important.  no need for syphilis or herpes testing unless you develop sores on your penis.  there are no cases of HIV ever proven to be acquired through receipt of oral sex so there is no need for HIV testing at all

I hope my comments are helpful and reassuring.  EWH


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45 months ago
Thank you for the response. It is very reassuring and expected based on other questions I have reviewed on this site. 

You are correct, I did not perform oral sex on him, I was only the recipient for about a minute or two before he stopped. No ejaculation occurred. 

With regard to the symptoms you mentioned in the rare cases of gonorrhea or NGU, how soon would those symptoms occur post exposure and when would I be considered in the clear for symptoms to occur. I understand it is rare but wonder what my window of time is for extra relief. 
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago
Symptoms of infection never appear within 24 hours of exposure.  The symptoms of gonorrhea typically appear within 3-5 days of acquisition of infection, sometimes sooner.  The symptoms of NGU are milder and, on average,  typically do not appear until 5-10 days of infection.   EWH
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44 months ago
I am not one who needs to test for psychological reasons and can certainly accept your recommendation to not test.

You mentioned the time frame for gonorrhea and NGU symptoms but what would the time frame be for symptoms to begin for syphilis and herpes?

Understanding the risk was very low to begin with and the fact that it has been over three weeks since I received unprotected oral sex, I truly feel I am out of the woods even for the remotest possible infection. Do you agree?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Thanks for your confidence in my recommendations, I appreciate it. 

Syphilis lesions may take up to three weeks, on average, to appear.  Your chance of getting syphilis from the exposure you describe is very, very low.  As for herpes, lesions would appear at about 4-7 days after exposure and almost never after 10 days. 

I agree completely, you are out of the woods.  I really see no reason for testing of any sort and would suggest that you move forward from here without concern.

Our Forum guidelines call for up to three responses per question.  This is my third response.  As a result there will be no further replies to this thread.  Take care.  EWH

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