[Question #2286] Unprotected Oral

46 months ago
I (male) received unprotected oral from a stripper 4 days ago. I was drunk and made a big mistake. I took 2g of Azee by Cipla 2 days later. I was previously diagnosed with Genital Hsv-1 10 years ago. I've only had one initial outbreak in that time. The oral lasted about 30 seconds. No genital to genital contact at all. I did not notice any visible sores on her lips. My previous test prior to the event were all negative except HSV-1.
What are my risks, bacterial and viral? My main concerns are HSV-2, HPV, and HIV.
When will symptoms appear, if any? 
If I did have a bacterial infection would the Azee cleared it and when can I resume sex with my partner?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Bottom line:  little or no risk of any STD and no need for testing

Questions about risks from oral sex are among the most common on the forum. Scan for other discussions for more details. The bottom line is that oral sex should be viewed as safe sex, with low risk for all STDs and zero (for all practical purposes) for others. Oral STDs are relatively uncommon, a lot less frequent than genital; and when present, they usually are not transmitted.

So the odds are great that the stripper didn't have anything to transmit by oral sex and your risk of being infected is even lower. I would have recommended against the azithromycin (AzeeĀ®), but in the event you were exposoed to gonorrhea, chlamydia, or syphilis, any of these would have been cured. (Some syphilis strains are resistant to azithro, but syphilis is virtually nonexistant in women, including strippers and sex workers, in most of the US. It's pretty much limited to men who have sex with men.)

So no risk for bacterial STDs. You are immune to HSV1 and can't catch it again, anywhere on your body. HSV2 oral infections are very rare, so no risk; genital HSV2 is virtually never acquired by oral sex. HPV risk isn't entirely clear:  the overall risk for oral to genital transmission is very low, but maybe not zero. However, as a sexually active person you can assume you have already had genital HPV, probably more than once, and this single exposure doesn't raise your risk any higher than it was already. HIV is zero risk for practical purposes:  there has never been a proved case of oral to penis transmission.

You can safely continue sex with your partner at this time. That's what I would do if somehow I were in your situation. If you want still further security wait until about 2 weeks after the exposure. If by that time you have had no abnomral discharge (pus, mucus) from the penis, no painful urination, and no blisters or open sores of the penis, you can be even more sure you aren't infected. I recommend against any testing for anything unless you develop such symptoms.

I hope this information has been helpful. Best wishes and stay safe--  HHH, MD