[Question #3203] Risk of transmission from kissing

37 months ago
Dear Doctors. First of all I thank you for what you have been doing for long period of time. You have been light to so many people in miserable times. 
My question is the following: I met a girl whom I don't really know and we kissed during our date. I kissed her neck and breasts(no French kissing) for a while and after returning to home I noticed that my lips are scratched like scratches from the cold. It wasn't big wounds or anything, just small scratches that could bleed a little bit.  So I got anxious afterwards and want to be sure. Even if the girl had some virus or something, is it possible to catch HIV or HCV or anything in this way. I didn't notice any blood on her neck or breasts but maybe I could miss small things.  Thank you very much. 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Welcome to our Forum and thanks for your comments.  It is nice to know that our comments are well received.

As for your question, you are not at risk for acquisition for almost any STI from kissing, even French kissing is not meaningfully associated with risk for STIs such as gonorrhea, chlamydia, HIV, or hepatitis.  Similarly, there is no risk for any STI from kissing a woman's breasts or neck.  Thus there is no reason for testing for STI related to the  events that you describe.  That your lips became cracked  or scratched during your encounter does not change this.

In the spirit of full disclosure, I should acknowledge that there is a small risk of acquiring oral herpes (cold sores) from the contact you describe, particularly if your  partner had a cold sore at the time you were kissing.  It sounds however that this is not the case.  I would not worry at all about the exposure you describe.  There is no need for STI testing of any sort.  I hope this information is helpful.  EWH
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37 months ago
Dear Doctor, 
Thank you for your reply. 
As a very anxious man, I make all type of scenarios so your reassurance is much helpful. Even if I had small bleeding scratch in my lip and she had small scratch somewhere I kissed, it is still not a possible way of transmitting HIV or hepatitis, am I correct? As much as I have read, for such a thing to happen the cut must be very large and the blood freshly bleeding and visible amount? Is it an accurate assumption? I may have had a very small bleeding scratch on my lip, and what if she had any scratch somewhere I kissed? 
Also regarding oral herpes, I got a bit concerned. I didn't kiss her lips, I kissed her only on neck, cheeks and breasts. Is it possible to get oral herpes from kissing the breast or neck?? I am very sorry if anything I say is repetitive, I just feel very nervous.  
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
As I said earlier, the fact that you and your partner both had scratches on your lips in no way puts you at any known risk for HIV or hepatitis.  The size of the cuts and amount of blood have no known effect.  There have never been cases of infection transmitted in this way.  I see no reason for concern and no reason for testing related to the events you have described. 

With regard to herpes, the risk is tiny.  HSV is transmitted by direct contact with the site of infection.  Both the neck and the breasts are extraordinarily rare sites for HSV infection. 

Please don't worry.  EWH
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37 months ago

Dear Doctor,

Thank you very much for your replies.
I apologize but I still have questions. I looked on your previous answers on similar question and saw one of your  answers which made my anxiety skyrocketed. It says:
theoretically syphilis or herpes could cause lesions in this location(nipples) and as such would be potentially infectious.  I have to admit that this has made me so nervous. During my meeting, it was dark and I didn’t really look on her breasts when I kissed them. So my questions are:

1.      Could I get infected by syphilis this way, as I didn’t see if she had anything on her breasts? Are you familiar with such cases?

2.      Should I get tested for syphilis based on this incident or get a shot of an antibiotic just to be on safe side?

3.      Is a test at 30 days after “exposure” conclusive?

 

Thank you very much, I truly appreciate your help.


Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
No need for apologies, although as this is my third response, this will be my final response and the thread will be closed later today.  I'm glad that you took the time to look at other responses but fear that you may be over-reading things.  Syphilis is a relatively rare disease (much, much less common than chlamydia or gonorrhea) and at present is most common among men who have sex with other men who now account for over 60% of all syphilis in North America.  Had your partner had a syphilis lesion, it would be most unusual for you not to have noticed.  I really would not worry.  with that, onto your specific questions:

1.  Theoretical answers are meant to be inclusive because rare things do happen, RARELY.  I have never seen a case of syphilis acquired in this way and have never seen a syphilis lesion on a woman's breast.
2.  Please do not take antibiotics "just in case".  this leads to side effects and promotes antibiotic resistance.  If you wish to have a blood test for your own peace of mind, there is no reason not to do that.  I would wait until at least a month after your encounter to test however unless you develop a painless sore on your mouth/lips which could be syphilis.
3.  "Official" guidelines say that a test could become positive as far out as 90 days but for all practical purposes, 30 and certainly 60 days is more than adequate.  In your specific case, given the rarity of syphilis and the nature of your encounter, I would consider a 30 day result to effectively be conclusive.

I hope these clarifications help.  Syphilis is a rare disease and just as you could, theoretically be struck by a meteorite falling form the sky today, you could also theoretically have acquired syphilis from the encounter you describe.  the odds of either happening are about the same.  Please don't worry.  EWH
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