[Question #3460] Gonarrhea Chlamidya HELP please (threesome)

35 months ago
I am a a 30 year old male. I recently had a threesome with my long term partner and another woman. We did this twice with the same additional partner.First off, Myself and my partner have never had a STD and have never had any STD'sWe had a threesome with another woman, and we engaged in the following.I will refer to the "new female" as the additional female partnerAfter the second encounter, the new female informed us her ex had tested positive to chlamidya, she last had sex with him the day after our first threesome, but told us after the second threesome.  I then did a chlamidya test and was negative for oral and urine testNow 2 weeks after this test, the new female informed her other partner had Gonarrhea, she is to be tested for this tomorrow.Since having the threesome and knowing that the new female tested 3some1 day later "new female" had oral, vaginal sex with a infected partner.7 days later 3some 2 days later new female informed us of infected status of partner, and she did a test for chlamidya, 1 day later Male partner does Chlamidya test, and 5 days later I received a negative result for oral test and urine test1 day later new female test positive for chlamidya1 Day later My Long term partner gets tested for chlamydia and is awaiting resultsMale giving oral to new femaleMale receiving oral from new femaleMale giving analinguis to new femaleMale kissing Male fingered new femaleMy Partner gave oral to new female for around 15-20minutesMy partner gave me oral with the new femaleMy partner fingered new female and then put those fingers in her own mouth and new females mouthMy partner had sex with new female with a straponNow My questions is, that I am worried about myself and my long term partner getting Gonarrhea from the above activites, WE DID not have vaginal or anal sex with the NEW female. Myself and my partner will get tested. I have read on many posts by Hunter Handsfield MD, that it is very hard to get gonarrhea from anything but vaginal and anal sex 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your question.

First, I will correct a misunderstanding reflected in your closing statement:  gonorrhea is commonly transmitted by oral sex, especially fellatio (oral-penile), less so but still possible with cunnilingus (oral-vaginal). I think you have misinterpreted comments I have made about chlamydia, which is uncommonly transmitted by oral sex.

You tried to make it clear what sorts of contacts you had with the various partners in your threesome exposures, but I'm having trouble following it. Were there two separate threesomes in the relatively recent past? Anyway, it sounds like a lot of mixing and matching of sexually exposed sites. It sounds like gonorrhea is the main concern; that one person had chlamydia (or a partner with chlamydia) in the past doesn't necessarily mean a high risk of current infection or exposure. OTOH, chlamydia often goes along with gonorrhea, so much so that whenever gonorrhea is treated -- or if antibiotics are given to prevent gonorrhea -- the treatment always should cover the possibility of chlamydia in addition.

So the proper approach here is at least for all three persons in your recent threesome to be tested for both gonorrhea and chlamydia, as you and your main partner are planning to do. (If there was another threesome and it was fairly recent, i.e. within the past 1-2 months, those partner[s] also should be tested at this time.) If it seems likely that someone in all this mix indeed actually was infected recently with either gonorrhea or chlamydia, then everyone should be treated for both. The standard recommendation would be an injection of ceftriaxone (for gonorrhea) plus either single dose azithromycin or 7 days of doxycycline (for chlamydia).

Your personal information suggests you have a connection with Melbourne, Australia. In case you're not aware, Australia's federally supported sexual health centres comprise what probably is the world's very best network of STD/HIV/sexual health services -- and the Melbourne SHC is the best of the best. If you're not already under care of MSHC, I strongly recommend it as a world class source of the best advice in this situation.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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35 months ago
Thanks for the reply. So are you saying that all parties should be treated for Gonorrhea? Or do we wait till we are tested and then act on those results?  

It was 2 threesomes with the same 2 woman, 2 seperate occasions over 2 weeks.
The new girl had Chlamidya, and found after the 3some.
I also just recently checked and my last urine test, after the 2 encounters, tested negative for Chlamidya and Gonorrhea oral and urine test.

However I did receive a quick 20 second oral sex from the girl, and my partner did give oral sex to the new girl After the new girl finished her antibiotics for Chlamidya.

It was a week after this 3rd encounter, that the new girl informed us she may have gonorrhea.

I will get retested again, however is it likely I would of gotten anything from the quick 20 second oral sex from the new girl? Which occured after the new girl finished her chlamidya anti biotics. But before she advised us that one of her partners had Gonorrhea?

Also are the urine test 100% accurate, is there any chance of a false negative?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Thanks for the clarifications.

Persons sexually exposed to untreated bacterial STDs (gonorrhea, chlamydia, syphilis) normally are treated even if their own tests are negative. However, chlamydia is rarely transmitted by oral sex, so a case could be made for not treating you, and for your regular partner to be treated without waiting for her own test result. HOWEVER, you also know your more recent threesome partner has been exposed to gonorrhea and may be infected with it -- and as noted above, people treated for gonorrhea should be automatically treated for chlamydia as well. On top of all that, the general policy is to have a low threshhold for treatment -- that is, if infection status and exposure are uncertain, it's best to err on the side of over treatment.

So if I correctly understand the situation, all three of you should be treated for both infections. It could be considered optional to do any additional testing (although I am unclear on whether your regular partner has been tested since the most recent threesome event). On the other hand, from what you say, apparently only urine or genital gonorrhea testing has been done, right? No throat swabs for oral gonorrhea? That's actually quite important, since standard treatment is slightly less reliable for oral than genital or rectal gonorrhea. Also, there indeed is a possility of false negative urine test results, which misses 5% of urethral gonorrhea in men and about 10% of genital gonorrhea in women; swab testing is best, especially in women.

Which brings me back to my closing suggestion above:  Consider a visit to MSHC and put these decisions in their hands both for testing and treatment.

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