I had sex with a 25 year old Russian girl who was on vacation in Israel.  The sex was protected, but we had oral sex both ways unprotected.  I recently shaved my genital area 2 days ago.  What is my risk of STDs?

Oral sex is safe sex -- not zero risk for STDs, but compared with vaginal or anal sex, but the risk for all STDs is low and for some it is zero for all practical purposes (including HIV). That said, Russia has a high STD rate and people who have casual sex when traveling often are high risk. Your penile exposure to your partner's mouth put you at small risk for gonorrhea, herpes due to HSV1 (the cause of oral herpes), nongonococcal urethritis (NGU), and syphilis. The form of NGU from such an exposure is generally harmless both to affected men and their partners:  if you develop symptoms (discharge and/or uncomfortable urination), you'll need treatment. If no symptoms, this doesn't require exam or testing. If exposed to gonorrhea, you'll develop obvious symptoms you would not miss:  painful urination, pus dripping from the penis. Similarly, if no symptoms of herpes (penile blisters or sores) it will be good evidence against herpes and no testing needed.

Your oral exposure (cunnilingus) is very low risk for everything. There is minniscule risk for gonorrhea, syphllis, and herpes due to HSV2. There has never been a known case of HIV transmitted by oral-vaginal sex.

Bottom line:  Be on the alert for symptoms of discharge from the penis, painful urination, and penile sores. If none of these by 10 days, you can be confident you didn't get herpes, gonorrhea, or NGU. However, for increased security you could consider having gonorrhea tests (urine, throat swab) any time 5+ days after the event, and a syphilis blood test at 6 weeks.The chance of HIV is too low to need testing, but HIV testing is pretty much automatic along with syphilis testing, so you can also do that at 6 weeks.

Alternatively, if you're still traveling and in touch with your partner, you could contact her and disucuss the idea of both of you going for STD testing (gonorrhea, chlamydia, syphilis, HIV). You may find she is just as nervous about her risks from you as you are about her, and maybe mutual testing would be helpful to both of you. If these results are negative, you'll both know you were not at risk from this encounter.

Because of your previous history of several follow-up anxiety driven questions -- which as Dr. Hook informed you is against forum policy -- please plan on covering any additional concerns within the normal limit of two follow-up questions on this thread.

In the meantime, stay mellow! All in all, this was a very safe event with low chance of any STD. If somehow I were in your situation, or if I were counseling my 25 year old son, I would not advise testing at all except if symptoms show up.

Best wishes--  HHH, MD

Side question, I was pretty promiscuous in college.  I did get chlymidia once, about 14 years ago.   But I read that 1/2 to 2/3 of people have hsv1.  I tested negative for this through quest diagnostics.  Statistically I should have had hsv1, though I never get sores on my lips.   Will the body eventually beat hsv1? 

I've tested twice this year through quest diagnostics  hsv igg antibody is less than .90 negative

Also I have had hep a & b immunizations, would not not cause the hep a test (igm) and hep b test (antigen) to show positive? I still have a furry coated tongue and just don't want to doubt the quality of quest diagnostics tests.

You should never have another HSV1 blood test; it would be a waste of money.

Do not waste your money on an hepatitis A blood test. The virus is rarely sexually transmitted and outwardly healthy people never need testing. And having been vaccinated, you can never catch it, so no point in testing. Also, you can never catch hepatitis B, so no point in ever again testing for that either.

Coated tongue is normal and occurs from time to time in entirely healthy people. By itself, it is never a sign of any sort of importatn health problem.

That concludes the 3 replies included for each question and so ends this thread. As you were informed several months ago, repeated anxiety driven questions are not permitted. Please do not be tempted to ask further similar questions. Thanks for your understanding!