1) Is analingus a common method of sti infection for the receiving partner? Which ones and what are the chances and symptoms?

2) If infected in the anus, could transmission to a vaginal sex partner happen or would it stay local? 

3) If the symptoms aren't strong enough, and I never tested but had the infection, does the body clear it or does it spread and get worse?

-A few weeks after exposure: Pain in the anus, perineum, thighs, penis, pelvis that came and went in severity. Most of this has subsided. (tested negative via urine at this time)

-Currently, months after: Painful anus and sometimes appears red, irritated red skin above the anus through the rest of the butt crack, and an overall feeling like sweating outside for a long time, or wiping vigorously would bring. This discomfort is not every day, but is more than I would usually experience. 

- Abdominal and lower back pain and cramping, low level, but comes and goes (anxiety perhaps)?

There has been no discharge, and it does not itch. It's just red, irritated, and painful at times. Waking in the morning usually is pain free. 

Does this event sound like something I should test for? I can't seem to find good info on the level of risk licking of the anus is, even when done for maybe 5 minutes or so. 

Thank you. 

1) There has been no research on STD transmission risk by analingus. However, I and other experts (as far as I know) have never seen anyone wiith any STD from analingus, especially the anal partner. In general, STDs are uncommon by any oral contact. Kissing is never a risk, and oral-genital sex is low risk for all STDs and virtually zero risk for some of them. Further, when someone has an oral STD, most transmissible infections are located in the back of the throat and not likely to be transmitted by lip or tongue contact. (That's probably why kissing carries little or no risk, but oral-genital sex sometimes does.) Anal herpes due to HSV1 is a theoretical possibility, but there are no reported cases of it. The main infection risk from analingus undoubtedly is for the oral partner, who is at risk for various intestinal infections or, more rarely, hepatitis A. I would consider any risk for the anal parter to be zero for all practical purposes.

2) In general, STDs do not travel through the body to other sites. Even if somehow infected anally, there would be no risk to partners from genital intercourse, oral sex, etc -- only by direct contact with the infected area, i.e. the anus. (Syphilis is an exception, but is essentially zero risk in this situation.)

3) Most infections, both STD and others, are cleared by the immune system over time. Herpes is an exception (all HSV infections are permanent), and some infections persist despite the immune response (e.g. syphilis); and of course HIV persists indefinitely. But gonorrhea, chlamydia, and most others are cleared within weeks to months.

4) Anal irritation is among the most common of all day-to-day symptoms experienced by all humans -- anal hygiene, local fungal infections, and unknown causes usually are responsible. There is nothing in your description that suggests an STD or any infection related to your analingus event. Your non-anal symptoms, such as abdominal pain, cannot be related to that event. Based on your description, much of what you are experiencing sounds like the result of anxiety over the event magnifying minor symptoms or even normal body sensations that you otherwise would ignore or perhaps not even notice. I would also point out that whenever someone suspects his or her own symptoms might have a psychological basis, usually s/he is correct!

If your anal or abdominal symptoms continue, you should see a physician for diagnosis and possible treatment. But I'm confident they have nothing at all to do with the analingus event, except for the possibility of anxiety over the event. I don't recommend testing for anything, and if somehow I were in your situation, I would continue unprotected sex with my wife with absolutely no concern about transmitting anything to her.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I tested for gon/chl at 5 days, 17 days and all STD's at 6 weeks. Everything was negative, except HSV1. I also visited my local doctor and received 2 in office urinalysis, both not showing any leukocytes or nitrates. However, a few questions: 

1) Is there anything else that I could be at risk for that was not covered above?  I have experienced symptoms similar to CPPS including pain in the penis, anus, groin, and the "golf ball" feeling. I have not experienced any discharge or dysuria since the event, 13 weeks ago. However, pain symptoms still come and go. Are these symptoms concerning? Could it be NGU or a UU/mycoplasma infection that doesn't cause obvious symptoms?

2) The abdominal cramping I mentioned before is new, starting at the 12th week. It's a dull ache/cramping there most of the day, mainly right around the belly button level and slightly below and above. It is not down low near my genitals. Sometimes it's in my lower back but posture could be adding to that. Is there any infection that could be causing this? If anxiety, I can easily accept that. Just want to rule out any infection first. 

3) Urine: I am analyzing every urination I have. In the morning, my urine is cloudy, darker, and certainly smells more. Last night I held overnight for 6 hours, but I hadn't drank water in about a total of 10 hours. It was a very dark and cloudy urination. As I drink water throughout the day, it is more clear with only small bubbles. When I search, UTI is always one of the first things mentioned. Is  there any concern with urine presentation in male infections, and if so, what is there to look out for? I'm trying to rule out concern over dull stomach aching and urine properties. Thank you!

2) This information doesn't change my opinion or advice as noted above. 12 week delay in onset is additional evidence against an STD or any other infection from the exposure you have described.

3) These wound like entirely normal variations in the color and character of healthy urine. Everybody's urine varies with hydration and with sleep (more concentrated urine in the morning) just the way you describe. In any case, no STDs cause variations in urine color or appearance.

You're obviously very obsessed over your body and every sensation that comes up, way beyond normal for most persons in your situation. I suspect you have mixed feelings at best and perhaps overtly negative ones about the sexual exposure and a sexual decision you apparently regret. If all this continues, you should consider professional counseling. I suggest it from compassion, not criticism. I remain confident you have no infection from that event.

The purpose of allowing two follow-up comments is not to allow entirely new questions, but clarifications of the original one. Let me know if anything isn't clear, but let's not re-hash the same symptoms or the details of the sexual exposure. OK?

The oral sex event took place 13 weeks ago. However, I have had varying symptoms of prostate, penile, pain, etc., but those have seemed to subside. I am now experiencing abdominal pain/cramping that has lasted a few days now, about a 3/10 on the pain scale. Although as I type, nothing to report.   It has never hurt when urinating and there has been no discharge. As a reminder, I tested at the following intervals:  Gon/chl at 5 days, 17 days and all STD's at 6 weeks. Everything was negative. I also visited my local doctor and received 2 in-office urinalysis, both not showing any leukocytes or nitrates.

Today I had very cloudy urine this morning, not dark, but cloudy. It almost looked like a wheat beer if you have ever seen those. Further on in the day, it's more normal. While coinciding with abdominal discomfort, I read that UTI could be a factor. I know UTI in men are not common, however is there an infection causing the cloudy urine and abdominal cramping? I purchased the AZO in-home UTI test kit and used it this morning after holding urine for 4 hours. It tests for both Leukocytes and nitrates using 2 applicator pads. The leukocyte pad showed purple color on it, indicating positive. It wasn't super dark, but it was clearly purple. The nitrate was clearly negative, no color at all. The result TERRIFIED me, and I ask these questions with the hope of some compassion:

1) Where do I go from here? How do I interpret this? Do I need to retest for Gon/Chl although I already have at the intervals described above? 

2) If I can rely on the lab based gon/chl testing performed above, what could be causing this result? NGU? Is there anything I could pass on to my partner? We are about to try for another baby and I'm very scared. I have Cipro, should I be taking it?

3) If it matters, the abdominal cramping isn't localized. It seems to go from the left to the right, sometimes higher, sometimes lower. I was really hoping it was an anxiety symptom, but now I'm very concerned it's not. 

4) I've read that abdominal pain could be caused by Hep B. Is there a reason to be concerned here with this? My negative test result for this was at the 6 week mark, which may be early. (She was of Asian decent, and I've read higher rates are in Asia)

5) Could this +Leukocyte test, weeks AFTER a negative one at the doctors office even be possible from the same exposure? Are the office tests more reliable? Should I continue taking the rest of the in-home ones and if they are both positive, go to the doctor? Going to the doctor is hard for me, as I risk exposure and if it's just anxiety fueled, I risk losing my family without an infection problem. 

I'm trying so hard to move on. Please help me here, this result this morning has me literally trembling. thank you. 

1) You "interpret this" as normal, with solid evidence you have no STD. However, see no. 5.

2) Normal variations in urine concentration and appearance, as suggested above. Unrelated to the analingus or hand-genital exposures described above, or any other sexual exposure.

3) No STD causes such symptoms.

4) Neither does hepatitis B. Nausea and abdominal pain can go along with hep B, but never as the only symptoms and not with cramping.

5) The urine WBC test is designed for use in women, not men. A weakly positive result could be the result of highly concentrated urine. However, I cannot say for sure you do not have a UTI. As you state, such infections are uncommon in men, but they do occur from time to time. If so, it's not an STD and not related to the analingus event.

You need to stop examining and testing yourself and see a health professional, then follow his or her advice about testing for UTI and perhaps other conditions that might explain your symptoms.

That concludes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes.