I was recently transferred to Beijing by my company for one month. I had not had sex since my ex-girlfriend and I broke up six months before arriving here. After arriving I joined OKCupid and I am ashamed to say became uncharacteristically promiscuous. Over a ten day period I met three women from the site two Chinese and one Dutch, and also met with two escorts, one Russian and one Chinese. In all cases the following contact happened: Significant kissing and unprotected oral sex both cunnilingus and fellatio, and always protected vaginal sex. I have looked online and seen many different answers, but based on what seems most reliable information I have the following questions based on the above situations:

1. I am at zero risk for HIV or Chlamydia because all vaginal sex was protected, even though all oral sex was not protected. Is this accurate?

2. None of women had any visible sores on their lips or vaginas, and I had HSV 1 as a teenager. Is it accurate that I am at extremely low risk for Herpes and syphilis?

Welcome to our Forum.  I'll try to help.  Despite their numbers and nature, the risks you describe are quite low risk.  Condom protected sex is safe sex, there are no STIs that are transmitted by kissing other than perhaps lesion diseases, and cunnilingus and receipt of oral sex have never been associated with risk for HIV and are very low risk encounters for typical STIs.  In addition, the azithromycin you took was likely active and would have provided further protection from infection.  If I were you, while I might reflect on my recent flurry of sexual activity, I would not be worried about STIs, including HIV.

In answer to your specific questions:

1.  Zero risk no but certainly close to that.  Chlamydial infections do rarely occur in the oral cavity but are inefficiently transmitted by this route.

2.  Yes, your risk for HSV-1 and syphilis is virtually zero.

3.  No.  Your azithromycin greatly reduces your already very slight risk for NGU and gonorrhea.  Both of these problems are typically symptomatic as well.  Since you do not have symptoms and given your very low risk, I would not worry.

I hope this perspective is helpful to you.  EWH

      Thank you! Two very quick follow ups. Would there be a significant risk of HSV2 from the encounters I mentioned? Also, I assume that the lesion type diseases you mention from kissing would be if someone had an active cold sore or some similar obvious lesion? Thank you for the amazingly detailed and quick answer! I am so grateful for the service you provide to the community and to people like me who don’t have an adequate knowledge base. I am definitely reflecting on my recent flurry of activity and will keep my libido in check. Thank you again!

Minimal risk for HSV-2 to multiple reasons including your condom use, that you already have HSV-1 (cold sores offer resistant to infection), that you do not know that you were exposed, among others.  HSV-2 is not acquired rom receipt of oral sex as it rarely infects the oral cavity. 

Hope this helps.  EWH

Your Z-pak was most likely good at the time you took it.  The expiration dates on the packages are quite liberal. 

This is the belated 3rd reply to your questions and thus this thread will be closed later today.  I will address your new question momentarily.  Sorry for the delay in this response. EWH