[Question #4651] unprotected oral at massage parlor in delhi

26 months ago
22 days ago, I made a terrible mistake and cheated on my pregnant wife. During a month-long business trip, I visited a massage parlor in New Delhi and received an unprotected blowjob. The blowjob lasted 5-7 minutes in total. I ejaculated outside her mouth. She rubbed her body on me. My penis may have brushed across her vagina. The massage parlor is located in a relatively expensive part of New Delhi. Based on local standards, it wasn't cheap. Yet I'm pretty sure that for some men, the place is essentially a brothel. I'm not sure if these details matter.

Since the incident, I've been extremely worried about passing on an STI to my wife. On Day 5, I took 1g of Azithromycin and 400mg of Cefixime. I didn't take Ceftriaxone because I didn't know how to inject myself. I understood this was a bad idea, but in that moment, I only cared about making sure I could not pass on gonorrhea or chlamydia. On Day 12, I couldn't resist and had brief, unprotected sex with my wife. I did not ejaculate inside her. On Day 16, I tested negative for gonorrhea, chlamydia, syphilis, and HIV. The HIV test is the one "which looks for the HIV virus". The clinic says you should wait 2 weeks after contact before testing (6 weeks for accuracy). For syphilis, it says you should wait 3 to 4 weeks (3 months for accuracy). It's Day 22. I haven't seen anything that looks like chancre on my penis. I'm experiencing fatigue and body aches, likely due to unrelated reasons.

These are my questions:

1. Based on my exposure, results, and lack of obvious symptoms, can I conclude I did not contract syphilis, HSV, or HIV?
2. What further testing is required? I would like to close this chapter and move on.
3. I am very concerned about my Day 12 sex with my wife. Do I need to be?
4. When can I safely resume regular, unprotected sex with my wife?

Thank you for helping me navigate through this dark period in my life.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome to the forum. Thanks for your question.

While I understand your concern and your desire to protect your wife, your risk was low and you overreacted (as you apparently understand). Oral sex is low risk for all STDs and zero risk, for all practical purposes, for some of them. I would have recommended against the antibiotic treatment, but it probably wasn't harmful -- just unnecssary. Gonorrhea is the single most common STD from such an exposure, but almost always would cause obvious symptoms (painful urination, pus dripping) within 5 days. Chlamydia is rarely ever acquired by oral sex. Other potential infetions, such as nongonococcal urethritis (NGU) probalby result mostly from normal oral bacteria that are harmless for both affected men and their regular partners. HIV, like chlamydia, is rarely if ever transmitted by oral sex. Syphilis is a potential concern, but at least that's one that would have been aborted by cefixime plus azithromycin. HSV is unlikely because 1) HSV2 is almost never transmitted by oral sex (few people have oral HSV2); and 90% or more of Indian subcontinent residents, probably including you, carry HSV1 beginning in childhood, making them immune to new HSV1.

Those comments pretty well cover your questions, but to be explicit:

1) Yes:  based on those factors and the comments above, you can safely conclude you have none of these infections.

2) I recommend against any further testing.

3) No, you either were not infected with any of these; or if you were, the infection would have been aborted by the antibiotic treatment. Either way, your wife was not at risk from that exposure.

4) You can safely continue unprotected sex with your wife at this time.

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