[Question #4707] HIV or gonorrhea risk

80 months ago

Doctor.

Thank you in advance for your consideration. Here is my situation. I had an encounter with a Transexual escort. Protected anal sex giving and receiving but oral was unprotected both ways. I was under the impression that it was safe sex, but as I have spent more time reading it would appear that is only true for the insertive partner. As I was both I an now a bit worried.

I know that the escort tested Negative for HIV 3 months ago. But that was 3 months ago and she is an escort, and a transexual one, so …...

I am also concerned about gonorrhea. It has been 7 days since the exposure. There has been no noticeable discomfort or discharge from my penis. So, I am assuming that I did not contract gonorrhea in my penis. However as of last night I have been noticing that my throat feels as if there my be some post Nasal drip as it feels like I have mucus in my throat and have the need to try to swallow it.

I am married and do not want to put my wife at risk. Should I go in for testing? Should I be concerned about anything?????

Thank you for your assistance.

H. Hunter Handsfield, MD

80 months ago

WElcome to the forum. Thanks for your question.

Whatever sources you read that said this was an unsafe encounter were wrong. Your initial impression was eactly right: you had only safe sex (Congratulations!). Condoms work to protect during anal sex, and oral sex carries no appreciable risk for HIV and low risk for other STDs, for both the penile partner and the oral partner.

With no symptoms after 7 days, it is very unlikely you have gonorrhea. Urethral (penile) gonorrhea can be acquired from mouth to penis, but generally causes prominent symptoms (pus dripping from the penis, painful urination) within 5 days. Throat discomfor is unlikely to be due any STD: most oral STDs, including gonorrhea, cause no symptoms at all.

Given your concerns, it would be reasonable for you to consider testing for common STDs, i.e. gonorrhea (urine, throat swab), chlamydia (urine) -- these are valid any time more than 4-5 days after exposure -- and HIV and syphilis blood tests at 6+ weeks. I recommend this not because there is much risk, only because for many persons in your siutation, negative test results are more reassuring than expert advice. If I were in your situation, I would not be tested for anything -- but it's up to you.

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

HHH, MD

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80 months ago

Thank you so much for your response.

This morning, which would be 9 days post exposure, I noticed what could be discharge in my underwear. I can't tell as I never see anything "dripping" from my penis, and there is no pain with urination. Would the puss be noticeable, like all day, or does it come and go? I do sometimes feel like a tingling in the tip of my penis, but wonder if that is just anxiety induced.

Based on your response to my first question I tend to agree with you, but I do worry a bit and seeing this "discharge" and the tingling I just wanted to check.

I appreciate your advice. Thank you in advance

H. Hunter Handsfield, MD

80 months ago

Thanks for the additional information, but it doesn't change my opinions or advice. "...what could be discharge" sounds iffy. If you have real discharge, it will be obvious, probably dripping from your penis and/or staining underwear. Clear fluid in the opening doesn't count -- could be urine, or normal urethral mucus. And "sometiems feel a tingling in the tip of my penis" also doesn't sound like a real symptom. And whenever someone suggests his or her own symptoms result from anxiety, usually s/he is correct. Of course see a doctor if you are convinced otherwise or if symptoms become more prominent. But I doubt that will happen; I think you're just attuned to trivial symptoms or even normal sensations that you would otherwise ignore.---
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80 months ago

Thank you for your reply.

Yes there was staining, but just the one time this morning after urinating. Was a rather large amount of discharge. Wondered if it could just have been from being aroused during the morning before urinating.

Since that time there have been no other staining or incidents that I have noticed. SO I assume that there would be more consistent discharge if I had contracted something.

H. Hunter Handsfield, MD

80 months ago

Indeed, apparent discharge on waking in the morning often is pre-ejaculate fluid, which is produced naturally during nocturnal erections -- which occur in most men whenever they are dreaming. And yes, any discharge caused by infection would be present continuously, not intermittently.---

80 months ago

Sorry, just to clarify, the discharge was AFTER urinating. There was no staining upon waking up. But the discharge caused staining and dried and was crusty. May be splitting hairs

If so I apologize

80 months ago

I am not sure why there are questions other than my last response, but those are not my questions.

H. Hunter Handsfield, MD

80 months ago

Those were inappropriate posts by another user and have been deleted. I don't know how it happened -- will be in touch with the web manager.

Had you moved your bowels at about the same time you urinated? Or afterward? That's another cause for expression of normal genital fluids or semen: pressure from straining at stool and stool passing over the prostate gland and seminal vesicles.

That completes the allowed follow-up questions and answers included with each initial question, and so ends this thread. If you have continuining concerns about all this, I recommend you see your doctor in person. There's really not much more we can do on this forum. I hope the discussion has been helpful.

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