[Question #4916] Risk Assessment & Testing

28 months ago
I am a 55 year old heterosexual male.  Today I visited a woman of similar age who has multiple sex partners. We had condom protected fellatio and vaginal intercourse. I also performed unprotected cunninglingus and received unprotected analingus.  I have tested recently and am negative for all STDs. I am HSV-1 positive. I know from reading the forum that condom protected sex is virtually no risk for gonorrhea , chlamydia and HIV and very low risk for syphilis and genital herpes. What is my risk for the unprotected cunninglingus and analingus?   What should I be tested for and when if necessary?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome back to the forum. Thanks for your continuing confidence in our services.

A general principle and well-established epidemiologic fact:  STDs are rare at your age. For a variety of reasons related to age itself and the nature of sexuality, the main STDs (gonorrhea, chlamydia, herpes, syphyilis, etc) are increasingly uncommon after age 25-30, and quite rare after age 40. This remains true even in people over 40 who have multiple partners or change partners often. That's not to say there is no risk at your age, but the chance your partner was infected with a transmissible STD, and the odds would be low even with unprotected sex. In addition, and perhaps more to the point, condoms work! The chance of any STD from condom protected vaginal sex or fellatio is very low. Finally, cunnilingus is inherently low risk, and STD transmission by analingus is also believed to be rare. In fact, the greatest infection risk from the exposure described is for your partner:  if you happened to be carrying an intestinal virus (which often causes no symptoms), she would be at risk for infectious diarrhea because of perfoming analingus on you.

In summary, I don't see any need for worry or testing for any STD on account of this event. Of course this assumes you don't develop any symtoms. But if within the next 10-14 days you don't develop abnormal discharge or penile sores, you can move on without any worries.

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

HHH, MD
---
28 months ago
Thank you for the feedback Dr. Handsfield. One concern I have is a burning sensation around my anus over the past 24 hours immediately following the exposure. It is similar to hemmorhoids which I do suffer. Is it possible that this could be an STD (ie. rectal gonorrhea) due to the analingus?  Should I get a throat and rctal swan, and if so when?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
The risk of rectal gonorrhea from analingus is very low, maybe zero. If the burning sensation is the same as you've had with hemorrhoids in the past, that's probably the explanation. I still don't see a need for testing, either anal or throat.---
27 months ago
A follow up please: while the fellatio I received was protected with a condom, she did put in on my penis with her mouth.  Is there any chance I could be infected with bacteria (gonorrhea, chlamydia, NGU) from the saliva that would have been on or in the condom?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
No, no chance. Stop obsessing and worrying about this event.

That completes the two follow-up comments and replies with each question, and so ends this thread. I hope the discussions and hopeful. ---