[Question #518] STI from Brief Blowjob from Vietnamese Stripper

38 months ago
Doctor,
Thank you for all of the guidance you have provided through previous questions.  I have read a large amount of your previous responses and have a good understanding of my risks, but still have a few questions of my own.

Background:A few nights back, my friends and I went to a local strip club.  I paid a stripper (she is originally from Vietnam) for a 30 minute dance.  While I obviously expected a provocative dance, I was extremely surprised when she pulled my penis from my pants and began to suck it.  I am married and was not interested in anything like this.  I put a stop to the oral sex shortly after it began - a couple seconds (5 seconds would be a conservative estimate).  From what I have read in your previous answers, I understand my risk of contracting an STI is low.  I understand that my main risks are for Gonorrhea and NGU, and that Syphilis is generally rare so, therefore, the risks are even lower than the other diseases.  However, I have a pregnant wife and do not want to take any chances with adding risk to this pregnancy.  That brings me to my questions:

Questions:1.  Because the stripper is from Vietnam (I'm not sure how long she has been in the USA), does that make the risk of  Syphilis infection any higher?  While I understand the majority of USA infections or in gay men, are things different in Eastern countries such as Vietnam, and should Syphilis now be a valid concern?

2.  I have discussed my concerns with my doctor.  While he feels there is nothing to worry about, he prescribed 1g of Azithromycin and a 250mg shot of Ceftriaxone as a precautionary measure.  Should I ask for a shot of Penicillin G to be safe regarding Syphilis?

3.  At what point after these treatments can I assume there is no longer a risk and resume unprotected sex with my pregnant wife?

Thank you for all of your help!
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

Welcome to the Forum.  I'll be pleased to address your questions.  I also want to thank you for reading some of our earlier replies- your familiarity with the information we have provided others will allow me to go straight to your questions related to this low risk exposure:

1.  That your partner was originally from Viet Nam is not as an important risk factor for STI as the fact that she is currently a commercial sex worker.  Presuming that she has been here in North America for more than a few months her recent behaviors are a greater risk factor than her country of origin.  And, as you know from your reading, the likelihood of her having oral syphilis is tiny and really not worth worrying about (more on this below).

2.  You already know we would not endorse your "just in case" treatment but I do understand your concerns and motivation for treatment.  The treatment that you received would not only be effective as treatment for gonorrhea, chlamydia and NGU but would also treat a syphilis exposure.  Studies have shown that the ceftriaxone you received would prevent syphilis and, for many patients, so would the azithromycin as well.  thus you can be confident that, even if you had been exposed to syphilis, your infection would have been cured/prevented.

3.  As a result of your treatment, there is no further risk for any of the STIs we have been discussing.  It is safe to resume unprotected sex with your wife. 

I hope these answers are helpful to you. EWH

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38 months ago
Thank you for the fast reply, Doctor Hook.
Your comments have really helped ease my anxiety.  However, I have one quick follow-up question.  You mention that Azithromycin helps prevent Syphilis.  However, the dose I received was 1g, not 2g.  Is this still effective?  Also, I will not receive my Ceftriaxone dose until Tuesday of this week.  If my exposure was on Thursday of last week, I took 1g of Azithromycin on Friday (12 hours after exposure) and will have a dose of Ceftriaxone 5 days after exposure, do you still believe that this has effectively prevented all STI's discussed?  Sorry for the follow-up question and I really appreciate your help.

Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Yes, the 1.0 gram dose was studied and shown to prevent syphilis from developing.  You are in the clear.  EWH
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