[Question #5330] Unprotected Oral Sex

23 months ago
Hi,

I was in Lisbon last week (Saturday night), in strip club, and I received unprotected oral sex from black girl.

I ejaculated in her mouth after 30 seconds, then she continued with sucking. After that she was on my penis (she was in lingerie) and kiss my body a few times, and after that she put my penis between his tits and sucked again. During that, it was a deepthroat. I guess that oral sex (total) was around 3-4 minutes, no more than that. In one moment, I touch his butt with my penis, but that was 1 second. Oral sex in one moment was harder than usual.

I didn't notice any bleeding, or any blood on my penis or her mouth. I don't know if she has any open bleeds in her mouth.

I had a few wet/soar places on my penis (because of my masturbation, and I think I used chloramphenicol that day), when she started sucking. When I back in appartment, I took a shower and really felt terrible.

Just after 1 day, I got soar throat and kidney pressure. I didn't feel well, I feel really pissed off, I was really upset, and in one moment (I had temperature 37.3 degrees - during one day). 

I notice two small papules (white in middle) around the penis, and two very small on the shaft of penis. I think I lost 1.5 kg during last 3-4 days, and I lost my appetite and I still have soar throat and l'm worry about the situation. 

I have wife and little baby, and I'm in fear that I can transmit something to them.

I went to urologist (on Thursday), he said that two small papulas are because of shaving (indeed, I shaved maybe 7 days before I had oral sex). He said that soar throat is a virust that I get from Lisabon, and he said that I shouldn't use medical until I test myself on gonorrhea, chlamydia, mycoplasma, hvp and ureaplasma. 

He said that I can't get HIV from oral, and that syphilis is rare and that I shouldn't worry about that.

He found sands in kidney, and he said that is not connected to the STD. Also, he said that I should make test on Friday (9 May). My unprotected oral was 28 May at 3:30 am.
Today, I still have pressure in kidney (sometime I have more pressure, sometime I don’t have pressure at all) and I drink some tea to help me through.

Doc, can you tell me your opinion, what kind of risk I have to get HIV, syphilis and HPV, and other STDS, and when I should test myself on all STDs and HIV?

Also, if somehow she has oral syphilis in mouth, and HIV, that would be easier to transmiss through my penis?

Also, one more question. I never tested myself on HIV. I’m in relation with my wife last 10 years, and we had a few breakout. During that, I had 2 unprotected oral sex and 1 unprotected sex with girls that I know. 

My wife and baby were probably tested on everything, and I guess if they are clean that I’m clean as well?

Thanks a lot.

James

23 months ago
One update:

I notice tonight 2-3 small red pustule/rashes (I don't know what it is), on the skin when I open the penis. So, they are below the head, on the skin.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Welcome to the forum. Thanks for your question.

Oral sex should be viewed as safe sex. It isn't completely free of risk, but it's a whole lot safer than unprotected vaginal or anal sex:  all STDs are a lot less common, and some almost never occur from oral sex.

Sore throat is not an STD symptom, and neither is flank pain (if that's what you mean by "kidney pressure"); and no STD can start to cause symptoms in only a day. 2-3 days is the minimum for all, and for most infections it takes a week or more for symptoms to start. I'm not sure what to make of the "papules" you have noticed on your penis, but the location sounds like normal periurethral glands. Everybody has them -- you may just be noticing them because you're examining yourself closely.

Your urolgist is correct about HV:  there has never been a proved case of transmission of HIV mouth to penis. He is also correct that you should not be treated, but should wait for the test results. But there is no need to wait until May 9:  the urine gonorrhea and chlamydia tests are good any time more than 4-5 days after exposure.

Your main question is "...what kind of risk I have to get HIV, syphilis and HPV, and other STDS, and when I should test myself on all STDs and HIV?" My answers:  zero risk for HIV, even if your partner had it. Extremely low risk for HPV and syphilis. Slightly higher but still small risks for gonorrhea and herpes due to HSV1 (the usual cause of oral herpes). What tests to have? Probalby none needed at all, butfor reassurance I recommend a urine test for gonorrhea and chlamydia, as suggested by the urologist, which can be done any time 4-5 days or more after the exposure; and blood tests for HIV and syphilis, which are conclusive after 6 weeks.  I would not test for Ureaplasma, which is a normal bateria in the urinary tract. Mycoplasma also isn't a worry:  ureaplasma and mycoplasma are not carried in the oral cavity, therefore zero risk from oral sex.

You can be sure your wife was tested for HIV, and probably for other STDs, during her pregnancy. There is never a risk to children or anyone else from STDs in the household; they are ONLY transmitted by sex.

So  don't overreact. This was a low risk event and there is little chance you have any STD at all. Do your best not to worry about it.

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

HHH, MD

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23 months ago
Hi Doctor,

Thanks for your answers. I really appreciate.

I have a few more questions.

1. What if that person have syphilis and HIV, and perform fellatio on me? I didn't notice any blood on my penis, and on girl lips.

2. Is it possible to have syphilis deep in the mouth, but not on the lips? And if that girl has syphilis in the mouth, and my penis touch that, I'm in trouble?

3. Can I take penicillin, just in case if she has syphilis?

4. I will take tomorrow test for gonorrhea and chlamydia, and I will post results here. They are 100% after 8 days of exposure?

5. What about HPV test? I found that one clinic have test for gonorrhea, chlamydia, HPV, ureaplasma and mycoplasma (all together, as a packet).

6. So, you are sure that I'm no risk for HIV, based on my exposure? I never notice any blood, penis was few times out of her mouth, since she put between her tits. I wrote this details, because you said that HIV can't resist on the air. Even though I was very tired, fatigued before that event.

7. Is any quick test for HIV and Syphilis (before 6 weeks and how accurate they are)?

Thanks for all answers.

James


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
1,6) As I said above, there has never been a known case of HIV transmitted mouth to penis, with or without blood. You won't be the first. Syphilis is almost as low a risk as HIV, with or without blood.

2) Yes, that's possible. But syphilis is rare in women in Western countries, including Portugal (regardless of race). There's probably less than 1 chance in a thousand that your oral partner had syphilis of the mouth or anywhere else.

3) Most experts would not recommend penicillin unless the risk of syphilis is a lot higher.

4) Yes: the gonorrhea/chlamydia tests are 100% any time more than 4-5 days after exposure.

5) HPV is rarely transmitted by oral sex. Anyway, you have already had HPV and may still have it. 90% of all sexually active people have it. That's why testing is not recommended in males:  there's nothing to do for a positive result, and it makes no difference in risk to partners.

7) You can test earlier than 6 weeks; a negative test at 3-4 weeks would be reassuring, but not conclusive until 6 weeks.

Each question includes two follow-up questions and replies. Let's have no further discussion or questions until you have had your gonorrhea/chlamydia test, if you would like to post the result. In the meantime, try to mellow out. There is little chance you have any STD.
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23 months ago
Hi again,

I tested (by PCR method) on STDs 10 days after the exposure.

My results are negative for neisseria gonorrhoeae, trichomonas, chlamydia, mycoplasma, ureaplasma.

Are results conclusive?

What should I do next? Should I test on syphilis and HIV?

Thanks,

James
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
I'm glad to see your negative results for all those tests, although some were superfluous, especially trichomonas and the mycoplasma/ureaplasma tests. These are not carried in the mouth or throat and therefore cannot be caught by receiving oral sex. The gonorrhea and chlamydia results are conclusive.

For all the reasons discussed above, there is no medical or risk-based need for syphilis or HIV testing. But you are feee to be tested if the negative results would help reassure you. For conclusive results, you can have blood tests for both 6 weeks after the event. However, since there is no chance you were infected, you should continue or resume sex with your wife now.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Please do not post additional questions about this exposure and your STD/HIV fears from it. No matter what questions or issues come to mind, you can be sure they would not change the opinions and advice above. Best wishes and stay safe.
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