[Question #5447] STD Risk from Kissing and Protected Oral

21 months ago
Good Day,

Thank you for this great forum constantly available.

I have a question regarding a recent exposure and also noticed one of your more recent posts regarding kissing

I had an encounter with an CSW where there was Deep french kissing and also had protected oral - those were my only 2 acts of sexual activity. I understand that the risk is minimal with the protected oral as long as the condom did not break. 


a) With regards to the kissing - i read an article recently published about how gonorrhea is being transmitted at a pretty high rate through kissing. While the study does focus on male on male partners - I wanted to understand how likely am i at risk for catching the STD - is HIV a transmittable disease through this way? 

b) Say i did catch it - Oral gono - what would my symptoms be and what is time frame i should be looking out for with regards to this STD?

c) With protected oral - assuming the condom stayed intact - would this be considered safe sex - very little risk - should i be worried about anything?


Thank you all for your help - i thought i was in the clear until i found out about STD through deep kissing. My reference to deep is about 2 to 3 seconds of stop and start again but then again i guess and STD may need only 2 seconds to be transmitted. Looking for your advice on this.

THank you doctor
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Welcome to the forum and thanks for your question.

a) Oral gonorrhea from kissing is a topic of special interest to me. The media attention to possible gonorrhea by kissing is premature at best. This is a theory, not proof, being propounded primarily by a group of researchers in Melbourne, Australia. They believe strongly in it, but most gonorrhea experts are skeptical at best. More research is needed.

The International Society of STD Research meets every two years and the next, in Vancouver, Canada, is occurring next month, with a thousand or so STD experts attending. A debate on the roll of kissing in gonorrhea in men having sex with men is scheduled. Nobody argues there is an important kissing transmission issue for opposite sex kissing -- which is one of the arguments against an important role in MSM. (Why only for kissing between men but no reports of apparent kissing trasnmission between men and women?) The lead Melbourne investigator (Dr. Christopher Fairley) in speaking in favor and I'm standing against the proposition. I'm spending much of my desk time now and in the coming month preparing my arguments. Suffice to say there are serious flaws in the Melbourne research, even for MSM. My forum colleague Dr. Hook is also much involved in these issues. He has written a commentary expressing doubt about gonorrhea transmission by kissing, to be published soon in the journal Lancet. (Given the media attention so far, there may be news stories following our debate. Keep your antennae up the week of July 15 and afterward.)

b) Oral gonorrhea usually causes no symptoms at all. Maybe one case in 20 gets sore throat, rarely severe. Testing by throat swab is the only way to detect it. I would not recommend such testing in your situation, notwithstanding the news reports from Australia. And no other STDs are regularly transmitted by kissing, so no testing of any kind is recommended after such an event. (But thanks for bringing up a point for my upcoming debate. If kissing can transmit gonorrhea, why not other STDs? In addition to gonorrhea, why aren't we seeing lots of oral chlamydia, syphilis, HPV, and others acquired by kissing?)

3) Oral sex is low risk for all STDs (and virtually zero for some) even without condom protection. With a condom in place during the entire exposure, there is zero risk of any STD.

Bottom line:  I recommend against any STD testing on account of the exposure described and you can safely continue your usual sexual practices if you have a regular partner. OTOH, if you have otherwise been sexually active outside a mutually committed relationship, routine STD testing from time to time might make sense. If so, have a urine test for gonorrhea & chlamydia (which, at your discretion, could include a throat swab for gonorrhea) and blood tests for HIV and syphilis. But not because of the events described above.

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

HHH, MD
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