[Question #5600] Analingus -msm

20 months ago

Hi Dr, thanks again for the all hard work you do, you helped me 6 months ago and I need your help once again . 

 

On 6/9/19 I received a massage for a man, during the massage he began to lick my anus with his tongue. This is the first time I have had an encounter with a man.  He preformed analingus on me for 5 minutes and did lick and poke with his tongue. Nothing to rough but he did lick aggressively . There was no contact with my penis or any sort of sexual interaction outside of that. I’m married to a female and trying to have a child This has been the only male male interaction I have had. I’m a  wm in 30’s and was just Tested in May for all stds and came back clear. I asked the guy if he has been tested and he said yes and he was clean of all and was tested in April . 3 weeks later I’m sure it’s my anxiety but I have had a consistent headache for 3 days and I feel tingling on my inner legs, buttocks and penis.  I know HIV has never been passed by this interaction based on other threads and I haven’t had any discharge so i assume I’m clear for most ghonnaria and chlymidia . Is reviving analigus risky for syphilis ? I know it’s spread by contact  with a sore and I’m worried since it was a male interaction this is more prevalent in the male community with other males. I asked the guy if he experienced any mouth issues, sores etc and he said no and he hasn’t experienced any issues.  Is syhlisis of the month hard to see or feel, not sure if he noticed anything ? He said he’s doesn’t do risky sex with other males. Should I be concerned and tested ? Is syphilis passed easy by receiving analingus ?   Should I be worried about herpes based on this event? Is that passed easily as well to the anus? I read other post and I see almost month std live in the throat, could it be passed by the tongue ? Also, since it was only at the anus, would any std pass to the penis and could I infect my wife ?

 

You insight would be appreciated , thanks in advance..

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Welcome back to the forum. Thanks for your continued confidence in our services.

There have been few studies of HIV/STD risk from analingus, but the experts consensus is that any risk is very low. Saliva rarely if ever transmits HIV, and there has never been a proved HIV transmission oral to penis. If anything the risk from analingus probalby is lower. Other STDs may be more risky -- recent controversial research suggests that gonorrhea may be transmitted oral to anus more commonly than once believed, but I stress controversial; most experts don't believe it. In any case, people in your massage partner's situation rarely lie about HIV and other STDs when asked directly, so his belief is strong evidence he isn't infected with HIV, syphilis, gonorrhea, or any other trraditional STD. Herpes probably is a small risk, but if you'd acquried anal herpes, you would know it by now because of usually severe symptoms of initial anal herpes.

Based on all the information available, you are at little or no risk of anything at all. (The greatest health risk from analingus is for the oral partner, if the anal partner is carrying a gastrointestinal infection or hepatitis A.) I do not recommend testing. However, if you remain concerned, you can always be tested. Some people are more reassured by negative test reults than by professional opinion based on probability and statistics, no matter how expert. If you think that applies to you, you can have a valid rectal swab test for gonorrhea and chlamydia any time, and blood tests for HIV and syphlis 6 weeks after the event. But be clear, I'm not really recommending this. Certainly I wouldn't be tested for anything if somehow I were in your situation.

Maybe a bit off topic, i.e. related to sexual health and decision making, not STD/HIV. However, this is the second time you have reported unwanted and unexpected sexual contact during a massage. I find it difficult to believe that this happened, twice, unless you either overtly or by body language indicated you were seeking or expecting oral sex, analingus, hand-genital contact, etc. If either exposure was truly unwanted and unexpected, you probably have a legal case for sexual assault. (Just listen to any ten randomly selected media stories these days!) My advice is that if you are indeed expecting, seeking, and/or hoping for a sexual component of future massages, explicitly discuss your expectations and desires at the outset. If you are not but are in an establishment where this might be expected, then also be explicit that you do not want (and will not pay for) such contact.

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

HHH, MD
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20 months ago

Hi Dr. Thanks for your comments, I have no one to blame but myself, I put myself in these situations and my body language did indicate I wanted these actions and I allowed it, it just took me time to realize this. This past encounter was not forced.  Based on your comments and other replies and situations, I feel better about my situation but have some educational questions in case I experience any future situations like others have gone through. I believe the guy about his status.

 

For this situation with respect to analingus, I assume when you say some "Experts don’t agree with the recent research findings about Oral to anal gonorrhea transmission, are you one of those experts that don’t agree?

For anal herpes, how soon would one that acquired anal herpes experience symptoms? 

 

As for Syphilis, I noticed that wasn’t a concern in your response, I read about anal syphilis by oral sex as very rare, even with M to M, is that right ? in the event he did have a syphilis sore in his mouth, could it be easily passed by the tongue to the anus? If I did catch it, how soon should I  see a sore?

 

I saw a comment by Dr hook in a older response regarding Oral Sex and STD transmission, he said most of the comments about oral sex and STD are fallatio (Penis to mouth) and not cunninguls and anal oral, is that right?


Lastly, can you explain why syphilis is more prevalent or early passed by MSM and rare with W to M sex, is it because of more anal sex with male to male? i wasn't sure if there was a difference when it came to transmitting syphilis by way of oral  and if it was the same risk for both types?


Again, thanks fo your kind words and feedback.


20 months ago
Sorry, i hit send to early, i forgot to ask, if i did aquire an STD by was of receiving  analingus, could any STD acquired affect other parts of my body ? like lymphnodes in armpits, sore throats, etc?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Most STDs don't travel through the body from the initially infected site; if the rectum is exposed, generally that's the only site of symptoms. Of course some infectsions (HIIV, syphilis, rare cases of gonorrhea) can cause systemic symptoms away from the site of initial infection, but generally only after at least several weeks to months, even years. Any sore throat or potential lymph node problems you have cannot be from your recent anal exposure.---
20 months ago
Hi dr thanks for addressing the 2nd part of my 2nd  response , did you see my prior response above that , the more detailed questions ?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Sorry about that -- the way my browser opened (on a small device), I only saw the follow-up question.

I'm in the majority of experts who contintue to believe oral gonorrhea is not easily transmitted to other sites except the urethra. I'm actually going to be speaking against that theory in a scientific debate at an upcoming STD research meeting in a couple of weeks. As your own comments suggest, Dr. Hook agrees with my perspectives on this.

All new herpes, anal or otherwise, generally causes symptoms within a few days, rarely as late as 2-3 weeks, never later than that. Syphilis can be transmitted by oral sex, but uncommonly -- and we already addressed the low chance your partner had any active STD, including syphilis. All bacterial STDs -- syphilis, HIV, gonorrhea and probably chlamyida -- are much more common in MSM than heterosexuals primarily because of high frequency of sex with multiple partners, often anonymously (so contacting partners of infected persons is difficult). Also dramatic reductions in condom use now that antivirual drugs are so effective in both treating HIV and preventing transmission, reducing the frequency of safe sex.

Your mind is working overtime on this, without justification. Try to just turn it off. Get tested if the negative results will help.

That completes this thread. I hope the discussion has been helpful.
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