[Question #6562] Any Additional Testing Recommended?

15 months ago
Hello, 

I am a 37 year old bisexual male.  My experiences over the last five years have been limited to mutual masturbation with other males, frottage/apposition (in the form of rubbing my penis against another penis), and giving/receiving unprotected oral with other men.  I've had conversations with each partner about safety/status before each encounter.  My last sexual encounter was a year ago.  A few weeks back, I went in for an annual checkup, and was tested for gonorrhea, chlamydia, HSV II, HIV, and syphilis.  All came back negative.  I have no symptoms--the testing was just a check up.  I am confident in those results.  

There's a possibility I may be entering into a relationship with a female now.  Is there any additional testing I should receive to ensure safety?  For example, I haven't been checked for trichomoniasis or mycoplasma genitalium, but based on my reading here, those are not possible without vaginal or anal penetration, which I haven't participated in.  Should I receive any additional testing, or am I safe to proceed?

Thank you in advance! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Welcome to the forum. Thanks for your confidence in our services.

You describe very safe sexual practices with your male partners, with no realistic chance of HIV and very low risks for all other STDs. (Congratulations -- good show!) The main risk has been for those STDs transmitted by skin-to-skin contact, i.e. syphilis, HSV, and HPV -- but even these risks were low, at least for the first two. And the negative tests you had are 100% reliable  So I'm glad you're "confident in those results":  so am I.

I don't recommend any other tests. As suggested, you could have been infected with HPV, but no reliable testing is available for males. However, almost all sexually active persons acquire genital HPV, and you can assume you have been infected and could be still carrying a dormant HPV infection. But the same is undoubtedly true of your prospective partner, and neither your risk of HPV nor hers is elevated any further by the sexual history you describe. (The frequency of asymptomatic infection, including people with conservative sexual lifestyles and few lifetime partners, is why pap smears and HPV immunization are recommended to all people, regardless of apparent risk. You and/or your partner could consider HPV vaccination if not yet done. It is usually advised routinely up to age 26, and then optionally and selectively, depending or risk -- and tolerance of small risk, a psychological issue -- up to age 45. And vacccination can be costly, depending on insurance overage. So perhaps something for you to discuss with your doctor(s).

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

HHH, MD
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15 months ago
Thank you.  One clarifying question:  is it accurate that trich and m. gen. are not spread between two men by the types of activities I’ve described above?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Trichomonas is rare to nonexistent in MSM. It probably can cause urethral infection (NGU), but uncommonly. And neither is likely to be transmitted by the exposures described. I wouldn't worry about either one.---
15 months ago
Thank you!  
15 months ago
I wasn’t sure whether I needed to specify this, but I have no further follow up questions, if this question needs to be closed out.  Thanks again for your help! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
You're welcome. Take care and stay safe.---