[Question #6942] Risky Past Sexual Encounter and My Current Partner

11 months ago

Hello Doctors, first allow me to say that I appreciate the work and attention you give to this forum.

I am a 21 year old male, I got drunk and had a risky sexual encounter 5 months ago in Hong Kong from a ‘one woman brothel’. I received oral sex, but the woman applied, at my request, a latex condom. She performed oral sex on me, and licked/sucked my testicles as well as nipples. She also lightly stroked the penis in order to wash it prior and after these acts. Even intoxicated, I am 100% sure this is all that happened.

5 months have passed. I have tested for Gonorrhea through a gram stain, it was negative but the test was only conducted 5 days after exposure. My resistance to hepatitis b was also found to be strong still. 2 weeks after exposure I came back to test for chlamydia and HIV, both negative. I could not get further testing for HIV and a test for syphilis because of this lockdown. 

My questions are:

  1. Should I have a retest for any of these diseases? Especially Gonorrhea granted they tested me pretty early from exposure. Am I at risk for HIV and syphilis?
  2. Am I at risk for HPV? I am aware I can’t get tested for high-risk strains. What is the chance that a genital infection could’ve transmitted to my own mouth/oral area?
  3. I have a new partner now, I have notified her of this exposure. So far we have only kissed vigorously but with no tongue or ‘French kissing’ and I sucked/licked her nipples and breasts. Is there any risk of transmitting HPV or any other aforementioned diseases from these acts? 
  4. My partner (same age) is vaccinated with Gardasil (quadrivalent one) at age 13 thanks to government programs.  Does her immunization need a booster of any kind? Should I get her Gardasil 9 before intercourse of any kind? 
  5. What sexual or intimate acts are me and my partner safe in performing without risk of transmission? Are our aforementioned acts of kissing and nipple sucking safe? (She is a virgin and my only concern is what I can give to her).


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

This was a zero risk event in regard to HIV and most STDs, including gonrrhea, chlamyida, and hepatitis B. It is statistically unlikely your brothel partner has HIV. Even if she did, the events described were risk free. HIV has never been proved to be transmitted by oral sex (i.e. oral to penis), even without condoms; and with a condom there was no chance you could have been infected. Mouth to skin contact anywhere on the body, including scrotum, nipples, or anywhere else also is risk free. The oral to skin events could carry risk for herpes due to HSV1, but absence of symptoms (blsiters, sores, etc) at the sites of oral exposure is strong evidence (although not proof) you were not infected. In theory syphilis also could be a risk, but exceedingly rarely -- and here too, if you had acquired syphilis, you would have had an obvious sore (chacre) at a site of unprotected oral exposure.

Are you sure the gonorrhea test was only a gram stain? If so, it was pointless:  the gram stain fails to detect most gonorrhea in men without symptoms. I would think the doctor or clinic would have also done standard lab testing for both gonorrhea and chlamydia. But even if not done, it really doesn't matter:  there was no chance of getting either of these from the events described.

Those comments pretty well cover your specific questions, but to be explicit.

1) No further testing is necessary.

2) HPV sometimes is acquired by oral exposure, but the risk is very low for any single exposure, and for sure there was no risk of penile infection. And even if you caught HPV at the other orally exposed sites, you probably would never know it and it would be very unlikely to cause any health problem; and probably would not be transmissible to your current or future sex partner(s).

3,5) I don't know why you informed your current partner of these events. It probably caused her at least a certain amount of alarm, making her fear infection when no risk exists for her. There is no medical reason for you not to have sex with her. Any and all sexual practices between you are safe.

4) Immunity to HPV from Gardasil is life long, or at least 10+ years. No booster is needed, assuming she received at least two doese of Gardasil. 

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

HHH, MD
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11 months ago
Hello Dr Handsfield, thank you for your reply. 

I’d just like to raise a few additional concerns and clarify some things with you. 

Regarding Gonorrhea, yes Doctor I am sure the test was only a gram stain as it’s indicated on my online results. It lists ‘no microorganism seen’ on the result. My chlamydia test was an antigen test I believe. 

On the off-chance that I contracted HPV, is it possible for self-inoculation to occur, such as transmission to my mouth or oral area? Are my other family members ever at risk of contracting it through casual contact like sharing drinks, food, utensils, etc.?

It seems my partner can’t seem to find her old vaccination records, if by the unlikely chance it turns out she wasn’t vaccinated yet, were our instances of intimate (but not open mouth) kissing a risk for transmission? 

Regarding herpes, I do not believe I see any blisters or sores on or around my genitalia, but would you still advise using condoms for anal and vaginal sex, and condoms and dental dams for oral sex? (In response to both HPV and herpes).  Are fingering/ handjobs a risk for transmitting HPV/herpes?

Lastly, am I right to assume that since my only exposure was through a blowjob, the only high risk strain I could’ve contracted is HPV 16? So my partner, being most likely vaccinated with Gardasil 4 already (she’s Australian, I believe they had a program for it in school) is safe?  I’d like to clarify if you still recommend I have her vaccinated with Gardasil 9 just to be sure. 

Thank you Doctor for your reassuring replies, this risky exposure has haunted me for the longest time. 

Best regards. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
Autoinoculation of HPV to additional body sites is believed to be uncommon, but it might occur from time to time. Many people with oral HPV deny giving oral sex, and might have transmitted the virus to their oral cavities in this way. But I stress that it's a) uncommon and b) doesn't matter. Most HPV infections are harmless.

No, you're not right to worry only about HPV 16. Several HPV types can occur in the oral cavity and be transmtited by oral sex. The reason you don't have to worry is that there was little or no risk of catching HPV of any type. But whatever risk there was includes all HPV types.

Gardasil 4 prevents ~75-80% of HPV related cancers and G-9 brings that up to 90%. It's up to your partner whether to seek this additional advantage, but most experts don't recommend it. However, if G-9 is available at little cost, many women would wish it. Both vaccines are equally effective in preventing genital warts.

I recommend against any barrier of any kind for sex with your regular partner. There is no need. Hand-genital contact and fingering are risk free for all STDs.

Your questions suggest you have unrealistic fears about STDs and their risks. You're very seriously overreacting to a no risk situation!
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11 months ago
Thanks for your reply Dr Handsfield, I am aware this is the last follow-up I am allowed to submit so I’d like to raise a few more questions, sorry if it seems my questions are redundant, I’m just very anxious regarding this.

It seems the only record of her Gardasil immunization we could find was for a single dose only, I am unsure if she received the second one.  Assuming she only got one dose, is she still protected from contracting anything from me through intimate kissing (so far, closed mouth kissing without tongue) only? 

We’ve talked about this and just to be sure, I’d like to get her shots for Gardasil 9 when we can. What sexual activities are we allowed to perform without possible risk of transmission before she can get her shots?  Should we abstain from intimate contact and/or all forms of intercourse until her series of shots are completed? Is deep/french kissing something we can do while she hasn’t finished the full series of shots yet? 

Again Dr, thank you for your attention to my questions. I wish you good health and safety.
Best regards. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
If your partner cannot document receipt of at least 2 doses, it would be resonable for her to start over with a 2- or 3-dose course of Gardasil-9. But this has absolutely nothing to do with your other sexual exposure or your unwarranted anxiety about HPV. I would give exactly the same advice to anyone.

Even if she is not fully protected, HPV is not a reason to not proceed with intimate sexual contact. As I aready said, in the meantime before she is vaccinated, you should proceed with any and all sexual practices (without protection) that give you mutual lpleasure. There is no chance you'll infect her with HPV based on the sexual contact you have described.

Thank you for the kind wishes. I hope you will re-read all my comments and accept that HPV simply is not an imporant concern for you. I hope my comments hlep you realize that. Best wishes and stay safe.
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