[Question #7745] Oral STI

14 days ago
Hello drs.
So exactly 2 weeks ago, I performed oral sex on a woman who I am familiar with. She also performed oral on me. None of it was protected. There was no intercourse. Also, about a month prior, I had fingered her and put the fingers in my mouth while she performed oral on me. I am married so this creates my anxiety. I made another mistake and get nervous because since this Thursday I’ve had a sore throat. Following the encounter 2 weeks ago on Sunday, just out of an abundance of caution, I went to urgent care and was orally swabbed and urine tested for GC. This was on Tuesday only 2 days so not sure if it was too early to be reliable but both came back negative. I did ask the doc to treat me just in case. She gave me 2 shots and 7 days of doxycycline. After getting the negative results I stopped taking the doxy with approximately 3 days remaining. Went to urgent care this morning and doc said throat is red but strep and Covid test negative. My wife has also been complaining of on and off sore throat. Is it likely I caught an STI orally and passed it on to wife? Does it matter that I didn’t finish the Med? Doc told me today to go ahead and finish it. Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
14 days ago
Welcome to our form. Thanks for your confidence in our service. I’ll be glad to comment. You describe several exposures, including receipt of oral sex and performing cunnilingus on the same partner.  I’ll make a few general comments which I hope will reassure you and then a summarize with a little bit more specific information to your situation.

The exposures you describe were low risk. Not only do most people not have STI’s but both giving and receiving oral sex are relatively inefficient mechanisms for acquisition of STI.  Even if your partner happened to have an infection, the majority of single exposures do not lead to transmission of that infection. Amongst the variety of different types of sexual activity, receipt of oral sex rarely leads to infection and performing cunnilingus is even lower risk.  After your exposures you sought testing which would’ve detected an infection if present and, even before results were available, received treatment which would have cured infection if present. This combination translates to the fact that at the present time you there is virtually no likelihood that you have an STI from the exposures you describe.

As an FYI, your sore throat symptoms, having ruled out a strep throat, are almost certainly due to a community-acquired viral infection. Oral STI’s are most often asymptomatic and do not cause symptoms while viral infections are the cause of most symptomatic sore throats. That you did not finish your medications after you received your negative test results does not change my opinion.

I suspect that you have transmitted your viral sore throat to your wife and that is the source of her symptoms. My advice would be for both of you to seek symptomatic relief for your sore throat’s and that you should have no concerns about continuing risk for STI’s related to the exposure you described. I hope that this information is helpful to you. Please don’t worry. EWH
---
14 days ago
Dr Hook,
Thank you so much for the timely response on a Sunday. This makes me feel much better. The urgent care doctor also told me she did not think this was related at all to the encounter. I’ve had hsv1 since childhood and she also suggested that the anxiety could possibly cause an irritation in the throat from normal hsv1. Just to confirm, even if she possibly had an STI, which there was no indication to suggest that she did, it’s very unlikely to acquire it through oral sex? I’ve also had an odd taste and slight burning sensation in my mouth lately which I was thinking was most likely related to allergies and sinuses as I do suffer from both. Thank you again 
Edward W. Hook M.D.
Edward W. Hook M.D.
14 days ago
While I agree with the urgent care physician that anxiety can make a person notice irritation of the throat that might otherwise be overlooked, in your case the fact that you have passed on your sore throat to your wife is a strong indication that this is a simple community acquired viral pharyngitis.

You are also correct that the exposures you describe would be quite unlikely to be acquired through the activities you describe.  I would not worry. EWH 
---
14 days ago
Dr Hook,
Awesome, thank you again. My last and final question is, I can be confident in both the negative urine and culture of throat test results for GC even though the incident occurred on Sunday and the test were on Tuesday? I’ve read I should’ve waited at least 3 days but I can’t help but imagine if there was anything present, the tests would’ve picked up on it. Again I realize this is my last question and want to really thank you for your responses. Enjoy the rest of your day. 
Edward W. Hook M.D.
Edward W. Hook M.D.
14 days ago
While waiting three days is optimal you can have confidence in your two day test results. Again I would not be worried. Thanks for your questions. Take care. EWH ---