[Question #7972] Trans escort kissing

50 months ago

Dear Drs,

Approximately 3 weeks ago (23 days exactly) I stupidly met a TS escort.

The activities we engaged in:

1) I masturbated her penis
2) She sucked me with a condom (condom was on the entire time, around 10 mins)

3) Deep french kissing for at least 5 mins

4) I masturbated into a condom to finish (opposite hand to the one I masturbated her with)

I am a complete and utter wreck Doctors. I have a pregnant wife and I'm absolutely terrified I've passed something on to her. It will destroy both of our lives.

What I am most concerned about is the kissing, as I initially wasn't concerned about it, but the whole Australian gonorrhoea research thing has kept me up at night in fear.

I often kiss my wife deeply and also have given her cunnilinguis once since the exposure.

Please Dr - realistically, what are the odds I've picked up gonorrhoea from kissing? What are the odds I will infect my wife via oral sex or kissing?

I am doing an STD screen tomorrow but it doesn't have a throat swab with it - I am ashamed to tell the clinic I was with a trans escort.

It is worth noting that in her ads she mentions she only has safe sex. But she definitely does give unprotected blowjobs, which is what concerns me.

Thank you Drs

Edward W. Hook M.D.

50 months ago

Welcome to our forum and thanks for your questions. The exposures you describe was close to no risk for acquisition of any STI. There is no risk for infection from mutual masturbation and condom protected sex is safe sex. That leaves your deep kissing. As you are aware, several Australian investigators have suggested that oral gonorrhea may be acquired as a result of deep/"French" kissing however this opinion is controversial. While it may happen rarely I have published a statement debating that it is a meaningful contributor to gonorrhea transmission and Dr. Handsfield debated the Australian investigators opposing their hypothesis.

Your exposure was low risk for infection. Tomorrow when you get your STD screen, I would request an throat swab for gonorrhea, not because I think you have it but because of the assurance it will provide you given your admitted anxiety. Asking for a throat swab does not mean your partner was a transexual.

Hope this helps. EWH

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50 months ago

Thanks Dr - would you normally recommend the throat swab for a scenario like this? Or too low risk to bother with?

50 months ago

And finally, would you recommend abstaining from oral sex with wife while I wait? (I will push to get a throat swab)

Edward W. Hook M.D.

50 months ago

Personally, I would not typically recommend a throat swab in your situation. My suggestion was made as a reflection of your statement that your were anxious.

I see no reason to abstain from unprotected sex of any sort (including oral) with your wife while waiting for test results.

Hope this helps. EWH

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50 months ago

Dear Dr Hook

At 26 days post-incident,

HIV negative (4th gen)

Gon & Chlamydia negative (urine and throat)

Syphillis blood negative

(I am still awaiting Hep B test result)

However, at day 32, the panic and fear has once again started.

I noticed a bump at the base of my penis (top side). I popped it and a little yellow stuff came out (like a pimple). Today it was slightly bigger. Once again I popped it and a little yellow stuff and small amount of blood came out, again like a pimple.

However, I'm TERRIFIED this is a pre-chancre. I'm scared to even look at my genitals in case I see it getting worse over the last few days.

1) Dr, what is the chance I tested negative for syphillis at 26 days and now the chancre is appearing at 32 days? How common is that?

2) Based on the description, does this sound like a pre-chancre?

3) Considering the spot is as the base of my penis and I received condom-protected oral, how is it I was even exposed? She certainly was not swallowing my penis right up to the base.

Unfortunately, due to covid policy, getting seen by a clinician in the UK is now next to impossible, or very delayed and costly at the least.

I am going out of my mind now for a couple of weeks now.

If i test positive for syphillis (or anything), I lose everything. My wife is halfway through pregnancy and I feel I'm finally getting paid back for doing what I did.

Please Dr can I request that you keep this open so I can post my final results (to give me closure if things turn out ok) - I will not post any more questions

Thank you

Edward W. Hook M.D.

50 months ago

Thanks for the update on your situation. It is most unlikely that the lesion that you noted was due to syphilis. It would be most unusual for the exposure you described to result in acquisition of Syphilis. Rather it is likely that it was a folliculitis lesion which, when popped as you did, tends to recur. Proper therapy for a lesion of the sort would be to wash thoroughly with soap and water and, to keep it clean, and to not try to pop the lesion again. In answer to your specific questions:

1. Syphilis blood tests can certainly be negative before the appearance of a syphilitic lesion. That said, as described above I would be most surprised if the Legion you described were due to Syphilis. Now the lesion is present however if the Legion were due to Syphilis hey Syphilis blood test would be positive.

2. No, see above. Syphilitic chancres do not typically present as you describe and, were they to be popped, would then form a shallow, painless ulcer and not recur as a Pasquale as yours did.

3. See my comment above. What you described is not suggest a syphilitic lesion end it would be most unusual for the exposure you describe to lead to Syphilis. I am confident this is not Syphilis.

I will keep the thread open so that you can post results. As you note, since this is your third direction as part of this thread there will be no further replies and the thread will be closed in the next 4 to 5 days. Please don’t worry. I look forward to seeing you were negative test results. EWH

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49 months ago

Just an update (hopefully the last!).

Hep B was also negative after a month. I've had some abdominal pain in the last few weeks which is why I was worried about Hep B - I'm assuming a negative test means the symptoms are most likely not due to Hep B.

As usual, Dr Hook you were right. The bump has receded in size and thankfully hasn't progressed into a sore or anything, and seems like it is just an ingrown hair. The GP I saw today was not concerned at all.

Thank you for the work you do. You and Dr Handsfields are truly legends for us idiots who have made stupid mistakes. I will get another test at 6-8 weeks for peace of mind for everything. Hopefully I don't have to come here again!

Edward W. Hook M.D.

49 months ago

Thank you for the follow up. Glad to hear THT he lesion you noted is resolving as well. Your negative test for hepatitis B proves that your abdominal discomfort is not due to hepatitis. No further testing is needed.

Take care. EWH

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