[Question #8232] Brief unprotected oral / protected vaginal with escort. Risks?
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47 months ago
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G
Good afternoon,I’ve gone through the forums and read a ton of answered questions. Some are similar to my experience, some aren’t so I decided it was better to describe my situation to get a more direct responseLong story short, I went to an Asian massage parlor in the United States - run out of their apartment - where half way through the massage, I was propositioned for oral sex. Stupidly, I said yes and she proceeded to wipe my area with what I assume was alcohol then lick and suck on my penis head for a few seconds unprotected, pull away due to precum, repeat a few more times, then proceeding to roll down a condom onto me with her mouth. She then mounted me and we had penetrative protected sex for about 2 minutes until I came. She then wiped me off again and the massage continued. Condom appeared intact. This was on 9/7I started experiencing feelings of guilt a few days later due to me being in a monogamous relationship for 5+ years. Around the same time, I felt an “icy” tingling feeling on my pubic area to the right of my penis. It comes and goes, mainly when I’m focusing on it and goes when I go sit in a bath. I’ve also noticed that it moves around in a sense that I’ll then feel the cold feeling on the pubic area right above my penis, sometimes on the bottom of my testicles then sometimes as a line going from the right side of my pubes down to my right testicle. Mind you, when I say tingling, it doesn’t really feel like electricity or pins and needles, just a weird feeling that comes and goes. This has been coming and going since 9/9. To help quell my anxiety, I went and got tested on 9/12, 5 days after potential STI exposure but have yet to get my results. After doing some research online, I found that the results may be inconclusive anyways due to testing too soon so I plan on getting retested next Monday 9/20 for the almost full 2 week incubation period.
My questions are as follows:
- Understanding that herpes prodomes typically don’t last more than 2 days, I’m trying to put HSV-2 out of my mind from my pubic area/testicles potentially touching her vagina. However, I am worried that I’ve been experiencing phantom prodromal symptoms earlier in the week but now I’m experiencing actual symptoms if that makes sense. From what I’ve read online, it’s incredibly rare for female to male transmission with protected sex for HSV-2 and since I’m fairly certain I have oral HSV-1 from childhood that it would be near impossible for me to get genital HSV-1. Is this true?
- With the brief unprotected oral, how likely is it that I got gonorrhea? Her tongue seemed clean (flesh colored, not white) and I didn’t notice any sores/odor from her mouth. I know chlamydia doesn’t like to live in the mouth as much and if it does, it’s in the throat. Same with gonorrhea. Considering she didn’t deep throat me, does that reduce my risk since I wouldn’t have touched a potentially infected throat?
- Are there any other STIs that I have to worry about? Like syphilis for example.
- Should I get proactive treatment for any sort of STIs?
- If I’m not exhibiting any symptoms minus the phantom tingling, how soon can I have sex with my monogamous partner without potentially infecting them? I’m planning on waiting for my 2nd set of results just to be safe but I don’t know if that’s overkill.
Thanks for reading.
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Edward W. Hook M.D.
47 months ago
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Welcome to our forum. Thanks for your question. Thanks as well for looking at other posts on the forum. We intentionally leave them available for others to read in the hopes of broadening peoples understanding of sexually transmitted infections, their diagnosis, and prevention.
The exposure you described was low, but not no risk. Most commercial sex workers do not have STI’s and most unprotected exposures to infected partners do not result in infection. In your case your only direct, unprotected exposure was through receipt of oral sex. The fact that you did not ejaculate does not decrease your risk for infection. Receipt of oral sex from an infected partner Is associated with a low risk of acquisition of gonorrhea, a low risk of acquisition of genital HSV-1 infection if you do not already have the infection, and a very, very low risk of acquisition of chlamydia or Syphilis. Your negative test results five days following the encounter provide conclusive proof that you did not acquire Gonorrhea. Further, that you have not developed lesions of genital herpes since the encounter provides strong evidence that you did not acquire herpes either. How do you acquired herpes lesions would most typically have occurred within 8 to 10 days following the exposure. There is no meaning for risk of acquiring HIV through receipt of oral sex. With this background, let’s address your specific questions:
1. Your summary is correct. The symptoms you describe, their duration, and the failure to evolve into lesions is proof that you did not acquire HSV-2. Since you already have HSV1, you have no additional risk of acquiring that infection. Your symptoms are not due to genital herpes of any sort.
2. As mentioned above, there is no reason for you to worry any further about gonorrhea. Your negative tests at five days are conclusive. Further, had you acquired gonorrhea you almost certainly would have developed obvious symptoms such as urethral discharge or burning on urination within 3 to 5 days following exposure. Believe your test results.
3. I would not worry about risk for other STI’s. The risk is simply far too low.
4. Absolutely not. Preventative treatment would only obscure the situation and nothing you have reported suggest any likelihood of infection whatsoever.
5. I would feel comfortable resuming unprotected sex with your regular partner at this time. There is really no need for a second set of tests.
I hope the information I provided has been helpful. If there are additional questions or clarification is needed please do not hesitate to use you were up to two follow-up questions for that purpose. EWH
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47 months ago
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Somethings worth mentioning. The test on 9/12 was a full panel blood and urine test. I also went to a urologist on 9/14 who did a physical examination of my junk and said everything looked good.
I also had shaved my pubic area a few days before the potential exposure.
Lastly, the weird feeling I’ve had primarily comes when I’m clothed. I sleep naked and don’t really notice it then
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47 months ago
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Also, to clarify, I haven’t received a negative test result yet as I haven’t received any results. Only results have been from a physical examination from a urologist who said I looked ok. Still waiting on blood and urine results
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47 months ago
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Sorry for my responses being out of sync as I was responding before I read your response, Doc.
I know you mentioned that I would’ve started experiencing symptoms of gonorrhea if I was infected. However, reading online, I see that men can be asymptomatic. Based on your response, I’m guessing that’s a rarity? Let’s say in the hypothetical that I am asymptomatic, would I still be infectious?
In addition, since I haven’t received my test results yet, would it be wise to hold off sleeping with my primary partner until I do? I really don’t want to put them at risk due to my sheer stupidity.
As you can guess, my anxiety is through the roof on this so trying to be as cautious as possible - ironic, I know. Not doubting your advice at all but trying to avoid ruining my partners life due to my infidelity.
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Edward W. Hook M.D.
47 months ago
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Thanks for your follow ups. I’ll be happy to clarify.
I misunderstood. I thought you had received your test results and am surprised that they aren’t. They certainly should be available at this time and I am confident they will be negative.
While you are correct that a very small proportion less than 5% of men with gonorrhea are asymptomatic, this is unlikely. That said, given your level of anxiety, it would be reasonable to wait until your test results are back although I am confident that when they do come back they will be negative.
That you had recently shaved your pubic hair in no way changes my assessment.
Finally, I suspect that the sensations you are feeling or a manifestation of your heightened awareness related to your anxiety. They certainly do not suggest any STI.
Hope this helps. EWH
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47 months ago
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Doc, you’ve been a huge help. I’m surprised that the results are taking this long too but I was told it would be 3-5 business days so I’m guessing I’ll hear back by tomorrow the latest
I’ll definitely wait on the results just for that final peace of mind but good to know that I should be good.
Would it be ok if we leave this open so I can confirm results for posterity? Want to enable people in the future to have some confirmation from my experience
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Edward W. Hook M.D.
47 months ago
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My advice would be to call wherever You had the specimen taken and see if the results are available. Sometimes it takes a while for them to report them.
I will leave the thread open for you to post your results. EWH
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47 months ago
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An update, I called the clinic where I got tested and everything has come back negative thankfully (although they’re still waiting on the HIV test but I’m not worried about that)
However, I did notice a red bump on my pubic area last night (9/17, 10 days after potential exposure). The bump itself is painless and is perfectly circular with 2 hairs growing out of its center. It was more inflamed last night but doesn’t appear as irritated today. I’m erring on it being an inflamed hair follicle but anxiety brain is telling me otherwise.
Assuming that this bump was indicative of HSV-2 about to break out, how many hours/days would it take for it to become a lesion? Just trying to timeline so I can keep an eye on it
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Edward W. Hook M.D.
47 months ago
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As you know, this will be the final response as part of this thread. We provide up to three responses to each client.
Few genital herpes lesions occur in the pubic area and when they do they are rarely solitary. In contrast, the description you provide is a classical description of folliculitis which occurs when bacteria on the skin in fact the base of hairs. If the lesion you were describing was due to herpes, it would go from being a red bump to a vesicles containing clear fluid within 24 hours of appearance.
I hope this final response is helpful. If you feel the need to prove that this is not herpes, I recommend getting a PCR test performed on a lesion swab ASAP. (Do not seek to diagnose this lesion with the blood test. It will not provide useful results until 6 to 10 weeks following appearance of the lesion). FYI as well, the lesion does not have to be an ulcer or fluid filled to provide a positive result). I am confident that if you choose to seek testing, the test will show that the lesion you describe is not herpes.
This completes this thread. Take care. EWH
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