Good day doctors,

I want to thank you for this amazing service.

To the point, I made an incredibly stupid mistake 2 days ago by going to aassage spa place where I got a handjob (no risk maybe) at one point the worker took off her underwea licked her vagina, focusing on her clit, never did my tongue penetrated her vaginal opening and my lips barely touched her vagina if at all, in addition, this lasted for no longer that 10-15 seconds. I checked and no sores atall. 

My questions are.

1) I see that by far the largest risk is for gonorrhea. Would it still be the case for me if my tongue did not reach her vagina internally or would a little bit of vaginal fluid be enough for infection?  I am married and as you can imagine i need to protect my wife, if I got gonorrhea orally, kissing would be ok but there may be a slight risk to give her this gonorrhea to my wifes vagina even if i just focus on stimulating her clit instead of penetrating with my tongue? 

2) I know hpv is widespread but Im concerned about the possibility of picking up the warts strain in my mouth and then pass it to my wife, I worry about warts because it may be the one single way my indiscretion can be revealed. would the oral cavity, tongue or lips be able to carry this type or hpv strain or is it limited to the genital region? In other words, do warts like the tongue? 

3) I had a tiny little cut in my lip when this happened,  would this make me at risk from HIV?

 I will follow your recommendations.

Thanks.

1) Even with prolonged exposure (probably including tongue in vagina), cunnilingus is low risk for all STIs. You are correct that among these low risks, gonorrhea is perhaps most likely, but even this is rare. As it happens, my forum colleague Dr. Hook was the senior researcher on one of the only research reports on this. Few or no oral gonorrhea infections can be attributed to oral-vaginal contact. And I agree that the minimal risk in your case likely was even lower than others, given the brief superficial contact you describe.

2) Oral HPV is much less common than genital, and the risk is very low (probably near zero) for any single exposure. Here too the brevity and superficial contact described probably further lower the chance of infection. And no, warts do not "like" the tongue:  even in people with known oral HPV, overt warts are very rare.

3) There has never been a scientifically validated case of HIV transmission by cunnilingus, despite billions of such exposures to HIV infected women. Since oral cuts and scrapes are common, it's fair to assume millions of those exposures occurred in the presence of such oral lesions -- and still no known HIV transmissions. (I'll also point out that the large majority of female sex workers do not have HIV anyway.)

This even was risk free for all practical purposes. As I said above, I would not advice testing, and if you have a regular partner, I see no need to not continue your usual sexual activities.

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

HHH, MD

Thank you for your quick response.

Everything seems clear except for a follow up question if you dont mind.

1) In the rare event I happened to have gonorrhea apparently most likely asymptomatic, will i put my wife at risk of transmission either by kissing or oral sex? If no, i would not bother testing assuming it will go away on its own. Do you know on avetage how long will it take to resolve?

2) When i asked about the possibility of warts not "liking" the tongue, i was envisioning a case where  infection from her genitals would have been picked up by my mouth, and because warts dont like tongues they wont grow in my mouth but that would not necesarily mean im not infected and it could show later on my wifes genitals since warts prefer to show up genitals? Unless what you meant was that the warts strain would not take a hold in my mouth making it not possible to transfer it to

 Genitals?  Is this a far fetched scenario?  Im sorry if im making my concern not clear or complicated.

Thanks for your help.

2) Oral HPV infection is rare, i.e. the virus itself infects the mouth or throat a lot less frequently than genital. I have never cared for a patient with oral warts, but have no way of knowing how many patients had asymptomatic oral HPV. But they almost never developed disease or any health problem, and probably rarely infected their partners. And yes, the genital ifnection issue indeed is a very "far fetched scenario".

All of which is pretty much irrrelevant anyway, given the zero chance (for all practical purposes) that you were infected. On top of which, if you've had an average sex life, you already have had (and may still have) genital and perhaps oral HPV infection. Any increased risk from this particular event is trivial and should be disregarded. I suggest you just let it go without further thought. 

That concludes this thread. Best wishes and stay safe.