[Question #8259] Oral Exposure
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46 months ago
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Hey Dr Handsfield,Great job all of you do on this site providing real information btw. I had a recent small incident with a girl I met online (I'm in Canada) and a week later I started getting a bit worried about it, so I figured Id get your opinion and maybe educate myself further in the process. My GF and I had been having some troubles and long story short I ended up hanging out with this other girl one night. Intentions were not to sleep with her and so I didn't even bring a condom such . Things did get a little physical and she certainly wanted to go that way. In her attempts to go that direction she did perform oral on me for 30 seconds or so to get me hard before I shut things down before any insertion happened. Well it's been a week now and at first I didn't think much about it. Being in my late 30's... BJ's were pretty common and safe growing up. But things have been improving with the GF and as I started thinking about us potentially having sex again I started worrying. It's been just past a week since the exposure, I know I've heard you say on here that herpes testing is not recommended due to accuracy. No sores to date and certainly didn't see any on her mouth, so not sure how much that matters and I assume herpes would have been the higher risk in this exposure? No pain while urinating during the week or discharge. Although just today right after I woke up I did notice a bit of white/clear discharge. Normally I'd be more worried but for years now I've had this from time to time. Been tested multiple times and even with the discharge present and always negative. My doctor thinks it's the natural bacteria from my gf and such reacting on me.. not sure. Anyway I also just start today Doxy twice and day for a week . So won't be having sex till that's finished. I know I've heard you talk about people not needing to freak out and run off getting testing after very exposure.. so wondering if testing is recommended on some once I'm done this Doxy cycle?
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Edward W. Hook M.D.
46 months ago
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Welcome to our forum and thanks for your question. As I suspect you know Dr. Handsfield and I share the forum. Although our verbal styles vary, we have worked together for over 30 years and never differ in our assessments or recommendations. Today I happened to pick up your question and will be answering..
Your risk for any STI from the exposure you described is very, very low. The most common STI’s a quired through receipt of oral sex is gonorrhea and when persons choir gonorrhea the most typically develop aYour risk for any STI from the exposure you described is very, very low. The most common STI acquired through receipt of oral sex is gonorrhea and when persons acquire gonorrhea, they most typically develop a urethral discharge and/or burning on urination within 3 to 5 days following the exposure. Chlamydia is almost never acquired through receipt of oral sex and there are no proven cases in which someone has acquired HIV from receipt of oral sex.
With regard to the possibility of herpes, even if you have never had a cold sore, there is a better than 50% chance that you have already acquired HSV-1 (Most people with HSV-1 infection are unaware that they have the infection), the virus that causes cold sores and the virus you would be at risk for from the receipt of oral sex. Further, had you acquired genital herpes from your brief exposure to oral sex, you most likely would have developed lesions within 8 to 10 days following the exposure. That you did not is additional strong evidence that you were not infected. Finally, I will point out that estimates are that even when a partner has active oral herpes, the risk of acquisition of infection, if exposed, is less than 1%. I strongly recommend against a blood test for HSV. As I suspect you already know the test is not a good test frequently missing infections or giving falsely positive results. It is also too early, had you acquired herpes, for a blood test to provide accurate results.
I hope the information I have provided is helpful. The decision of how often the test is a personal choice and depends on your assessment of risk and your level of concern. I would not have prescribed doxycycline for you in this situation and suspect that if you choose to test after completion of the doxycycline your results will prove that you were never infected. EWH
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46 months ago
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Hey Doc,
I appreciate the response and information. So yes given I'm at the 8-10 day post exposure mark now with no sign of sores, I will put herpes out of my head. Is it true that without an active sore present, the chances of infection are lower?
I will also take this chance to further educate myself ... The Doxy was actually prescribed unrelated to this incident... But is it true that should I decide to test for the bacterial infections after this, that they would have been killed off already by the antibiotics? Does sexual contact while on antibiotics make it harder to contract and transmit bacterial infections?
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Edward W. Hook M.D.
46 months ago
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You are certainly correct. In the absence of lesions the likelihood of acquiring herpes from and infected partner are substantially lower.
Some STI‘s such as chlamydia or syphilis, both of which are most unlikely and your situation, would be killed by the doxycycline you are taking. Only about half of gonorrhea infections are cured by doxycycline however. If you choose to test, I would encourage you to wait at least 3 to 5 days following completion of anabiotics before you test in order to make sure your results are as accurate as possible.
Finally, you are correct that if you were taking antibiotics at the time of an exposure to an infected partner, that would reduce the Likelihood of acquiring an STI.
I hope this additional information is helpful. EWH
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46 months ago
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Thanks for the answers Doctor.
Im sure these are just random and normal occurences. But will just confirm with my last reply.
With this recent oral exposure, I did have some short/sharp pain bursts in the upper groin area. They started about 3-5 days post exposure. They happened a handful of times and didn't last long. They also seem to have stopped after a couple days. Sound like a symptom that could have come from this exposure?
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Edward W. Hook M.D.
46 months ago
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The sorts of transitory pains you describe do not suggest any STI, including HIV. The symptoms of STIs tend to persist or worsen over time, not to come and go. I would not worry that they are related to the encounter you described.
I hope that the information I have provided is useful. As you know, we provide up to three responses to each client’s questions. Thus, this thread will be closed shortly without further responses. Please don’t worry. EWH
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