Thank you so much for providing this service. I was an avid reader of Medhelp, and I received a lot of relief from reading your work on there, but I still feel that I need to ask a question about my own personal situation. 

I was quite promiscuous from ages 18-24. I performed oral and received oral with around 50+ men, most of whom were gay. On one occasion, I was an anal bottom, and on two occasions, I was the penetrative top. All the other encounters are mostly me giving oral sex and receiving ejaculate, and about 5 times I received oral sex.

After being with 40+ partners, I took a year or two of abstinence, then took a full panel blood test; all STD results were negative, so I am not concerned about my 40+ past encounters. Since that blood test, I have received oral sex 4 times from 3 different men. It has been nearly 3 months since those encounters and I have no symptoms. 

My questions is:

1) Is it necessary for me to get another blood test after these 4 receipts of oral sex from 3 different men? 

2) I can't shake this feeling of being dirty due to my promiscuous past of 50+ partners. Do I carry any HPV/STD risk for potential sexual male partners in the future if I only give them oral sex? 

3) Am I clear to continue sex with other people? 

Thank you so much again for reading my inquiry. I want to move on from my past and rescind my promiscuous ways. I want to develop meaningful sexual relationships with other people, but I am afraid that I might give them something to worry about as a result of our sexual encounters. 

Thank you!!!

 In answer to your specific questions:

1.  No I do not see the need for blood tests for syphilis or HIV.  There are no proven instances in which HIV has been acquired from receipt of oral sex.  Syphilis is very, very rare from oral sex and had you acquired it, we would expect you to have developed lesions at the site of exposure.

2.  See my earlier comment.  You have no need for feeling guilty.  You may or may not have acquired HPV from your earlier contacts but that is not typically a problem, a reason to test, or a reason for concern.  If you have not had it already, I would recommend that you get the HPV vaccine.  There are many benefits and it is recommended routinely for men who have other men as sex partners.

3.  Yes, I would not be concerned about having sex with other persons although I would suggest you practice safe sex, asking if they are infected, when they were last tested for HIV and other STIs, etc.  We also continue to recommend condoms in most situation, realizing that they are a personal choice.

Hope these comments are helpful.  EWH

I've wracked myself with so much guilt over these encounters that I've created a mental barrier between me and potential partners, because I felt sexually inadequate due to my past. Your words have comforted me deeply, but I'm still in disbelief over my ability to still enjoy loving and sexual interactions with others. Truly, I still don't believe it, but I will come back to this post every now and then for reassurance when I need it most. 

Like another user on this forum, I had a troubled past and was sexually abused by a male guardian, and I believe I used these encounters as an unconscious way to cope. This trauma was unbeknownst to me at the time of my promiscuity, and the repressed memory presented itself to me a few months ago, and now I am learning how to cope with it and to better understand the reasons for my promiscuity, rather than beating myself up for it. My anxious mind seeks further reassurance with questions and tests, but I know that I have no reason for concern. I will do my best to move forward from this whole ordeal. 

Thank you Dr. Hook again for your response. I hope you have a great new year.

3) Could you give me some words of wisdom to help me stop freaking out about all of this?

Thank you Dr. Hook.

5. What would patients consider your best advice for moving forward?

Thank you so much Dr. Hook for your help once again.

1.  Yes, all results will be conclusive.

2.  I do not refuse to test my patients.  I advise them as to the need for testing. If they are at a time when results will be conclusive, I do ask that they test once and then move forward without concern and not test repeatedly because of their own continuing guilt and anxiety.

3.  As I said earlier, I am not a mental health professional and while this is something I advise, I am not the one to provide it.  Remember however, your contacts were relatively low risk and the numbers of contacts you mention is by no means unusual.

4.  There are no good data to answer this however the sense is that oral HPV is relatively uncommon, that when it occurs it typically resolves without consequences over a period of months, and that it is not particularly transmissible thought performance of oral sex.

5.  See 3 above.  I suggest you seek counseling

Take care.  EWH