This happened more than 6 months ago. What are risks for HIV and other STIs?

1. At this point am I in the clear for STIs?

2. Should I get tested for other STIs?

3. Should I get tested for HIV?

4. Would it be safe to have sex with long term partner without putting her at any risk?

Thank you

1.  As mentioned above, receipt of oral sex is a relatively low risk activity in terms of STI risk with a lower per exposure risk of STI acquisition than other sorts of sexual exposures. The most common STI’s acquired from receipt of oral sex are gonorrhea and non-chlamydial NGU which is a process in which oral bacteria are introduced into the urethra urethra and cause inflammation but do not represent a health hazard for persons with the infection or their sex partners.  Chlamydia infections are quite rare.  There are reports of acquisition of syphilis from receipt of oral sex but this is very very rare and you would’ve seen a lesion if you had acquired syphilis. For persons who have not already had HSV-1, the cause of cold sores, there is a small risk of acquisition of genital herpes but, like Syphilis, had you acquired this infection you would’ve had an outbreak with visible lesions.

2.  You have been examined by a clinician, your dermatologist. Mostly STI’s show some evidence of infection. Had you had a problem, I expect the dermatologist would’ve noticed an abnormality and performed appropriate tests. While gonorrhea can very rarely occur asymptomatically, your risk of this is very very low. At this point the main reason for testing would be for your own peace of mind. If you choose to test, the most important test is a urine test for gonorrhea.  Blood tests for HIV and Syphilis are probably not necessary although they are often routinely included in STI testing.

3.  There are no proven cases in which HIV has been acquired is the result of receipt of oral sex. You are not going to be the first. I see no scientific reason for HIV testing.

4.  In your position I would be comfortable having unprotected sex with my regular sex partner and not fear that I might be transmitting an STI acquired from the encounter  you describe above. 

I hope this information is helpful. If there are further questions or any part of my response is unclear, please use your up to follow ups for clarification. 

Take care. EWH

If I am reading correctly you think there is not a need to test based on my exposure. Testing is for peace of mind. If going through with test you mention blood tests are probably not necessary for HIV or Syphilis, however section below that you mention not scientific need to test. How confident of a negative outcome do you think it would be for STI urine and blood tests would be for HIV, Syphilis, Gonorrhoea, etc based on your extensive background medically and scientifically?