I am really embarrassed about this - when I tell you this story please don’t judge and understand it is just so you know the whole picture. But it’s not a reflection on myself. 

I have recently split with my boyfriend (I’m a woman). I did not deal with this very well and had a little mental breakdown. 

I ended up at a sex club about two weeks ago. I was mega nervous and had a few drinks but kept my self to my self for the most part and observing. I drank a few more and noticed that sex was happening in the open men on men men on women the lot. 

I then while drunk volunteered to for an event. (Sorry for this description) basically I was to kneel on the floor and numerous different men was to jerk of and finish on my face and body. 

I was naked apart from a thong which stayed on and I never directly touched any of these men. 

The rjaculate for these men was mainly on my face or breasts.

I have been ashamed of this to this day, and really want to move on. I have been reaserching STI (how I came across your sight) and while I tried to keep mouth closed I can not be confident that some didn’t go into my mouth so I have done a throat swab (negative chlamydia and gonorrhoea) I think I’m quite safe for HIV. But I think syphilis is a bit easier to catch. 

I realise that women don’t really get syphilis but I did witness these men having sex with other men. 

I have to wait 12 weeks for conclusive results according to this website (I am testing online because I can’t bare to explain this in person to anyone) 

I know there is probably no studies on this but can / is it possible that syphilis can be spread in contact to ejaculate ? Some websites say it is spread in genital fluids other say direct contact. Is sperm classed as direct? 

Thanks for you consideration in answering this. Please don’t think of me bad x 

Syphilis first, since you raise it as your main ongoing concern:  The risk is very low, but I cannot say it is zero. There is a biological reason that most chancres (the sore of primary syphilis) occur on the penis, the vaginal opening or labia minor, the anal area, and sometimes the mouth:  T. pallidum, the bacteria that causes syphilis, generally must be massaged into susceptible tissues for infection to take hold. You will recognize that these all are sites typically subject to friction during sex, often for prolonged times. Second, in people with syphilis, T. pallidum probably is not frequently present in semen, or only in low numbers. On the other hand, as you apparently are aware, syphilis occurs dominantly in men who have sex with men, so some of those in the club certainly could have been infected.

What to do now? From strictly medical and risk perspectives, it is sufficient to be on the lookout for symptoms and to have blood testing. Chancres typically are slowly enlarging generally non-tender open sores of exposed areas -- in this case, maybe lips, eyes, etc would be most likely. If nothing like that develops in the next 2-4 weeks, it would be reassuring. And you also needn't wait 12 weeks for initial testing; most newly infected people would have positive blood tests by 6 weeks, but a final test at 12 weeks still would be a good idea. However, I can also understand how anxiety-producing it might be to wait that long. In my opinion it would not be unreasonable for you to be treated as if exposed to syphilis, i.e. a single dose of benzathine (long acting) penicillin. This is a close call in terms of medical appropriateness, but if someone came to my STD clinic with this story and requested treatment, I would provide it.

As for other STIs, I'm glad to hear you've had negative tests for oral gonorrhea and chlamydia, and I agree that HIV is extremely unlikely. That said, you definitely should have an HIV antigen-antibody (AgAb, "4th generation") blood test at 6 weeks; and maybe at 4 weeks for earlier reassurance, by which time ~98% of newly infected persons have positive results. In case you're wondering, I would have advised against post exposure prophylaxis (PEP) with anti-HIV drugs, but it's a moot point anyway:  PEP has to start within 72 hours of exposure. There is little or no risk for herpes or HPV in this situation. Both are not likely to be transmitted via semen, as far as is known; and like syphilis, massage into exposed sites probably is usually required for transmission.

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

HHH, MD