Please excuse me for the explicit details I am about to share, but I am concerned that I may have acquired an STD because I recently had a very prolonged, probably 4-5 kissing sessions that lasted 15-20 mins each, it was deep open mouth kissing with lot of tongue involved with a male just yesterday. Today I feel that my throat is a bit sore. He also sucked on my breasts, specifically nipples and bit them to the point that they became a bit sore. I was checking to see if there was any blood or cut in my nipples but I could not tell, they just looked sore. I learned that this male I had the interaction with had numerous previous partners and some were sex workers from overseas, and he doesn’t use protection. I became very concerned upon learning this information. We did not engage in any type of intercourse or other sex acts. The interaction was limited to just the deep open mouth kissing, with tongue,  and sucking of nipples.

I also want to mention that I have HSV1 orally, so I am not worried about catching oral herpes at all. I am however worried about HSV2, CMV, Mononucleosis, oral syphilis, oral Chlamydia, oral HPV, and oral gonorrhea. Because the sucking of nipples involved a lot of biting and they were somewhat sore, I am worried about getting HSV2, Syphilis, or HIV or other STDs that way if suppose my nipple was possibly bleeding or had a cut. Not sure it’s possible, but I’d appreciate your input on the risks associated with these acts I engaged in.

Do you recommend any testing?

Thank you.

In general, deep, vigorous kissing is less likely to result in STI transmission/acquisition than oral-genital or genital-genital contact.  There are several reasons for this.  First, oral STIs are less common than genital infections.  Second the "efficiency" of transmission through oral contact is lower than genital contact.  For this reason your risk for having acquired any STI from the episodes you describe is low.  There are a few reports of gonorrhea which most likely were acquired through deep kissing but this is rare.  Transmission of chlamydia, or syphilis is rare still.  Viral infections such as CMV, like other viruses which may be present in the throat may occur but the precise frequency and efficiency is not known.  Oral HSV-2 is very, very rare and I am unaware of any instances when oral HSV-2 infections are transmitted from the mouth.

In addition, I should point out that for most typical STIs, on those occasions when oral infections do occur, they are typically asymptomatic.  You do not mention how recently the kissing episodes you describe were but I presume it has been in the past few days.  If that is the case, your symptoms are most likely either a regular, "every day" community acquired viral sore throat (possibly acquired from your kissing partner) or a manifestation of the duration and vigor with which you were kissed.  It is unlikely that your symptoms represent an STI.  Personally, I would not pursue testing related to the encounter you described if no genital contact was involved.  If you feel the need for testing however, my advice would be to test for gonorrhea (a chlamydial test would typically be done automatically at the same time) as well as common upper respiratory causes of sore throat such as strep.

I hope this perspective is helpful.  EWH

Thank you for your answer. The kissing happened just two days ago. I have a few follow up questions:

1. If I want to test for Oral Gonorrhea/Chlamydia, do I just get a regular urine sample or is there another type of test for oral Gonorrhea/Chlamydia? 

2. What are your thoughts on the male sucking on my nipples to the point that they became sore because he bit them. Could that have possibly transmitted any STD if there’s a cut or bleeding?

3. Is oral HPV not a risk with deep kissing or the sucking of my nipples?

4. What about the risk of mononucleosis? I don’t know how or where to get tested for it and CMV too. I don’t think I’ve ever been tested for either.

Thank you.

1.  No, gonorrhea and chlamydial infections are transmitted only through direct contact and stay where the infection occurs.  you would need a throat swab to look for oral gonorrhea.

2.  No, this is a no risk event.  You basically have a "hickey" or lore mark on your tipple.  I anticipate it will improve and become normal over the next few days

3.  Like other STIs oral HPPV is far less common than genital HPV.  The HPV vaccine, which we recommend for just about everyone, protects against it.  There are few data (and little concern) about transmission of HPV through kissing.  

4.  At this point I would not check for mononucleosis.  Mono is caused in most cases by two viruses, CMV or Epstein Barr Virus.  Most adults will have had both infections at some time in their youth.  I would not test for mono unless your sore throat persists for more than a week and/or you develop other symptoms of mononucleosis.   FYI, should you have acquired mono, which technically ins not considered an STI, there is no treatment other than to wait it out

Hope this helps.  You have one more follow-up.  EWH

Just out of curiosity, is a Syphilis blood test only conclusive after 6 weeks? I have received the T. Pallidum AB test before (not related to this interaction) and my doctor said this type of test, the T. Pallidum AB is conclusive at 3-4 weeks. I wanted to confirm if this information I received is true

Thank you

Should you choose to test for syphilis, unless you develop a sore at a site of contact (this would typically occur around 3 weeks after your contact on/in your mouth or perhaps on your breast)  blood tests for asymptomatic acquisition of infection would not be definitive until 6 weeks although the vast majority of infections would be detected by standard blood testing at around 4 weeks

Hope this helps.  As you know, this completes this thread which will be closed shortly.  EWH