[Question #9408] STD Exposure

33 months ago

I had an exposure a few days ago that concerns me. I performed fellatio on a guy for 3 to 5 minutes. I am not sure if he ejaculated (if he did it was a small amount). When he pulled out, I noticed at the opening of the penis a white substance. This was not noticeable at the beginning of or during the fellatio experience -- not until he pulled out. The medical professional I saw was reluctant to give me penicillin and instead told me to take 1g amoxycillin twice a day for a week and 2g zithromycin in one administration. I have read up on both syphilis and gonorrhea and see mixed reviews of this type of treatment. What are your thoughts, especially because the exposure was only a few days ago? Since fellatio is oral, what are the risks of my passing along one of these infections (assuming I acquired one) via deep kissing? .

Edward W. Hook M.D.

33 months ago

Welcome to the Forum. Thanks for your questions. I'll be glad to provide some information. Several general comments:

1. Fellatio is a relatively low risk exposure in terms of susceptibility to infection. The main infection acquired through fellatio is gonorrhea and the majority of exposures to partners known to be infected do not result in infection. HIV infection from fellatio upon an infected person is rare- estimated to occur no more than once in every exposure to untreated, HIV-infected partners - in other words, if your partner had untreated HIV, which is statistically unlikely, chances are 99.99% that you would NOT get infected.

2. Whether or not ejaculation occurred does not change the risk for infection.

3. Most persons do not have STIs including HIV. The white substance that you noticed at the completion of fellatio may well have been genital secretions and not a sign of infection.

4. If you were exposed to gonorrhea, the azithromycin you took may have prevented/cured infection. Neither penicillin nor amoxycillin are particularly active against most STIs..

5. Deep kissing rarely, if ever transmits gonorrhea.

My advice. If you are concerned, I would suggest a throat swab to test for gonorrhea. I anticipate that the test would be negative. Alternatively, the likelihood of infection is so very low that it would be entirely understandable if you chose to not bother to test and not worry at all.

I hope this information is helpful. EWH

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