[Question #9770] Oral sex
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29 months ago
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Hello and thanks for your service. I had a couple of encounters with a woman Feb 13 and Feb 16th. Prior to meeting we discussed sexual health and even shared test results. She had oral swabs done urine and blood work for syphillis, hiv and hepatitis late Jan all were negative. I still decided to get a urine test done n Feb 20th for chlamydia and gon and that came back negative. Exposure was unprotected oral and protected vaginal sex. Also took a tpa syphillis test on March 8th and that was negative. Do I have any risk here? I reviewed the test myself from her and it was from planned parenthood in late Jan and we met Feb 13th. Reason I am concerned I had unprotected oral sex with my long term partner and she now has a sore throat and body aches. Doctors say it’s laryngitis and prescribed amoxicillin 14 pills 875mg ea.
1) can I consider my c&g test conclusive at 4 and 7 days from unprotected oral
2) syphillis tpa test says reliable at 3-4 weeks is this correct? I do not have any sores and assume I would have to have a sore and or test positive to pass this on correct?
3) I have no other symptoms other than some skin irritation on the shaft of my penis and some flaky skin. Been going to hot tub a lot not sure what could cause this?
4) if I did pass anything to my partner would the amoxicillin help?
5) am I missing anything? I tried to be very careful here but concerned about my partners sore throat.
Thanks in advance for your response
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Edward W. Hook M.D.
29 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. The encounters you describe were low risk for STIs, including HIV. Receipt of oral sex is a biologically inefficient route for acquistion of STIs and condom protected sex is safe sex as long as the condom is worn from beginning to end of the sex act. Further, given that your casual partner was negative for STIs in late January, it is statistically unlikely that she was infected in the interval between her tests and your encounter.
In response to your specific questions:
1) can I consider my c&g test conclusive at 4 and 7 days from unprotected oral
Yes, absolutely
2) syphillis tpa test says reliable at 3-4 weeks is this correct? I do not have any sores and assume I would have to have a sore and or test positive to pass this on correct?
3 weeks is a bit early for conclusive syphilis results. Most experts would be comfortable at 4-6 weeks although some recommendations state that syphilis tests are not conclusive until 3 months following an encounter.
3) I have no other symptoms other than some skin irritation on the shaft of my penis and some flaky skin. Been going to hot tub a lot not sure what could cause this?
The signs you describe are not particularly suggestive of an STI and could well be due to your recent time in a hot tub.
4) if I did pass anything to my partner would the amoxicillin help?
Amoxicillin in the doses you describe would be expected po prevent/cure syphilis and have some activity against chlamydia'
5) am I missing anything? I tried to be very careful here but concerned about my partners sore throat.
Your partner's sore throat is far, far more likely to be due to influenza, COVID-19 or an "everyday" viral infection than any STI.
I urge you not to worry. EWH
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29 months ago
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Thanks so much, of course I tested again today at 32 days probably didn’t need to. Just so I know for future can you answer the second part of my syphillis question: I do not have any sores and assume I would have to have a sore and or test positive to pass this on correct?
Also are there any risk from mutual hand masturbatio.n and condom protected oral sex?
This is my final question, thanks so much for your response!
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Edward W. Hook M.D.
29 months ago
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Sorry I missed that part of the question:
Yes, syphilis is sexually transmitted through direct contact with an infected site (the sore).
There is no appreciable STI risk from either mutual masturbation or condom protected sex, including condom protected oral sex. EWH
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28 months ago
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Dr one final question, I did get results back for c&g syph and hiv at 32 days all negative. I assume I can completely rule these out? Do I need to test for Trich or mgen? My partner still has a consistent sore throat after the antibiotics. Not sure if Trich or m gen could be transmitted oral mouth to penis to me or during protected intercourse?
Thank you
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Edward W. Hook M.D.
28 months ago
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Test results for gonorrhea and chlamydia are entirely conclusive any time more than 3-4 days after an exposure. Your results are conclusive.
Tests for HIV are technically not completely conclusive until 6 weeks following an exposure although we have never seen or heard of a person who had a negative test at 4 weeks (28 days) go on to develop a positive test. Given the low risk nature of your partner, her negative tests, and your test results you can have complete confidence you did not acquire HIV from the encounter you describe.
You are not exposure for trich or M. genitalium from receipt of oral sex or condom protected sex. There is no need for testing for these organisms.
I encourage you to move forward without concern. This completes this thread. EWH
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