Hi experts -- so relieved to be able to access this service.

I'm so worried about giving my partner an STI. Is there anything I can/should do to prophylactically treat whatever I'm at most risk for? What exactly am I at risk for? 

I'm nervous to be intimate with my partner, as well. I'm trying to get more info from the guy I saw on whether or not he is DDF. Any advice / reassurance for how to get through this would be great.

How and where did you meet your "stranger" partner? (Bar pick-up? Gay bath house or other sexual venue? Other?) (I'm not up to date with current urban dictionaries and familar with DDF, but quick google suggest "drug and disease free", right?)

In general, oral sex is fairly safe sex. The frequency of oral STDs is a lot lower than rectal (or vaginal), and when present, transmission mouth to penis is inefficient. Although HIV might be on your mind, there has never been a scientifically documented case of oral to penile transmission; you can consider it zero risk. (CDC has calculated a possible risk of one chance in 20,000, which is equivalent to receiving BJs by infected partners once daily for 55 years before infection might be likely.)

However, you're definitely at some risk of gonorrhea, nongonococcal urethritis (NGU), genital herpes due to HSV1 (but not HSV2), and syphilis. Of these, you can more or less ignore NGU, which in this setting is believed to usually result from normal oral bacteria, harmless, and not likely to harm one's other partners. And syphilis is not a concern in the short term:  it is not transmissible until a chancre (syphilitic sore) appears, or after 10 days. Herpes? Exceedingly unlikely after any single exposure, and statistically there's a 50% chance you've had HSV1, in which case you're immune to a new infection. (Have you ever had oral herpes yourself, i.e. cold sores?) Despite the overall frequency of sexually transmitted chlamydia, it infrequently infects the oral cavity and is very rarely, if ever, transmitted by oral sex.

Therefore gonorrhea is the main infection of concern, and I would advise no sex with your main partner -- or at least no sexual contact involving your penis -- for a few days. You can have an accurate urine test 2 days after exposure, so not too much time to wait. And if you don't have painful urination and/or pus dripping from your penis within 5 days, you can safely assume you don't have it.

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

HHH, MD

Yes - all men involved! & DDF is correct. Met him on Grindr.

What I can add about the partner is that he is monxkeypox vaccinated & on PREP. Seems to be highly sexually active but also in a longterm, open relationship so perhaps they are dilligent about routine testing. 

Would you advise any prophylactic measures? Would cefttriaxone injection and a week of doxycycline prevent infection across all the bacterial infections?

Makes sense that Gonnorhea is the highest risk. Thank you. 

Thank you for the advice. Last bit of information: how soon after taking prophylactic antibiotics can one resume sex safely? Is it the same as if you actually were infected (7 days after an injection)? 

Mainly asking about ceftraxione and doxycycline, which it sounds like the latter won’t be necessary

Thanks. 

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.