[Question #9806] Excessive Saliva as lube/std risk

28 months ago

Hello. I had an exposure this past Thursday with a massage parlor girl. She started giving me a hand job and then drooled and spit on my penis. She let the saliva drip out of her mouth on my penis and use it as a lubrication multiple times. There was a lot of saliva but no actual penis in mouth. I went back and asked her the next day if she had any issues, and she adamantly said no and got mad and asked me to leave. I’m not sure I believe her. On Friday I started feeling testicular pain almost like an epididymis. I had/have no discharge from my penis. On Friday I started doxycycline 100mg bid (will take for two weeks)and actually got a rocephin 500mg shot in the butt yesterday. I have a few questions.

1) what is my risk for HIV with this episode?

2) with the Rocephin 500mg, if it was gonorrhea with that cure and keep it from developing?

3) will the shot I had eliminate the risk for syphilis? I see various opinions on the dosage and my shot was 36 hours after exposure.

4) will doxycycline 100 mg twice a day for two weeks be sufficient to cure any potential syphilis/chlamydia and in it’s very earliest stages if in fact, I have acquired?

5) what other STDs do I need to be on the lookout for with this episode?

6) do I need to test specifically for these processes, since I have started treatment 36 hours after the episode? If so, what specific test for each? Specifically syphilis?

7) what are my chances of these treatments failing even if I caught extremely early before any signs, but just the symptoms of testicular pain.

Thank you

Edward W. Hook M.D.

28 months ago

Welcome to our Forum and thanks for your implied confidence in our service. You have over-reacted to the events you describe. Most commercial sex workers do not have STIs or HIV and neither STIs nor HIV are transmitted in saliva when it is used as a lubricant for masturbation. This is the case even when there is lots of saliva involved. If you had asked if you were at risk, I would have said no and that there was no reason for concern or for testing. Even if you had been exposed the therapies you have and are taking would have prevented/cured gonorrhea, chlamydia and syphilis. Thus, in response to your specific questions:

1) what is my risk for HIV with this episode?

Zero. HIV is not spread in saliva. In fact there are no proven cases of HIV which were acquired when an untreated HIV infected person performed oral sex on an uninfected person.

2) with the Rocephin 500mg, if it was gonorrhea with that cure and keep it from developing?

Although you did not need it, the dose of Rocephin you received is recommended therapy for gonorrhea and would prevent syphilis if you had been exposed.

3) will the shot I had eliminate the risk for syphilis? I see various opinions on the dosage and my shot was 36 hours after exposure.

See above. I performed the research studies that proved that Rocephin in lower doses than you received prevented syphilis more than 25 years ago.

4) will doxycycline 100 mg twice a day for two weeks be sufficient to cure any potential syphilis/chlamydia and in it’s very earliest stages if in fact, I have acquired?

Yes. One week of doxy is sufficient to prevent both syphilis and chlamydia. Not that you needed it but you are being over treated.

5) what other STDs do I need to be on the lookout for with this episode?

None!!!

6) do I need to test specifically for these processes, since I have started treatment 36 hours after the episode? If so, what specific test for each? Specifically syphilis?

Your treatment eliminates any need for testing, particularly since your exposure was no risk.

7) what are my chances of these treatments failing even if I caught extremely early before any signs, but just the symptoms of testicular pain.

See my comments above. The testicular discomfort was unrelated to the encounter you describe. Epididymitis does not start that soon.

I hope this information is helpful. EWH

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28 months ago

Thank you for your reply. So the place I went on Saturday morning called me today and said that they did not mix the Rocephin up correctly. They had me come back and gave me another injection. I still have full ache testicles since the exposure which started Friday/Saturday. This exposure has really worried me because of symptoms.

1)is taking the rocephin(500mg) because of their mistake(36 & 88 hours) soiled treatment that it will arrest any Gonorrhea or syphilis before it has a chance to really take hold?

2)is rocephin as good as pcn in treating syphilis this soon after exposure and keep chancre from developing if really aquired it?

3)with these treatments along with my doxycycline, how long before I’m not infectious if I had something?

4)is there good value in treating as fast as I did?

5)any value in me getting a TPPA test this early of will Saturday’s and todays rocephin knock it out?

6)can you get genital herpes(hsv 2) from a woman giving you a blowjob or in my case saliva?

7)I have had no penile discharge at all. Am I out of the woods with no chance I will develop these infections manifest themselves from this exposure?

8)do I need to be watchful of anything odd over the next few weeks?

9) how long do I need to wait(in theory) if I am/was infected with these to have sexual relations. I hear different timelines on this from 1-2 weeks? Do I need to wait 6 weeks for hiv in case she had blood in her saliva?

Lots of questions.

Thank you for your compassion

28 months ago

Hello Dr Hook. I’m not sure, but I think my first reply got missed. No worries. I’ll just copy and paste and won’t add anything to that first reply. I will wait for your response.

28 months ago

1)is taking the rocephin(500mg) because of their mistake(36 & 88 hours) soiled treatment that it will arrest any Gonorrhea or syphilis before it has a chance to really take hold?

2)is rocephin as good as pcn in treating syphilis this soon after exposure and keep chancre from developing if really aquired it?

3)with these treatments along with my doxycycline, how long before I’m not infectious if I had something?

4)is there good value in treating as fast as I did?

5)any value in me getting a TPPA test this early of will Saturday’s and todays rocephin knock it out?

6)can you get genital herpes(hsv 2) from a woman giving you a blowjob or in my case saliva?

7)I have had no penile discharge at all. Am I out of the woods with no chance I will develop these infections manifest themselves from this exposure?

8)do I need to be watchful of anything odd over the next few weeks?

Lots of questions.

Thank you for your compassion

Edward W. Hook M.D.

28 months ago

I'm sorry. I'd answered and for some reason my replies did not post. Here you go:

I'm surprised to hear of the problems with the Rocephin. Could you provide more detail on what happened? Irrespective and reminding you that the encounter was virtually no risk for acquistion of HIV and other STIs and therefore you really did not need treatment or testing. That said, if you had been exposed here are my thoughts:

1)is taking the rocephin(500mg) because of their mistake(36 & 88 hours) soiled treatment that it will arrest any Gonorrhea or syphilis before it has a chance to really take hold?

Yes, there will be no problem related to the delay in treatment. If you need treatment, 500 mg of Rocephin will be reliably curative/preventative for gonorrhea and syphilis. The delay would not be a problem.

2)is rocephin as good as pcn in treating syphilis this soon after exposure and keep chancre from developing if really aquired it?

Yes

3)with these treatments along with my doxycycline, how long before I’m not infectious if I had something?

Biologically, any STIs pathogens present should no longer be infectious 3-4 days after starting antibiotics however the standard recommendation is to abstain from further unprotected sex until you have completed treatment.

4)is there good value in treating as fast as I did?

The sooner the treatment, mostly in terms of preventing complications or transmission to others

5)any value in me getting a TPPA test this early of will Saturday’s and todays rocephin knock it out?

There is no value to testing for syphilis this soon after an exposure. As already mentioned, the Rochephin would prevent syphilis if you had been meaninfully exposed.

6)can you get genital herpes(hsv 2) from a woman giving you a blowjob or in my case saliva?

HSV-2 is almost never acquired from receipt of oral sex and is not transmitted in saliva when saliva is used for lubrication during masturbation.

7)I have had no penile discharge at all. Am I out of the woods with no chance I will develop these infections manifest themselves from this exposure?

You were not at risk to start with. You are out of the woods.

8)do I need to be watchful of anything odd over the next few weeks?

See my response to your question number 3 above. You do not need to worry about HIV. Your encounter was no risk and even if she had performed oral sex on you, no one has ever been proven to acquired HIV from receipt of oral sex.

I really think you are worrying more than you need to. EWH

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28 months ago

I’m having trouble submitting my reply

28 months ago

What truly worries me is my groin/testicular area pain happened 24-36 hours after exposure. It seems better after yesterdays rocephin shot.(thoughts)?

They called me back because they diluted it too much didn’t give me the right dose.

1)Assuming I had/have some sort of std infection, how soon after treatment(doxy and recent rocephin) could one see improvement of symptoms? Or when should they be completely gone?

2) How confident can I be that these therapies will cure anything if I indeed have it? Since I started the Doxy 24 hr after exposure and the Rocephin 4 days after exposure?

3)should I test after completion of treatment? What I’ve read people say yes

4)Could these 2 treatments fail for gonorrhea, syphilis, chlamydia if they are done correctly and appropriately and I don’t miss any doses

28 months ago

5)can rest assured I can’t get a chancre at this point with the tx I’ve had?

6)if I tested now, and treated so quickly, would I get a positive test?

7)any infection you can think of that I could have acquired from exposure that’s causing me symptoms? Would my current treatment cover other etiologies?

8)how long do i have to take doxy for syphilis(2 weeks?), and chlamydia(1 week?) and how much longer after that do I have to abstain from sex?

9)do I still need to consider the possibility of an STD if symptoms don’t go away after treatment?

10)rocephin just as effective as pcn for syphilis in incubation stage?

-if it were not for the symptoms that came up right after I wouldn’t worry, they have me worried.

Thank you

Edward W. Hook M.D.

28 months ago

This thread should have been closed earlier. My reply will be brief.

These questions are, in large part repetitive.

Your Testicular pain began sooner than is typical for complications of STIs such as epididymitis.

1)Assuming I had/have some sort of std infection, how soon after treatment(doxy and recent rocephin) could one see improvement of symptoms? Or when should they be completely gone?

Improvement is typically quite quick, certainly within a day or two. If the symptoms you are focused on continue, I would suggest looking for another cause.

2) How confident can I be that these therapies will cure anything if I indeed have it? Since I started the Doxy 24 hr after exposure and the Rocephin 4 days after exposure?

You should be very confident. I said this before.

3)should I test after completion of treatment? What I’ve read people say yes

Follow-up testing is not routinely recommended because the treatment is so effective. Of course you can test again if you choose.

4)Could these 2 treatments fail for gonorrhea, syphilis, chlamydia if they are done correctly and appropriately and I don’t miss any doses

Repetitive. Treatment is unlikely to fail.

5)can rest assured I can’t get a chancre at this point with the tx I’ve had?

Yes

6)if I tested now, and treated so quickly, would I get a positive test?

On occasdion tests can remain positive for several days due to residual material from dead bacteria.

7)any infection you can think of that I could have acquired from exposure that’s causing me symptoms? Would my current treatment cover other etiologies?

Your exposure was virtually no risk. No need to relax

8)how long do i have to take doxy for syphilis(2 weeks?), and chlamydia(1 week?) and how much longer after that do I have to abstain from sex?

See earlier comments

9)do I still need to consider the possibility of an STD if symptoms don’t go away after treatment?

Unlikely

10)rocephin just as effective as pcn for syphilis in incubation stage?

Previously answered- see above

You are asking repetitive questions related to a virtually no risk exposure. You need to move forward. You should not need to return to the Forum with additional questions. If you do, follow-up, anxiety-driven questions of the sort you are asking may be deleted without a response and without return of your posting fee. EWH

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