[Question #9821] One More Question
28 months ago
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I'm back 1 more time. Dr Hook was kind enough to answer my recent question. My situation I honestly don' think there was any oral contact at all but the "what if" would have been very incidental/brief as stated. I also have had no pus/discharge or painful urination and it has been 12 days since the event. I do urinate more frequently which I believe is anxiety. Here is my further question: I believe you indicate that the liklihood a CSW has gonorrhea is around 3%? I think you also estimate that probably less than 10% of oral receipt ends up as an infection, let's say 8%? I also believe you state that around 10% of gonorrhea infections are asymptomatic. So, is the math first you have to be unfortunate to have engaged with the 3% chance the CSW had it, then you would need to be in the 8% chance it transmitted (which I assume is far less in the event of 2-3 second incidental contact if not zero) and then if both of those occur AND you are without discharge and painful urination (pissing razors) then it would need to be another 10% at best chance. Curious, what would you estimate those odds to be? Are we talking 1 in 10's-100's of thousands? Not even sure if you could quantify in the event of 2-3 second contact? Sorry to be asking for more clarity here but hoping you could weigh in. Thank you
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H. Hunter Handsfield, MD
28 months ago
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Welcome back, but I am disappointed you found it necessary. You have previously been advised about the low to zero risk of STDs from the various exposures you have described. And now you ask for a numerical risk calculation for an event that you believe didn't happen!
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The 3% guesstimate that a particular female CSW has oral gonorrhea is probably on the high side, and in any case is highly variable based on geography, risk profile, race/ethnicity, setting (escorts vs brothel workers, for example), and other factors. There are no reliable data on the likelihood of urethral gonorrhea after oral sex by a partner with oral gonorrhea, but I suppose 10% could be in the ballpark. If you want to calculate the numerical risk based on those figures, feel free. It's just a question of multiplying the figures, in this case 0.03 x 0.1 = 0.003. That is, 3 infections per 1,000 exposures. (I don't follow your meaning about 8%.). It's true that the risk would be a lot lower for only 2-3 seconds of contact. Anyway, you paint a very unrealistic scenario, and I won't play any games around risk calculation. Just accept that your exposures are very low risk for gonorrhea and any other STD. The chance you have gonorrhea drops another 99% in absence of typical symptoms within several days of exposure. If you remain concerned in spite of all this, of course you are free to go to a clinic or lab for testing.
Please note the forum has a policy against repeated questions, especially when anxiety driven, as I would classify some if not all your questions to date, including this one. Such repeated questions are subject to deletion without reply and without refund of the posting fee. This policy is based on compassion, as we have found that repeated answers tend to prolong anxiety and worry rather than relieving it. (There's usually a "yes but" or "could I be the exception" sort of response.) Also, the forum sponsor (ASHA) is not keen on being paid for questions with obvious or repeated answers. Finally, such questions have limited educational value for other users, one of the forum's main purposes. Thank you for your understanding. I do hope this and the preceding discussions have been helpful to you.
HHH, MD
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28 months ago
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Thank you for the response and apologies for any policy ignorance I may have caused.
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H. Hunter Handsfield, MD
28 months ago
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No apology is necessary. Just want you to know the expectations going forward. Of course you are welcome to continue to use the forum for clarity on different exposure types you may experience, symptoms that haven't been discussed, and so on.---