It’s been a while since I’ve visited this site. I was recently on a business trip to the Philippines and visited a bar with some work colleagues. For context - it was not a high end establishment, but not a seedy dump either. Probably average by western standards. 

I engaged in deep kissing with two different women, say for a few minutes each, and later learned that one was transsexual. There was no other sexual contact. Neither struck me as CSWs - probably both young professionals/postgrad students sort of thing. 

What’s the risk from this encounter? I had thought quite innocently that deep kissing wasn’t really a risk, but having gone down the internet rabbithole, I’m terrified of having contracted some from what appears to have been a very non-description encounter, particularly relative to some of the other posts here. More importantly - is there an imminent risk to any future partners? 

Thank you.

Kissing is extremely safe for all STDs, including HIV; often it's considered completely risk free. In theory kissing might transmit HIV and it's often listed as a potential HIV risk. However, in the 4 decades of the recognized worldwide HIV/AIDS epidemic, there have been no credible reports of scientifically documented HIV transmission by kissing, even prolonged sexual (open mouth) kissing. So although it cannot be classified as definitely risk free, any actual risk is microscopic.

As for other STDs, there is currently a controversy about the likelihood and frequency of gonorrhea transmission by kissing -- with supportive data by investigators in Australia, but lack of similar experience elsewhere; and in any case, the Australia situation appears to be entirely limited to men having sex with men. Oral gonorrhea is much less common in sexually active women than in MSM and there is little or no risk from the events you describe above, except if the trans person is anatomically male and has frequent contacts with MSM, perhaps there is a small risk. Syphilis can be transmitted by kissing, but it's rare; and infection is rare in straight women (but as for oral gonorrhea, it would not be surprising if your trans kissing partner had it). In addition, lack of symptoms (oral syphilitic sore) in the next three weeks would be fairly strong (but imperfect) assurance you weren't infected. Oral herpes or course is possible but isn't considered an STD.

I don't recommend testing and don't think you need be at all worried. However, if these facts about theoretical or potential possibilities make you concerned, you could be tested. In that event, you have a throat swab for gonorrhea (valid any time more than 2-3 days after the event); and blood tests for HIV and syphilis after 6 weeks. I strongly recommend against testing for anything else. (Chlamydia testing is nearly universal along with gonorrhea, but is zero risk from kissing.) But all risks are low enough that if somehow I were in your situation, I would not be tested and would continue my usual sex life with my wife.

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

HHH, MD

Thanks as always for the detailed response. So the summarise - the main (and theoretical) risks were with respect to the trans partner and concerning oral gonorrhoea and syphillis. Is it fair to say that even if the trans partner had these, the actual risk of transmission would still be low?

I don’t know much about the status (stage?) of the trans partner, other than they appeared fairly advanced and were male to female rather than vice versa which I assume was apparent from my initial post. There was also no visible sores on their lips or face either, although you’ll recognise the practicalities of being able to check inside someone’s mouth in this scenario.

I assumed your trans parter was M to F. Checking in the mouth is pretty much useless anyway; in the event of similar events in the future, I suggest not even trying. You probably would miss any potentially pertinent abnormality, and most things that don't look right probably are OK. It isn't worth the effort or worry. By far the more important factors are the basic nature of your partner and the relationship (sex worker? trans? sexual practices planned or completed? and so on).

Thanks again for the other reassurances, and confirming my suspicion in that testing is not warranted! 

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.