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STDs (Expert Forum)
Few Questions regarding Syphilis
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Few Questions regarding Syphilis
by son222, Jul 25, 2006 12:00AM
Hi- Here's a brief overview of my situation:
A guy that I was dating for a brief time called and told me that he had syphilis. We never had vaginal sex, but I did perform fellatio on him one time, w/ ejaculation. When it occurred, there were no lesions or sores on his penis.
A few days after, I went to the doctor for other reasons, which I know are not because of the encounter because of timing, but I was put on an antibiotic and I believe it was azythromycin(sp)? When I found out from the guy about his situation, I went straight back to my doctor and she tested me for the syphilis. I am still waiting back on the results, but as a precautionary measure, they started treating me 12 days ago with doxycycline (talked about the incubation period as for why they used the doxy?) I have had no oral symptoms and it has been over two months.
My questions are:
1.) What are my chances of acquiring syphilis from my encounter? and how much lower are the chances because there were no visible lesions or sores?
2.) Would the antibiotic I took unknowingly have cured orkept me from getting the syphilis just days after the encounter?
3.) If I did get the syphilis from that encounter and the first antibiotic didn't work, how long after taking the doxy would I be safe to not spread it to anyone? I am not planning any sexual activity, I am just curious to know when it is safe.(oral sex, not vaginal)
4.) Is mouth-penis, penis-mouth transmission of syphilis equal or which is more common? In other words, are the chances of me getting syphilis from fellatio as common as me spreading syphilis from my mouth to a penis?
Thank you for your patience and I truly appreciate what you do for people on this site. Thanks Again.
A guy that I was dating for a brief time called and told me that he had syphilis. We never had vaginal sex, but I did perform fellatio on him one time, w/ ejaculation. When it occurred, there were no lesions or sores on his penis.
A few days after, I went to the doctor for other reasons, which I know are not because of the encounter because of timing, but I was put on an antibiotic and I believe it was azythromycin(sp)? When I found out from the guy about his situation, I went straight back to my doctor and she tested me for the syphilis. I am still waiting back on the results, but as a precautionary measure, they started treating me 12 days ago with doxycycline (talked about the incubation period as for why they used the doxy?) I have had no oral symptoms and it has been over two months.
My questions are:
1.) What are my chances of acquiring syphilis from my encounter? and how much lower are the chances because there were no visible lesions or sores?
2.) Would the antibiotic I took unknowingly have cured orkept me from getting the syphilis just days after the encounter?
3.) If I did get the syphilis from that encounter and the first antibiotic didn't work, how long after taking the doxy would I be safe to not spread it to anyone? I am not planning any sexual activity, I am just curious to know when it is safe.(oral sex, not vaginal)
4.) Is mouth-penis, penis-mouth transmission of syphilis equal or which is more common? In other words, are the chances of me getting syphilis from fellatio as common as me spreading syphilis from my mouth to a penis?
Thank you for your patience and I truly appreciate what you do for people on this site. Thanks Again.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jul 25, 2006 12:00AM
, Jul 25, 2006 12:00AM
It would be good to know more about your partner's syphilis, specifically the stage, duration, and whether he had been treated. Syphilis can be sexually transmitted only during the first year (and mostly during the first 3-6 months) after infection. And if someone has had any treatment at all, it cannot be transmitted. And oral sex is low risk.
If you were exposed, the azithromycin likely would have prevented active infection; and doxycycline certainly will prevent it. The preventive treatment of choice is penicillin by injection; unless you are allergic to penicillin, that would have been preferable. But the doxy is fine as long as you take all of it as prescribed. Therefore, the rest of your questions are more or less irrelevant: even if exposed, you can be totally confident you won't have any problem. To your specific questions:
1) Very low risk for the exposure you describe, especially since there were no visible lesions. 2) Probably the azithromycin took care of it, if you were exposed. There are azithromycin-resistant strains of syphilis, however. (If you happen to be in San Francisco, there is a strong chance of azithromycin resistance.) 3) Syphilis cannot be transmit to another person until at least 3 weeks after infection, even without antibiotics. Either doxycycline or azithromycin will effectively prevent transmission within a few hours of the first dose. 4) Syphilis is most readily transmitted by vaginal or anal intercourse. Oral can do it, but less frequently. There are no data on whether transmission is more efficient in one direction or the other.
Bottom line: You're home free; don't worry about syphilis. (Presumably you are being tested for HIV. For practical purposes, every case of syphilis occurs in someone at high risk for HIV infection.)
Good luck-- HHH, MD
If you were exposed, the azithromycin likely would have prevented active infection; and doxycycline certainly will prevent it. The preventive treatment of choice is penicillin by injection; unless you are allergic to penicillin, that would have been preferable. But the doxy is fine as long as you take all of it as prescribed. Therefore, the rest of your questions are more or less irrelevant: even if exposed, you can be totally confident you won't have any problem. To your specific questions:
1) Very low risk for the exposure you describe, especially since there were no visible lesions. 2) Probably the azithromycin took care of it, if you were exposed. There are azithromycin-resistant strains of syphilis, however. (If you happen to be in San Francisco, there is a strong chance of azithromycin resistance.) 3) Syphilis cannot be transmit to another person until at least 3 weeks after infection, even without antibiotics. Either doxycycline or azithromycin will effectively prevent transmission within a few hours of the first dose. 4) Syphilis is most readily transmitted by vaginal or anal intercourse. Oral can do it, but less frequently. There are no data on whether transmission is more efficient in one direction or the other.
Bottom line: You're home free; don't worry about syphilis. (Presumably you are being tested for HIV. For practical purposes, every case of syphilis occurs in someone at high risk for HIV infection.)
Good luck-- HHH, MD
Thanks again for your responses...you provide a service that helps so many people. Have a good day.
Thanks for the thanks-- HHH, MD