STDs Expert Forum
General Risk for M2M Oral Sex
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The STD Forum 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.

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General Risk for M2M Oral Sex

I am a gay man, partnered in an open relationship.  Over the past 6 years, I have had approximately 75 casual sex partners where I only performed oral sex on the guy.  Some instances, they ejaculated in my mouth and others they did not.  I have never had unprotected anal sex with any of them.  Aside from a strange rash on my torso last year (over one year ago) that was diagnosed by a dermatologist as Pityriasis Rosea, I have never had any symptoms characteristic of an STD nor has my partner. As of last month, we stopped the casual play outside of our relationship as it really does not suit our lifestyle any longer and are now monogamous with each other.  I was tested today for the full panel of STDs (herpes, gonorrhea, clamidyia, syphilis, HIV and hepatitis) and await the results.  As is normal, I am particularly nervous and was wondering if you could provide a relative risk level for having any of the STDs listed?  My anxiety is higher right now because I have tenderness under my jaw (swollen node?) with an intermittent earache and always fear an STD.
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Welcome back to the forum; I recall our discussion about PR a year ago.  Thanks for this question.

I'm glad to year you and your partner are working toward a mutually monogamous relationship.  From a sexual safety standpoint, it's obviously the way to go.  While oral only is reasonably safe, it still carries modest risks for M2M sex.

Beyond that, it's hard to comment on the risks.  For example, if your partner, like you, had only oral sex with his other partners, the risk is lower than if he had anal sex (top or bottom) with any of them; and it also depends on what practices you have shared with your partner (anal? top and bottom for both? condoms?).  The symptoms you describe conceivably could reflect an STD, but probably not; far more likely a minor respiratory infection, allergy, etc.

What anatomic sites were tested for gonorrhea and chlamdia?  In addition to urethra/urine testing, you need a throat swab for gonorrhea and, your regular partner tops you anally, rectal testing for both.  Probably the same for your partner as well, depending on the sites exposed.  All the blood tests are highly reliable, but they take a while to become positive.  For 100% assurance, you and your partner will need HIV testing at 6-8 weeks after the last outside exposure, or only 4 weeks if your doctor or clinic does the duo ("4th generation") test; syphilis and hepatitis at 6 weeks; and HSV at 3-4 months.

I can say more if you can fill in the information about your partner's outside activities and your practices with him.  But in the absence of symptoms, I expect all your tests will be negative.

Regards--  HHH, MD
4 Comments
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Avatar_m_tn
Sorry, forgot to mention that my partner had no relations outside of ours - he was just not interested but was aware of my casual hook-ups on occasion.  It was only me who pursued casual sex on occasion - mostly with married men and with younger men (under 30) and again, only oral with occasional ejaculation in my mouth and sometimes swallow. Regarding the sex that my partner and I have together, it includes oral sex and anal sex.  He is the top and our anal sex, although less frequent than oral, is without a condom. My last outside exposure was 6 weeks ago and it was only me giving oral to a 19 year old male.
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It sounds like you've been at low risk yourself, and if you're confident your partner had no others, then it's less important that you have rectal testing for gonorrhea and chlamydia.  But still, that's routine in the STD evaluation of all people who have had receptive anal sex (bottom) at all, so this is a question of how anal (in its other sense!) you want to be about complete and thorough testing.  In any case, now even more I expect all your tests to be negative.
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Avatar_m_tn
Thanks Dr. Handsfield.  I appreciate your astute feedback and thoughts. Much appreciated.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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