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Unprotected Oral Sex Question

Dear Dr.
I am a 40 year old male.  I had an "erotic massage" with a working masseuse (woman) 3 days ago that ended with unprotected oral sex for about 2 minutes and ejaculating in her mouth (she swallowed).  I also touched the outside of her vagina (no insertion).  Afterwards, I was completely worried that I had all STDs and, having access to Zithromycin, I took a single 2 gram dose yesterday.  I have no symptoms and it has been 3 days.  Even if I did have any diseases/infections, would the antibotics knock them out after taking them the day after the event.  I called an online testing service and I am being tested for chlamydia, gonorrhea and herpes next Wed (9 days after the event).  I do not want to have this show up on my insurance and tell my primary care doctor.  Am I doing the right thing? What should I do?  Should I worry about catching anything or am I being overly paranoid?  Your answers are great.  Can you help me?
Thanks!
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Oral sex is inherently low risk for all STDs, much lower risk than vaginal or anal sex.  You are wasting your money to have testing, online or otherwise.  In the absence of symptoms, almost certainly you were not infected.

Let's take the possibilities one at a time.  Gonorrhea: can be acquired from oral sex, but uncommonly, and there are almost no urethral infections without symptoms, so no point in testing.  Chlamydia:  Never acquired by oral sex; oral chlamydial infections are virtually nonexistant, so nothing to transmit by oral sex.  Herpes:  only HSV-1 is a risk, and there is a 50% chance you have had HSV-1 before and now are immune; no risk of HSV-2, which, like chlamydia, rarely causes oral infection, so nothing to be transmitted to your penis.  HIV:  No risk, for practical purposes.  Syphilis:  theoretically possible, but rare from oral sex among heterosexuals -- there are only around 20,000 new cases of syphilis per year in the entire US, and most of those occur in gay men or a few very localized populations of heterosexual men and women, e.g. along the western border with Mexico and a few areas of the southeast.

On top of all that, the Zithromax you took would have cured most of the infections you describe, making the tests negative even if you had been tested.  Please don't waste your money and emotional service on something you do not need and that cannot possibly provide useful information.

So to answer your question at the end:  I'm not sure it's "paranoid" to have asked the question. But I honestly do not think you need STD testint of any kind, especially after such a brief exposure and after taking the antibiotic.  But if my reassurance isn't sufficient, please don't waste your money on an online testing service.  See a proper health care provider.  Your primary care doc isn't going to breach your confidentiality, and your insurance company cannot do so without very large fines under federal law; or you could tell your doc you wanted to pay yourself.  Or visit the local health department STD clinic for expert advice at little or no cost.

Regards--  HHH, MD
Helpful - 1
Avatar universal
Dear Doc,
Thanks!  Your reassurance is all I needed.  You are wonderful.
Helpful - 0

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