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Syphilis Risk
Hello Dr.,
About 4 1/2 weeks ago i received brief unwanted oral while visiting and asian massage parlor in a major North East city. It was very dark in the room and the massage went initially expected until the end when this occurred and the episode was stopped. The person giving the massage, who I originally thought was a thai women, afterwards appeared more to be a transsexual when the lights came on at the end. I did not see the person until the end. I was initially not worried about STD's as the exposure was brief but now I am very worried. Can you maybe answer some of my questions regarding this event:
1.) What is the risk of Syphilis from a brief reciept of oral sex? Is it higher because this was a CSW? Higher because this was a transsexual?
2.) I have not had any obvious chancre's or lesions that look like syphilis to me at this point, would this suggest that I probably will not?
3.) A lot of literature says that chancre's can appear out to 90 days, but how typical is that?
4.) Would you recommend testing for this event (Would you test if this were you)? Is six week test conclusive for Syphilis or do you have to wait longer?
I also have had no symptoms of gonnereah, clamydia, NGU, Herpes, etc. I also understand that HIV should not be a concern but would appreciate if you could confirm that for me.
Any help you can provide would be greatly appreciated.
About 4 1/2 weeks ago i received brief unwanted oral while visiting and asian massage parlor in a major North East city. It was very dark in the room and the massage went initially expected until the end when this occurred and the episode was stopped. The person giving the massage, who I originally thought was a thai women, afterwards appeared more to be a transsexual when the lights came on at the end. I did not see the person until the end. I was initially not worried about STD's as the exposure was brief but now I am very worried. Can you maybe answer some of my questions regarding this event:
1.) What is the risk of Syphilis from a brief reciept of oral sex? Is it higher because this was a CSW? Higher because this was a transsexual?
2.) I have not had any obvious chancre's or lesions that look like syphilis to me at this point, would this suggest that I probably will not?
3.) A lot of literature says that chancre's can appear out to 90 days, but how typical is that?
4.) Would you recommend testing for this event (Would you test if this were you)? Is six week test conclusive for Syphilis or do you have to wait longer?
I also have had no symptoms of gonnereah, clamydia, NGU, Herpes, etc. I also understand that HIV should not be a concern but would appreciate if you could confirm that for me.
Any help you can provide would be greatly appreciated.
MEDICAL PROFESSIONAL
"Would you recommend no further testing and to just move on with my life?"
Yes, for sure. Best wishes.
Yes, for sure. Best wishes.
Dr.,
I wanted to give you an update. My 6 week RPR test for Syphilis (actually 1 day short of 6 weeks) came back negative. This coupled with the fact that I had a negative gonorrhea / Chlymidia urine test 1 week after the incident in question, do you think I am good to move on. I have not had any symptoms of bacterial infection at all and no evidence of HSV over the 6 week period. I assume HSV2 would not be a concern from receiving oral and I have had HSV1 on my mouth forever. Would you recommend no further testing and to just move on with my life?
Thanks!
I wanted to give you an update. My 6 week RPR test for Syphilis (actually 1 day short of 6 weeks) came back negative. This coupled with the fact that I had a negative gonorrhea / Chlymidia urine test 1 week after the incident in question, do you think I am good to move on. I have not had any symptoms of bacterial infection at all and no evidence of HSV over the 6 week period. I assume HSV2 would not be a concern from receiving oral and I have had HSV1 on my mouth forever. Would you recommend no further testing and to just move on with my life?
Thanks!
MEDICAL PROFESSIONAL
Either the lab or CDC is being hyper conservative. 6 weeks is fine for RPR.
Dr.
Sorry last question. I called to schedule a test and the person told me that due to the type of test they use (RPR) the CDC recommends testing at 3 months and he told me not to get tested right now. Everywhere on the internet I kept seeing that 6 weeks is conclusive. Is this a function of whether the test done is a non-treponemal (VDRL or RPR) or a treponemal test (FTA-ABS, TP-PA, various EIAs)? I just want to make sure my test is accurate.
Sorry last question. I called to schedule a test and the person told me that due to the type of test they use (RPR) the CDC recommends testing at 3 months and he told me not to get tested right now. Everywhere on the internet I kept seeing that 6 weeks is conclusive. Is this a function of whether the test done is a non-treponemal (VDRL or RPR) or a treponemal test (FTA-ABS, TP-PA, various EIAs)? I just want to make sure my test is accurate.
MEDICAL PROFESSIONAL
Two days short of 6 weeks is fine. Quest or any other lab is fine -- there are no unreliable syphilis tests.
Just a quick follow up, as I did not see a response to my last one. Is it necessary to wait the full 6 weeks or can I do the test a few days early (6 week mark would be in 2 days). Is there a specific test I should be getting done? I ask as I was planning on going through Quest as opposed to my Primary Care Physician as I would prefer this test not be in my records. Would quest use the best Syphilis test available to ensure proper results?
Thank you for your prompt reply. Since this event was 4 1/2 weeks ago and I can plan to get tested for Syphilis at 6 weeks, should I continue to abstain from having sex with my wife until after I get the results? I assume, since you said that you probably would not even get tested after such an event, you would not think it necessary to do so but just wanted to make sure.
Thanks in advance!
Thanks in advance!
MEDICAL PROFESSIONAL
Welcome back to the forum.
Syphilis is current rare in most of the US -- although your risk might be a bit higher with a male-to-female transsexual partner than from a biological female. OTOH, oral sex is low risk for syphilis. Based on this unprotected exposure, I would advise a urine test for gonorrhea and a syphilis blood test. These can be done at any time -- enough time has passed for accurate results. (HIV and chlamydia testing are done routinely with HIV and gonorrhea testing, respectively, but oral sex is virtually risk free for both.)
1) Nearly zero risk, but see above for discussion. You can expect a negative syphilis test result.
2,3) It's too late for onset of a chancre, which usually appears after 10-20 days. If it actually takes 90 days, I've never seen such a case.
4) Personally, I would not be tested. But the tone of your question, and the previous one a few weeks ago, suggests you are likely to continue to worry until you have had a definitive test result. But it's up to you. Six weeks is sufficienty for a condlusive result.
My comments above already address your closing comment/question.
Please note that MedHelp has a rule that allows a max 2 questions every 6 months on each of the professionally moderated forums (see Terms and Conditions). The purpose is to prevent domination of forums by a few users with repeated, anxiety-driven questions. This being your second on this forum in a month, no more until October, please.
Best wishes-- HHH, MD
Syphilis is current rare in most of the US -- although your risk might be a bit higher with a male-to-female transsexual partner than from a biological female. OTOH, oral sex is low risk for syphilis. Based on this unprotected exposure, I would advise a urine test for gonorrhea and a syphilis blood test. These can be done at any time -- enough time has passed for accurate results. (HIV and chlamydia testing are done routinely with HIV and gonorrhea testing, respectively, but oral sex is virtually risk free for both.)
1) Nearly zero risk, but see above for discussion. You can expect a negative syphilis test result.
2,3) It's too late for onset of a chancre, which usually appears after 10-20 days. If it actually takes 90 days, I've never seen such a case.
4) Personally, I would not be tested. But the tone of your question, and the previous one a few weeks ago, suggests you are likely to continue to worry until you have had a definitive test result. But it's up to you. Six weeks is sufficienty for a condlusive result.
My comments above already address your closing comment/question.
Please note that MedHelp has a rule that allows a max 2 questions every 6 months on each of the professionally moderated forums (see Terms and Conditions). The purpose is to prevent domination of forums by a few users with repeated, anxiety-driven questions. This being your second on this forum in a month, no more until October, please.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
