Unprotected Oral Sex

[Lumpazi]

Hi Doctors,
Thanks so much for providing this service. I recently had a sexual encounter with a trans sexual sex worker. I both gave and received unprotected oral sex and had protected anal sex (for about20 seconds) . Could you break down my risk? Also, what are the symptoms of ghonorhea or an NGU that you contract orally? Will they manifest themselves in my urinary tract or only in my throat? I am married and am really concerned about passing something on to my wife from this stupid encounter. I feel so awful About it and can't sleep at all.

Thanks for all your help!

[Edward W Hook, MD]

What a silly question.  Yes, of course I have seen such patients.  This is to be expected after more than 30 years of practice and  thousands of patients.  Cough is NOT a sign of ANY STD. EWH

[Edward W Hook, MD]

Welcome to the Forum.  This was a low risk exposure.

Properly use condoms which remain intact are safe sex.  Thus there is no appreciable risk for STD or HIV form your anal exposure.

As for your oral exposures, oral sex is an inefficient way to acquire or transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are acquired through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  

As for your performing oral sex, there is a small risk of acquiring gonorrhea.  Ha you acquire gonorrhea, it would most likely be asymptomatic an only detected by testing.  

I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time.  

I hope these comments are helpful. EWH

[Edward W Hook, MD]

If a condom was used, you are not at risk.  If you had anal gonorrhea however, your anus would need to be tested.  A urine test would not pick up anal gonorrhea. EWH

[Lumpazi]

Thanks doctor. Igot a test this past Monday and am waiting on rsults. My 4 and 1/2 week HIV test was negative at least. But now I am really concerned that I should have gotten tested for anal gonnorhea since my rectum is itchy a lot and I feel like I have to have a bowel movement a lot. But she wore a condom and was only in me for three, maybe four thrusts. How common is anal gonnorhea? And would a urine test also catch this? I promise this is my very last question.

[Edward W Hook, MD]

Most likely.  A test is the only way to be 100% sure but in your case, odds are99.9% that you did not get gonorrhea.  EWH

[Lumpazi]

A final follow up: it has been over 4 weeks and I was wondering if I don't have any symptoms of goonnorhea yet if that means I am in the clear

[Lumpazi]

Last question doctor , I promise: have you ever seen any patients who contracted STD from giving and receiving oral sex? I am nervous because I now have a strong cough since my exposure. My wife is 8 months pregnant and I don't want to endanger the health of her or my child.

[Edward W Hook, MD]

No good statistics on getting gonorrhea from eithe giving or receiving oral sex however it is quite uncommon.  I doubt that there is a medical reason for testing. If you choose to be tested, you are doing it primarily for you peace of mind.  EWH

[Lumpazi]

Thanks for the quick response. What are the chances of catching gonorrhea from giving oral sex? Are there stats? Would you recommend testing? Thanks!