unprotected oral risks for recipient

[ablebeckon]

I received a hand job and unprotected oral from a male masseur last night.  It was mostly a hand job with very limitied mouth to penis contact - though he did use his spit for lube for the hand job.  I am concerned I may have had a small abrasion on my penis shaft that I had forgotten about from a pants zipping incident a couple of days ago.  

I am a married man who was curious and did something really stupid.  I am concerned about what STD exposure I may have introduced myself to and what I may in turn need to do to keep from giving anything to my wife. What std's should i be concerned about getting and what do I need to do test wise to know for sure what issues I may have caused myself from an std perspective?  I know that I have HSV1 because I have had that for a few years but that is all.  

I am not one to do this sort of thing and I can't believe I have.  I appreciate any advice that you can provide.

[Edward W Hook, MD]

No change in my assessment or advice.  I do not think you need testing and do not need to abstain from unprotected sex with your wife.  Take care. EWH

[ablebeckon]

Live not love...though I do live and love here!  lol

I should also clarify I can't find that 4th generation test offered anon or not based on internet searches.

I appreciate your consideration and will accept your final answer and the end of the thread. And thank you again so much for your help.

[ablebeckon]

I can't seem to find an anon test as you describe near where I love. I have restrained myself from sexual relations with my wife since this incident.

I have an anniversary this next week (which I told her I was "saving" up for as in withholding sex)

You have already said to me you feel it is safe to resume sex and you have already said you see no reason for HIV testing based on my description of this incident and you have likewise said the same about syphyillls testing given this description and the lack of any evidence/symptom of it after this described encounter.  

My testing at 10 days showed no chlamydia or gonorrhea.

Is my assessment of your opinion still correct?  

Stop worrying and have unprotected sex?

[Edward W Hook, MD]

Yes, a 4th generation, combination HIV antigen/antibody test will provide conclusive results at 4 weeks. I anticipate that it  will prove that you did not get HIV from the expsoure you describe.  EWH

[ablebeckon]

I want to thank you for your previous response(s) on this subject.  It has been almost 28 days (June 13) since the exposure I inquired about.  I have had no symptoms of any kind like what you talked about.  Further, I was tested (about 10 days after the encounter) for gonorrhea & chlamydia.  Those tests were negative.

If I should wish to have an HIV test at 28 days, is there one that could be conclusive at 28 days?  If so, which one would it be?

Thank  you,
AB

[Edward W Hook, MD]

There is no need for herpes testing and, in fact it is often misleading.  If you do not develop lesions of herpes within two weeks of your exposure, you did not get herpes.  The same is true for syphilis. If you acquired syphilis from receipt of oral sex, you will develop a penile sore withint three weeks of the exposure.  For syphilis, if you wish to prove that you were not infected, you can take a syphilis blood test but there is no need to do this until at least two months after your exposure.

Your risk for getting syphilis or HIV from the exposure you described is less than 1 in 10,000.  

NGU is best detected with a swab specimen taken from the penis.  It can be detected through the detection of white blood cells present in a voided urine specimen as well.  

I once again urge you not to worry about this exposure.  EWH

[ablebeckon]

Is there an early detection test for syphillis?  Likewise, for herpes2?  Does ngu need tested by a physical exam or could a blood/urine test show that?  

The point of my question for syphillis and herpes2 is does it take a full 3 months to know for sure that I am negative on those?

Thank you again for your consideration of my circumstances.  

[Bill469]

To ablebeckon.  I read your post on medhelp forum.  Like you, I am a married heterosexual man.  Also like you, I made a mistake sometime last summer while in an adult arcade and received oral sex through a "jolly hole".  I gave into the temptation because, although being married for 19 years, my wife is never really interested in having sex.  In fact, you could count the number of times we have sex in a year on one hand (with fingers to spare). Being a human and a male, I happen to like sex.  So, instead of trying to have a relationship on the side with a woman, I found myself in a situation where I could just have oral sex with no questions asked, no emotional attachments, etc.  So, with the lack of sex over the years, I gave in.

I am telling you this because most of the posts on this site involve a male having sex with a female and then asking questions, or a male who has sex with other men on a regular basis.  your post was kind of like mine.  I guy who is married but did something out of the ordinary (received sex from another male).

With that in mind, Dr. Hook is also the one who responded to my post.  He really eased my mind.  Your concerns were the same ones that I had.  I had std tests done in December and then again in March.  All came back negative.  I do have this re-accuring rash which is what still causes me concern, but my primary doctor does not believe it is an std.  The blood tests seem to confirm that (as well as what Dr. Hook said).  The only reason I got re-tested in March was because of this re-accuring rash.  My dermatologist did a skin biopsy and said it was follicultis.

So, the long and the short of it is for you to hand in there.  You are not alone.  Best of luck.

[Edward W Hook, MD]

1.  I should abstain from sex with my wife for a few days to make sure that I have a chance to see about any potential issue that may come up.

That would be the safest course although, as i said, the risk for infection is quite low.

2.  Within a couple or three weeks, I could have an STD test and feel good about those results being accurate?

Tests for gonorrhea or NGU will be accurate at any point three or more days after your exposure.  


3.  Within a couple of weeks, with no symptoms & neg STD test results, I could resume regular unprotected sex with my wife (and never do the stupid again...)

If you are tested and and have no signs of infection, I see no need to wait further to have unprotected sex with your wife.  EWH

[ablebeckon]

Thank you for the response.  I appreciate your time and consideration of my circumstances.  Based on your response, it sounds to me that:
1.  I should abstain from sex with my wife for a few days to make sure that I have a chance to see about any potential issue that may come up
2.  Within a couple or three weeks, I could have an STD test and feel good about those results being accurate?
3.  Within a couple of weeks, with no symptoms & neg STD test results, I could resume regular unprotected sex with my wife (and never do the stupid again...)

Does that sound reasonable?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help. Please know that you are not alone in your concerns.  At the present time, receipt of oral sex is the most common form of unprotected exposure involving new partners and while there are still risks for STIs from such exposures, the risks are lower than for other sorts of unprotected genital exposures. The reasons for this are that oral STIs are not as efficiently transmitted as most other STIs. In addition, most people do not have STIs.

In the case of the exposure you describe, your risk was low. To elaborate, there is no known risk associated with your -partner's use of his saliva as a lubricant for masturbation, even considering the abrasion present on your penis.  Further, as mentioned above, even among persons with many sex partners, oral infections are uncommon and for a number of biological factors too complex to go into here, the efficiency of transmission of infections through oral sex is lower than for penetrative genital-vaginal or –anal sex.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; for all practical purposes, chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  Since you already have HSV-1, you cannot get it again, even at a different site and HSV-2 is almost never acquired by receipt of oral sex.   If you had gotten gonorrhea or NGU you will most likely develop symptoms of urethritis (penile infection) such as burning on urination or a penile discharge within 3-5 days of your exposure.  Even if your partner had an STD (any STD and it is likely he did not), most exposures do not lead to infection.  In your case, your exposure was also brief; as a result, I would urge you not to worry. If you must, you could go to your local STD clinic or health care provider to be tested at this time.

I hope these comments are helpful. I really would not worry. EWH