Passing on Gonorrhea Through Oral Sex

[Benji8008]

I am a male and recently over the course of a month have given oral sex to three different men. The first one of which contacted me after about three weeks to tell me that he had tested positive for gonorrhea and recommended I get tested. Is there a chance that I had oral gonorrhea prior to our encounter and did not know it and passed it to him through oral sex? Or additionally is there a chance I contracted oral gonorrhea from him and could have passed it on to these other men? Prior to these three men I was in a monogamous relationship for three months and my partner did not show any signs of genital gonorrhea. As far as I know, I am not exhibiting any symptoms myself.

[HowardH]

"...you advise being treated regardless of whether the tests return positive or not?" Absolutely. That's the standard advice from all public health and STD experts world wide:  known contact to gonorrhea warrants treatment, regardless of test results. Normal practice is to collect the test specimen and treat at the same visit.

Bottom ("receiving end") in anal sex is the highest HIV risk of all sexual practices among MSM. Consistent condom use of course is crucial, but condoms do break and there can be unrecognized condom failures.  A fair proportion of all MSM with HIV say they always use condoms during anal sex.  So you definitely should consider yourself at risk and should be tested routinely for HIV from time to time -- at least once a year and maybe more often, depending on frequency of exposure.

[Benji8008]

Thanks for your response. I am going to a clinic tomorrow to get tested, but was hoping to ease my anxiety in the meantime. The man who tested positive did have partners after me so it's quite possible he contracted it through them. Fingers crossed. But you advise being treated regardless of whether the tests return positive or not?  

Also worth mentioning that any time I've engaged in anal sex I have been on the receiving end and there was a condom used, so that should hopefully decrease the odds that I would have it in other sites.

[HowardH]

Either of those possibilities could be true -- that you have had pharyngeal (throat) gonorrhea and infected your partner, or that you were exposed to his infection and became infected. Most pharyngeal gonorrhea causes no symptoms at all -- no sore throat, nothing. As for whether you could have been infected by your monogamous partner, I have no way of knowing -- but if he had other partners up to (or during) your relationship, that certainly is possible.

The most important thing now is that you need treatment for gonorrhea. Ideally you should also be examined and tested for gonorreha at all exposed sites (a standard urine test won't detect pharyngeal or anal infection). But treatment should be given before the test result is available, or even if testing is negative.

For men having sex with other men, gonorrhea at any site indicates very high risk for HIV, so I hope you're taking appropriate precautions -- condoms for anal sex, discussion of HIV status with partners, etc. And you should be having routine HIV testing from time to time.

Best wishes and happy new year.