Welcome to the STD forum.
You are correct that oral sex carries little or no risk for HIV; some experts believe no such transmission ever occurs. And most sex workers don't have HIV.
The STDs possible from oral to genital transmission are gonorrhea; herpes due to HSV-1; perhaps nongonococcal urethritis (NGU), which sometimes may be caused by entirely normal oral bacteria; and syphilis. There are no risks for chlamydia, HPV, HSV-2, hepatitis, or any other STD. Even for the ones that could cause risk, there are really no serious worries. All possibilities are rare and all would pretty much always cause obvious symptoms; and syphilis would be vanishingly rare in this situation. In the absence of symptoms -- i.e., abnormal penile discharge or sores of the penis -- you really don't need testing after this sort of event. It is not reasonable to take any antibiotic, especially cipro, which is not reliable against any of the conditions I listed.
But if you insist on testing for peace of mind, wait 3-4 days and have a urine gonorrhea test. There is no point in any other testing after this sort of event. If I were in your situation, knowing what I know, I would not get tested for anything and if I had no symptoms within a week I would continue unprotected sex with my wife, with no fears.
Best wishes-- HHH, MD
Sometimes I wonder if you guys know how much a reply like this can mean to somebody like me. I know I am being irrational, and I have read plenty of other threads regarding similar issues, but to read those calm, rational and easily understandible words is worth so much in a moment of personal and medical doubt. Thank you.
I will wait for a few days to see if any symptoms occur and get a test at the end of the week. I booked a business trip to avoid any complicated conversation with my partner, and hope that neither symptoms nor positive results will occur and that I can come back without risking her health which is my main concern. I cheated, that is a moral issue, but she should never pay for it with her health.
Just out of interest (I am really not panicking here) why is chlamydia not a risk? TV adds in the uk seem to suggest differnently (it is "on the rise amongst teenagers") and why are you not suggesting a herpes test aswell or a NGU ?
Syphilis I gather is so rare that you only put it on your list for correctness, not for practical use?
Thanks again.
There are other discussions of this on the forum, but not for a while and this issue bears repeating from time to time. You are correct that many (most?) STD education sources say that oral sex is a risk for chlamydia. And once a few seemingly reliable sources (e.g., health departments, STD/GUM clinics, etc) start saying it, the notion tends to be perpetuated.
But the fact is that several research studies clearly show there is no statistical association of genital chlamydia with oral sex, and that chlamydia of the mouth and throat is rare, meaning that the mouth cannot be a source of genital infection.
Why the misinformation? Probably because there are so many parallels between chlamydia and gonorrhea. Both cause more or less identical symptoms (although chlamydia generally less severe) and both infections are indeed transmitted by both vaginal and anal sex. Thus, health educators tend to make the leap that the diseases are identical in all respects, which they are not. Gonorrhea is transmitted by oral sex but chlamydia is not.
Syphilis is very rare as a heterosexually transmitted STD in the US and other industrialized countries; when present, it is not frequently transmitted by oral sex; and primary syphilis of the penis usually causes an obvious sore (the chancre). Hence testing for asymptomatic infection really isn't needed in this situation.