Hepatitis from giving oral sex

[grnchilegirl]

I am a 25 year old healthy heterosexual female living in the US.  About a year ago I gave unprotected oral sex to a man of unknown sexual history or status.  I swallowed his semen.  I know this was a poor and unsafe choice and I have learned my lesson.

I recently consulted Planned Parenthood and they recommended that based on my exposure, I get tested for chlamydia, gonorrhea, and HIV. I did and all were negative.   They would not test me for others since I did not have symptoms.  

I'm now worried that somehow I could have contracted Hepatitis B from that exposure and want to get tested

My questions are:
1.  What can you tell me about the likelihood of transmitting Hep B from swallowing semen/giving oral sex?
2. If I did indeed have a Hepatitis B vaccine as a child, how long does that protect me? Would that still protect me at 25?

[H. Hunter Handsfield, M.D.]

On one hand, the chance of syphilis is too low to need testing -- in that sense, your clinician is correct.  On the other hand, syphilis testing is cheap, and if blood is being drawn anyway (for HIV), in most clinics syphlilis testing is done routinely, and we would do that in my STD clinic.

This is a legitimate difference of approach and it doesn't mean your Planned Parenthood clinic's policy is wrong, and I don't think it's worth the time and inconvenience for you to have another blood draw for syphilis testing.  However if you're the sort who is likely to sit around worrying about it (which is my impression, given the nature and tone of your questions here and on the HIV forum), it probably would be best for you to be tested.

[grnchilegirl]

Thanks Dr. HHH.  Do you agree with the Planned Parenthood clinician's assessment that I should have only gotten tested for chlamydia, gonorrhea and HIV for the exposure mentioned above? Do I need any additional testing (syphillis?) despite absence of symptoms.

[H. Hunter Handsfield, M.D.]

First, protection from the hepatitis B vaccine is believed to be lifelong.  While this isn't proven (there has been no research one way or the other), certainly protection lasts at least 10-15 years and probably for life.

Although Hep B can be sexually transmitted, most sexual transmissions occur between men having sex with other men.  In heterosexual couples, vaginal or anal sex appears to the the only regular routes of transmission.  If there is any risk at all from oral sex, it is very low; to my knowledge there has never been a case of transmission by oral sex.  As for hepatitis C, it really shouldn't be considered an STD at all, at least not between men and women. It's a proved STD only among gay men who have particularly traumatic rectal sex practices, with bleeding.

So just as for your questions about HIV several days ago, you have no worries on the hepatitis front either.

Regards--  HHH, MD