Mutual Oral MSM

[joesmith1]

Thanks for the forum doctors, great information here. I am a straight male who recently had mutual unprotected oral with a crossdresser/transexual (male appearing female). They tested HIV- neg back in march, but I didn't ask about other STDs, they said they always played safe (I'm assuming they meant for penetration). I found out you can get stds from oral recently. Researching, I found that risks are gonorrhea, syphillis, and HSV1 mainly.
1.a. Gonorrhea, my urethra has a chance of infection: Read in a medical study (http://www.ncbi.nlm.nih.gov/pubmed/17051493) that pharyngeal gon has 5.5% prevalence in MSM, so a 5/100 chance that the CD had oral gon. Then around 5% chance that I wouldn't show symptoms in urethra after a couple weeks, so around a 1/400 chance that I got it and wouldn't show it.
1.b. About my throat, there was no ejaculation, no pre-ejaculate or discharge from the CD that I could see or taste (CD didn't get full erection really). So there is again ~5% chance that they had asymptomatic penile gon that I could have gotten in my throat (90% asymptomatic), but chance of this is very low.
2. HSV1, Syph - No sores seen/felt on the CD, so very low chance, and syph is especially rare in the states.

I was recently tested full panel a month ago and this is my first screw up this year. I ask because I am trying to get back with an ex and don't want to give her something that we'd both be asymptomatic for and destroy her reproductive health, mainly me going down on her frequently and giving her gonorrhea (she's clean). I am going to wait a few weeks to do anything with her to make sure no signs of urethral gon, syph chancre, or HSV show, but is testing really warranted for this encounter? FYI, I already know I'm paranoid about STDs. Thanks.

[markrainaw99]

Hi Doc
I am a male 25 & Virgin all my life.
I have a girlfriend shes divorced & 33 years old with 2 Kids. She is HIV negative & i am also HIV negative as per our medical reports almost 5 6 months ago.
I slept with her 2 days back.
We had lots of kissing.
She gave me oral also i had intercourse with her for 3 minutes without condom & i ejaculated by taking out my penis on a tissue paper.
The same hapened twice that night. I told her to use condoms but she dis agreed & said laughing shes not a prostitude & she is clean so i am.
After that i just got a few sneezes after that else everything is good with me.
So i should believe i am safe & can i continue with her.
Need for guidance. Thank u

[Mj8103]

Hey doc I sex with a female  I met online I used a condom I wanna know am I safe and I took a hiv test on 29 day after I had sex so am I ok.

[Edward W Hook, MD]

Great.  That is just what we would advise.  EWH

[joesmith1]

Thanks Doc. I got a very mild sore throat on Saturday (6 days after), but I'm gonna chalk that up to one the 1000s of other things that can give you a sore throat. At this point I'm going to go with your recommendation to skip the testing and get on with my life (sexual and otherwise). Thank you very much for the reassurance and the great work you and Dr. Handsfield do here.

[Edward W Hook, MD]

If you are asking if you should be worried, the answer is no.  EWH

[joesmith1]

Your comment is extremely helpful Doctor. Figuring that there is maybe a 1/100 chance for me having pharyngeal gonorrhea from this encounter (a stretch, 5/100 CD asymptomatic x 20/100 transmission), that even in that 1% chance, it would still be extremely difficult to transfer to a female during oral on her, right? Since the infection site is at the back of the throat (I figure if there was more than a trivial amount of GC in the mouth, they would be taking mouth swabs, not of the throat).

[Edward W Hook, MD]

Welcome to the Forum.  I'll be glad to comment. I I agree with your reasoning but would guess that your estimates are higher than they should be. The one thing you did not factor in is that if your partner was infected, your risk for infection is no greater than 20% (i.e. infection occurs less than 20% of the time with exposure to an infected partner) and probably lower depending on which STI you are talking about.  If I were you, I would not worry and would not test.  If you wish to be completely sure however, the fastest way to get this sorted out is to test for pharyngeal gonorrhea (of the infections you might have gotten this is, by far, the most likely) with a swab specimen from the throat. When this is negative, you can move forward without any concern at all.    

I hope this comment is helpful.  EWH