backroom mistake

[arruza]

Hello.  I am a 51 y/o male and made a drunken mistake.  Last week I went to a bar with a darkroom in France.  I had been it before a few years ago (and posted here) with relatively low risk behavior and since then nothing.  This time, not so much.  I exchanged oral sex with one man my age (we gave each other fellatio), and I then gave oral sex to three other fellows--two for about a minute each and the other for probably five minutes, all guys around my age. I know this is a mistake. I would like to please know what my risks are (and how high), and how soon I can get accurate tests. If I'm reading your forum right, I am at risk not for HIV, but for syphilis, gonorrhea, and maybe ngu and chalymidia.  Thank you.  PS, I accidentally also posted this to the community forum, but I was looking for a doctor response.

[Edward W Hook, MD]

Welcome back to our Forum.  While there is some risk from your decision to perform oral sex on four new partners, as well as receiving oral sex from one partner, that risk is relatively low.  Most people do not have STIs and when they do, most exposures to infected partners do not lead to infection.

There is no known risk for HIV from receipt of oral sex and if any of your partners were infected, the risk for getting HIV from performing oral sex on an infected partner is less than 1 infection per over 10,000 sex acts.  Thus, as you point out, there really is no meaningful risk for HIV from your exposures.

In addition from receipt of oral sex there is a small risk for development of penile gonorrhea or NGU.  Both of these problems are most often symptomatic in less than a week of exposure.  If you desire testing, a urine test will be diagnostic at any time more than 2-3 days after exposure.  Your risk for these infections is low.

From performing oral sex, the main STI you are at risk for is oral gonorrhea.  This can easily be diagnosed with a swab specimen from your throat at any time three or more days after the exposure.

The risk for syphilis is even lower,particularly if your partners did not have lesions you were aware of.  Syphilis is a rare disease.  You could further rule out syphilis with a blood test  4-6 weeks after your exposure although I really do not think this is likely.

I hope these comments are helpful to you.  Take care.  EWH

[arruza]

Thank you Doctor.  I noticed elsewhere that people often say wait ten days for a gonorrhea test or even two weeks, but that may be conservative.  Are the tests more accurate if you wait longer, or are they even highly accurate after just three? Thank you again.