std risk

[jessisscared]

Dear Doctor,

Thank You for providing such a great service.

My situation:
A month ago I discovered that the man I was dating was married. We were having unprotected sex/oral and he was also having unprotected sex with his wife. This has given me much anxiety with regards to my risk of catching an std.

Around 7 months ago we also attempted to have unprotected anal sex but he didn't actually penetrate all the way but tried to repeatedly that one time. A month ago after we stopped seeing each other I tested negative for all stds. I had been having some anal discomfort, primarily anal itching after going to the bathroom but never thought much of it and did not mention it to my doctor when I went to test.

I still have it a month later and after reading today on the internet that gon/chly/trick can infect the anus and the throat I have become concerned as I didn't realize this and didn't bother to mention it to my doctor.

My concern is do I need to return and get a throat and anal test done? Attempted anal once but had oral repeatedly.
Am I at high risk?
I'm embarrased about having to get an anal exam from my male doctor and would really like to avoid it if possible!

[Edward W Hook, MD]

My assessment is that you do not need a throat culture.  My advice is to put this entire business behind you and move on.  EWH

[jessisscared]

Doctor:

A follow up question:
This situation and your advice has made me think back to all my previous partners. I never really used protection for giving oral sex in the past. Just had the vaginal test done always.  I called my doctor today, the nurse said she didn't think it was necesarry, that they don't do the throat culture. Wasn't the least bit helpful or understanding. I feel so stupid and uneducated for not realizing the risks associated with oral sex.

I'm debating about getting another gynecologist but wanted to ask if you think I should get the oral swab done?

[Edward W Hook, MD]

No, gonorrhea would stay where it was inoculated, not travel to other sites in your body.  EWH

[jessisscared]

Thank you for putting me at ease. Based on your response I feel pretty confident about not getting tested again. Wondering can gonorrhea travel from the throat and infect other parts of the body? If so I will get the tests done if not then I'm not going to worry about it.

[Edward W Hook, MD]

I suspect that your risk of infection is low.  Here are the reasons:

1.  He was married.  For better or worse that likely means that you and his wife were his only partners. Both of your are low risk.  Therefore his likelyhood of getting an infection from either of you and transferring in through him to the other is low.
2.  The most vulnerable site for infection is your cervix which would be infected with vaginal sex (numerically more exposures over a longer period of time) vrs. possible oral infection which is less likely to occur and the rectum which was never exposed through penetrative sex.
3.  Your most likely site of infection was tested and is negative.

Does that mean you are infected- no, but it makes it quite unlikely.  I do not think you need testing at this point. At the same time, i can understand if you would like to be absolutely sure.  If this is the case, i would suggest going to your local health department where you can be examined by experts for who confidentiality is of great importance.

Finally what about your symptoms.  I suspect they are unrelated to your exposures.   I hope this is helpful.  EWH

[jessisscared]

I noticed many people provide a timeline for you so here is mine to better explain:

july-07-starting having unprt intercourse/oral
sept-07-anal incident

april-08-stopped having intercourse, noticed itching started
may1st/08- tested negative for stds

may17/08-tested negative again