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Asymptomatic STDs passed on

Thank you in advance.

I am 25 year old heterosexual male who has had multiple unprotected oral sex (receiving fellatio and giving cunnilingus). Tested for chlamydia, gonorrhea, syphilis, and HIV yearly and always negative, but no testing for herpes and no throat testing.

Recently had a small (1/4 diameter of a dime) red shiny flat spot on penis head (just above rim), no pain, no itching.  Red spot appeared six weeks after my only possible exposure of mutual masturbation with possible vaginal secretions on her hand. 6 weeks later red spot still there although maybe less red.  Doctor said it is just mild irritation and not STD. No syphilis test given.  HIV rapid test and chlamydia/gonorrhea test conducted 12 wks post exposure.

1. HIV = zero risk from mutual masturbation?

2. Should I insist to have a syphilis test following MM given the red spot?  If no syphilis test, should I be on the look out for secondary syphilis symptoms such as rash or fever? Secondary symptoms always present?

3. Always use condoms with girlfriend.  Is throat to vagina transmission of chlamydia/gonorrhea possible? Never had throat symptoms following cunnilingus with other women, but never been tested either.

4. Is transmission of chlamydia/gonorrhea via outside of condom to vagina possible? Once I started to unroll condom on wrong side and flipped it so worried that asymptomatic chlamydia could have been spread via condom. My gonorrhea/chlamydia tests were done yearly so may not have caught infection that resolved itself.

5. My main concern in asking questions 3 and 4 is that girlfriend would develop PID.  She goes to doctor for yearly pap smear/examination and everything so far has been normal, but she does not get tested for STDs since we started dating. What to do?

Thanks!
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Avatar universal
It's ok.  You must have misunderstood the subtlety of my question.  The question was asking about whether chlamydia/gonorrhea is transmitted in the other direction... female vagina to male throat via cunnilingus.  Above you answered that chlamydia/gonorrhea can and is transmitted from male throat to female vagina via cunnilingus.  Although this implies that the male got the STD in the throat from previously performing cunnilingus it might be that it is limited to bisexual males who obtained the throat infection from giving fellatio to a man.

Anyway, what I take from your responses is that gonorrhea does transmit in both directions.  Although I'm still led to believe that STD infection of throat from a 1-3 episodes that is subsequently passed on to a female is rare when you compound the two low frequency events (although they do happen).

By the way, girlfriend and I have an open relationship and my coming here is because she does not want to get tested from a "possible" oral transmission.

All the best!
Helpful - 0
1024597 tn?1296022876
Is it me?

I thought

"Gonorrhoea can and is spread from males to females via oral sex"

answered this

"is it also frequently transmitted via performing cunnilingus?"

already??????? Enough. I wont be back to this.

Merv



Helpful - 0
Avatar universal
Sorry.  I misread your statement above.  I thought it said from females to males.  

So what I wanted to ask is the other question above: I understand that it is easy to transmit to throat via fellatio (thus gay men and heterosexual women), but is it also frequently transmitted via performing cunnilingus?

That will be all.  Thanks!
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Avatar universal
Could you answer my last question above: frequent cases of women getting gonorrhea/chlamydia from cunnilingus? does it happen at all?

That would be all for me.  Thank you again Merv.
Helpful - 0
1024597 tn?1296022876
Hello,

Gonorrhoea can and is spread from males to females via oral sex.

2. You said "many cases of syphilis which are not immediately apparent." Do you mean there is no chancre or chancre is mild enough to be confused with mild irritation?  The evidence against me having syphilis is: heterosexual, only mutual masturbation, red spot started at 6 weeks (a little later than usual), and red spot still present after 6 weeks.  Doctor wasn't even going to test me for chlamydia/gonorrhea and I had to insist on that so I didn't push on the syphilis.

Syphilis is a great imitator. In the HIV positive population it is common without any symptoms or signs - - it is extremely unlikely that in your position you would be syphilis positive. The many variants of syphilis are too numerous to mention here but the obvious answer is that if you are concerned to go and get tested.

Merv
Helpful - 0
Avatar universal
I just read from the CDC website that appears to be relevant to #3:

- N. gonorrhoeae is efficiently transmitted from males to females via vaginal intercourse and also by rectal intercourse and fellatio.
- N. gonorrhoeae can be transmitted from females to males via vaginal intercourse and less efficiently by cunnilingus.

It says nothing about gonorrhea being passed from male to female via cunnilingus, so I am led to believe that this does not happen. I believe it is the same for chlamydia.

link: http://www2a.cdc.gov/stdtraining/self-study/gonorrhea/gonorrhea12.asp

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Avatar universal
Thank you for your thorough and to the point responses.  I really appreciate it.

Could you please follow up on points #2 and 3?

2. You said "many cases of syphilis which are not immediately apparent." Do you mean there is no chancre or chancre is mild enough to be confused with mild irritation?  The evidence against me having syphilis is: heterosexual, only mutual masturbation, red spot started at 6 weeks (a little later than usual), and red spot still present after 6 weeks.  Doctor wasn't even going to test me for chlamydia/gonorrhea and I had to insist on that so I didn't push on the syphilis.

3. You said throat chlamydia and gonorrhea is frequent. Does this apply to heterosexual men?  I understand that it is easy to transmit to throat via fellatio (thus gay men and heterosexual women), but is it also frequently transmitted via performing cunnilingus? Also, frequent cases of women getting gonorrhea/chlamydia from cunnilingus?

Regards.
Helpful - 0
1024597 tn?1296022876
Hello Mr Anxious,

1. HIV = zero risk from mutual masturbation?

Agreed - no risk at all.

2. Should I insist to have a syphilis test following MM given the red spot?  If no syphilis test, should I be on the look out for secondary syphilis symptoms such as rash or fever? Secondary symptoms always present?

If you have multiple sexual partners then it is prudent to have a full sexula health screen from time to ytime and that includes syphilis. I also work in a very very busy NHS HIV unit in London and we see very many cases of syphilis which are not immediately apparent. These obviously are in our HIV positive population which is slightly different but it is so easy to test for it using blood samples that I think it would be foolish not to.

3. Always use condoms with girlfriend.  Is throat to vagina transmission of chlamydia/gonorrhea possible? Never had throat symptoms following cunnilingus with other women, but never been tested either.

Yes, of course - throat chlamydia and gonorrohea is eminently possible - and frequent. 90% of people who have oral or throat gonorrhoea do not know they have it - so yes absolutely get a throat chlamydia and gonorrhoea swab done asap and regularly if you continue like this.

4. Is transmission of chlamydia/gonorrhea via outside of condom to vagina possible? Once I started to unroll condom on wrong side and flipped it so worried that asymptomatic chlamydia could have been spread via condom. My gonorrhea/chlamydia tests were done yearly so may not have caught infection that resolved itself.

This is most unlikely

5. My main concern in asking questions 3 and 4 is that girlfriend would develop PID.  She goes to doctor for yearly pap smear/examination and everything so far has been normal, but she does not get tested for STDs since we started dating. What to do?

Well look buddy, you're cheating regularly on your girlfriend and you're asking me what to do? I'll let that hang in the air a bit but one thing you must do is keep her safe and if that means testing after every sexual encounter you have outside your relationship then tahst what you've got to do isn't it. Decent thing at the very very minimum.

Merv

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