What do negative STD test results after having unprotected oral sex indicate?

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Posted on Mon, 8 Jun 2015 in Sexually Transmitted Diseases
Question:
Hello Doctors,
I recently had a question answered here. It was very helpful for me. As I am a very anxious person, I wanted to also ask a specialist. Please see below this introduction my question I recently asked, as well as the follow-up advice. Could you please let me know your specialist medical opinion regarding my situation, and if you agree with the advice I have been given. Thanks!


Dear Doctors,
I am in pretty rough shape right now. I love my wife with all of my heart. I have messed up in the past. (I really hate it when people say you can never cheat on someone if you really love them, because that is not at all true).



Anyways, about 4.5 years ago I was very drunk and someone from work surprised me by following me to my hotel room. We chatted as I was drunk, and she then threw me on the bed and began to kiss me. Like an idiot (and drunk) I let it happen. She began to undo my pants and I told her I did not want to have sex as I am married. She began to give me oral and as the room spun I just laid there. Then I felt her climb on me and felt myself inside of her. After a few seconds I ended this encounter and left. I told my wife about my indiscretion, but I left out the part about sex. It only lasted a few seconds (maybe 10-15?) and I did not seek it, enjoy it or finish it. I felt it best to not make my wife suffer over this.

A few years later, I also gave brief (5 min) oral to another man one time. I was again drunk (I’ve since stopped drinking) and curious. I have never been attracted to men, but only to the idea of giving a bj. My experience was more out of curiosity as to what it was like. Well, I did not like it. After a few minutes I stopped, apologized and left. It kind of grossed me out. The reality is not what was in my mind. I guess I enjoy getting them so my mind had always been curious with the idea of giving, but I did not enjoy it. No cum in mouth. Maybe precum but not sure.



Lately my depression and anxiety is at an all-time high. I love my wife and children to death. Telling my wife does not seem like an option. If I was a betting man, I would bet that she would forgive me, but I don’t want to hurt her or risk the harmony in our family. I need my wife and kids. Without them I’m not sure I have the mental ability to go on. After my first encounter I said I would never stray again. I’ve had opportunities with other women but never had. The guy thing was a curiosity thing that kind of consumed my mind and I did not really realize the seriousness of my actions until it was over.



My questions:

1. I’ve been tested for STDs. No worry about the incident 4.5 years ago, but the more recent one does not really carry an HIV risk?



2. What about HPV? What are the odds I could have gotten HPV? My wife had a normal pap when pregnant with our third child about two years ago. I’ve had no symptoms. I want to think my encounter of a few seconds 4.5 years ago was a very low-risk one, but I’m not sure. As for oral, could I get it in my mouth from performing a few minutes of felacio and then transmit it to my wife by kissing or giving her cullingus?



3. We were both virgins before we met. Only had sex with eachother until my mistake. We did, however, both have previous oral sex partners before we were together. What is my overall HPV risk and should I be worried?

I’ve learned a lot from this, and it has really put my love for my family in perspective. I will never do anything like this again.



Any information would be very helpful to me. Thank you very much.

Asked by Me , 3 hours ago



Doctor's reply to your question above...
Brief Answer:
You have no need to panic. But you should see a counsellor

Detailed Answer:
Hi

Thanks for asking on HealthcareMagic.

I have carefully gone through the details mentioned. Let me try and answer your questions one by one:
1. HIV viral load of saliva is very low and if the other male had intact penile skin, the chances of transmission of HIV is very less. Practically you need not worry about it.
2. HPV can spread by oral sex and hence the possibility of transmission of HPV cannot be ruled out. Males infected with HPV most commonly do not present with any symptoms. At the moment, there are no tests for detection of HPV in males. If you have been infected with HPV, you could transmit it to your wife by kissing or by cunnilingus. The following links should be useful for you:
http://www.cdc.gov/std/hpv/hpvandmen-fact-sheet-february-2012.pdf
http://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm
3. The overall probability of transmission of your being infected by HPV is around 1%. I think that you need not worry about that.

I think that you should see a counsellor and discuss your situation with him. He will be able to give you some simple tips about how to deal with your situation and not to get depressed.

Let me assure once again that you need not panic.

Regards
Dr. XXXXXXX Saha

Replied by Dr. Prof. XXXXXXX Saha , 1 hour ago


Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.



Thanks for your reply. So in your estimation, I have a 1% chance of HPV from the incidents described. So in your opinion, would I be safe to try to put this out of mind and not worry regarding all sexual contact with my wife? Thanks again.

Asked by Me , 1 hour ago




Just one more question if I may...you state that if I have oral HPV I could pass it along by kissing or cullingus. I've read elsewhere that this is rare if it occurs at all. If I did have oral HVP, is it likely to pass by these methods or unlikely? And is there any concerns to my children?

Asked by Me , 1 hour ago



Doctor's reply to your question above...
Brief Answer:
The chances are very low. I do not think that you should worry about it.

Detailed Answer:
Thanks for writing back. I think of all probabilities, you should put behind the worries and proceed towards a healthy relationship and sexual life with your wife. I do not think that you should worry about a mere 1% chance that you could be infected and an even lesser possibility that you could be transmitting it to your wife, and a lesser still chance that she could get a cancer due to that. There are other things that can always go wrong and the possibility of those are much more than the chances of HPV ruining your lives. So, for all practical probabilities, you should just forget about it. Remove your worries and remove your depression.



Wishing you all the best.



Regards

Dr. XXXXXXX Saha

Replied by Dr. Prof. XXXXXXX Saha , 1 hour ago


Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.



Thank you so much. You've helped me greatly.

Just one more question if I may...you state that if I have oral HPV I could pass it along by kissing or cullingus. I've read elsewhere that this is rare if it occurs at all. If I did have oral HVP, is it likely to pass by these methods or unlikely? And is there any concerns to my children?

Asked by Me , 1 hour ago



Doctor's reply to your question above...
Brief Answer:
The chances are indeed extremely rare. You need not worry.

Detailed Answer:
You have read the right thing. The chances of your transmission to your wife by these methods is indeed extremely rare. That is the reason that I told you to stop worrying about it. There are no health concerns for your children involved.



Wish you all the best.



doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
You seem to be safe

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query in detail and I have understood your concern.

Unprotected sex, whether it was oral, vaginal or anal potentially does carry a risk of STD's.
Also, longer the sexual act lasts the greater the risk of transmission of infection.

Since you were screened for STD's after your sexual contact with a female co-worker therefore that rules out all other STD's except HPV.
I am assuming that the screening tests adequately ruled out all the other STD's i.e syphilis, genital herpes, gonorrhea and chlamydia, including HIV.
HPV can remain clinically silent for months and years. The incubation period varies from a few days to 20 months.
However, body' s own immunity takes care of HPV infection and therefore most of the infected individuals are able to free themselves of infection over time.
The good thing is that you never developed any clinically visible warts and moreover your wife's Pap smear 2 years ago was normal.

Coming to your second illicit sexual encounter, which was active oral sex and it did not culminate into ejaculation.
If the partner receiving oral sex has HIV and ejaculates into the mouth of the other sexual partner, HIV is a risk to the partner giving oral sex. Not otherwise.

HPV can definitely transmit through oral sex, whether active Or receptive/ passive.
There is no test to detect presence of hidden HPV infection in males.
However, its been long since you had these sexual encounters and moreover since you never developed any clinically visible genital warts and neither did your wife and as I already mentioned that in majority HPV infection clears by itself, therefore, I don't think you have really anything to worry.


Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 45 minutes later
Thank you. Could you let me know if you agree with the other doctor's advice and his opinion that HPV is unlikely and probably 1% or so?

Also...

1. Should I be normally sexual with my wife?

2. Is it likely to transmit oral HPv by kissing my wife or cullingus?

Thanks again
doctor
Answered by Dr. Kakkar S. 5 hours later
Brief Answer:
You can engage in all forms of sexual activity

Detailed Answer:
Hi.

I am a Specialist Dermatologist and a Venereologist.
I did my MD in skin and STD's (Venereal Diseases), therefore I am well versed with handling STD's.

Hpv can be transmitted by all forms of sexual activity i.e oral, vaginal and anal sex. Even a condom does not ensure 100 % protection.
Therefore the fact that you had an illicit contact twice does put you at risk of Hpv however whether you got it or not depends on factors like whether your sexual partners had it Or not.
It is not possible to put a number to the risk whether it is 1% or more or less. We can only say whether the sexual act was risky or risk free in terms of STD but nothing more than that.
Besides even a 1 in 100 chance means nothing because every sexual contact with a partner with unknown sexual status is considered a risky sexual contact. So even if it is a 1% risk or 0.1% risk means that it is not safe!! You would still get tested.

Since you both had oral sexual contacts prior or marriage therefore even those were a risk for Hpv infection.

However barring these 2 illicit sexual contacts after marriage you don't have any other source of Hpv infection and since it has been a long time since your last illicit sexual contact therefore most likely you are free on infection NOW! even if you got it from someone before it was most likely cleared from your system.
Whether you got it Or not initially is entirely a different matter altogether.

Points in favor that you are free of Hpv are...
-you never developed a clinical lesion i.e genital wart since you had those contacts.
-most of the Hpv infections clear by themselves over time by body's own immunity.
-your wife Pap smear 2 years back was clean means she also did not showed any signs of Hpv infection.

Yes, you can engage sexually with your wife.
Most likely you are free of Hpv therefore you can engage with all forms of sexual activity with your wife.

Nevertheless, your wife should get regular Pap smears. The Pap test is recommended for all women between the ages of 21 and 65 years old as a part of cancer screening.
Pap testing can be combined with Hpv testing also and is then known as co-testing. This would make you double sure whether there is any Hpv virus infection Or not.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 1 hour later
Thank you. This will be my final question. If I had oral HPV and performed oral sex on my wife, is this a common path or a rare path of transmitting to her? From oral to genital? Thanks. You've been a great help.
doctor
Answered by Dr. Kakkar S. 9 hours later
Brief Answer:
Oral to genital route is known but not very common

Detailed Answer:
Hi.

If one has oral Hpv, it is possible to pass the infection on to partners genitalia during oral sex. It is a known route but it is a less common route.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8886 Questions

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