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Throat Gonorrhea and HIV risk

May 2, 2009

Hi Dr Bob

Thanks for your answer regarding oral sex, poppers and alcohol from a few days ago. I was diagnosed after the two sex encounters with throat gonorrhea and treated with antibiotics. Just a quick follow-up question as the more I delve into internet research (elsewhere), the more confused I get. I presume I contracted Gonorrhea from pre-ejaculate given that neither partner came in my mouth. I read that small amounts of HIV can be present in precum and if either partner was HIV+, Im assuming that the same precum that passed on G may have contained HIV. Given my STD tests prior to the two encounters described in my prior email were negative on all STDs (HIV & Syphilis two weeks prior and Gonorrhea / Chlamydia about two months prior), and assuming they were true negatives, was is the risk of concurrent transmission of gonorrhea and HIV from the same pre-ejaculate, assuming a HIV+ partner?

I now feel totally turned off sex, am low on energy and am experiencing dizziness which I guess are all symptoms of depression. I have always assumed that oral sex was very low risk, always practiced safe anal sex, get regularly tested for STDs and this recent episode is the first contraction of an STD for me in a number of years.

Thanks again for your clarity and sanity

Response from Dr. Frascino


You're welcome. Regarding gonorrhea, it's important to point out that gonorrhea is much easier to transmit and contract than HIV. Yes it's possible to contract both HIV and gonorrhea (or other STDs) simultaneously. However, just because you contracted gonorrhea doesn't automatically mean you contracted HIV as well. The issue of increased susceptibility to HIV when other STDs are present involves the inflammatory process involved with gonorrhea, herpes, syphilis and other STDs. The inflammatory reaction recruits white blood cells to the infected area, which increases the risk HIV can set up shop. It primarily involves someone having an STD (particularly one that causes blisters, sores, lesions or considerable inflammation) being more susceptible to then contracting HIV if exposed. I cannot give you a specific risk estimate regarding concurrent transmission, as there are far too many confounding variables. Your best option is to get tested at the three-month mark. The odds remain all in your favor that you did not contract HIV from oral sexperiences.

Finally, don't be totally turned off to sex! Just be informed about its realities as well as its limitless pleasures.

Good luck.

Dr. Bob

Just moved to SF
Genital Herpes

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