QUESTION
If the discharge from my penis that was just discovered this morning turns out to be gonorrhea, could the person whom I performed oral sex on six days ago have given it to me? Could I have given it to him if the test results reveal there is nothing found in my throat culture?

ANSWER
It is possible that you were exposed to it within that time frame if you had oral sex with him and he had it. He’d have to have had it in his throat to pass it your penis. Sucking him could not have spread gonorrhea to your penis. When it comes to getting STDs, it’s important to think about location and action. Therefore, if he has an STD (i.e. gonorrhea) in his penis, you can be exposed two ways -- through unprotected oral or anal sex. Both the anus and the mouth are locations where an infection can be transferred to you and likewise where you can transfer an infection to someone else. Simply put, the infection needs to come into contact with the mouth/throat, the buttocks, or the penis. We do know that in some cases you or he might not have any symptoms

Most men develop symptoms of gonorrhea within two to five days after being exposed, with a possible range of one to thirty days. Although most women are asymptomatic (without symptoms), for those who do have symptoms, they usually appear within 10 days after being exposed. Men who have gonorrhea in the penis or anal area may experience a discharge from the head of the penis or the anus; pain or itching of the head of the penis; swelling of the penis or testicles; pain and/or burning upon urination; frequent urination; anal or rectal itching; white anal discharge; and/or pain during bowel movements. Women with gonorrhea may have a discharge from the vagina; lower abdominal pain, especially during or after sex; unusual bleeding with cramping; pain or burning with urination.

If you are HIV+ and have gonorrhea, the area where you are infected, can have a high amount of HIV. If the gonorrheal infection is in your penis, you can shed 8-10 times more HIV in your semen

If you are HIV- but have gonorrhea, the disease-fighting cells of your immune system are especially susceptible to HIV if you have unprotected sex with an HIV-infected partner. Rectal gonorrhea increases the risk of contracting HIV through anal sex by ten to twenty times.

There are several different testing options for gonorrhea. Your medical provider will decide which one is best given your situation and the lab facilities available at the clinic or medical practice. Some tests are done on a urine sample, and some on a swab of the secretions from the infected area. It's important to talk to your partners to maintain your sexual health and that of our community. Also you must abstain from partner sex for one full week from when your antibiotic treatment is started.

Using condoms (male or female) for sexual activity is your best bet for protecting yourself. Since gonorrhea can be transmitted during oral sex, primarily mouth-to-penis or penis-to-mouth contact, some people use condoms during oral sex. Also, we recommend regular STD checkups every six months if you're sexually active with more than one partner. Gonorrhea and other bacterial STDs are curable with proper diagnosis and treatment.

For treatment, you can visit the San Francisco City Clinic at 356 7th Street, San Francisco. You can get tested and receive treatment for a total of 10 dollars, regardless of whether you have insurance or not. They will diagnose you, give you a pill, and that will clear up your gonorrhea infection. Give them a call at 415-487-5500 or visit them in person to get tested. Visit them online at www.sfcityclinic.org.

For further information on gonorrhea, you can call the Center for Disease Control STD hotline at 1-800-232-4636. When you call, you can speak to someone directly and ask questions about gonorrhea, other STDs, or any other topic associated with your sexual health. It is completely confidential.

To your health,
Dr. K