Dr Steve Chapman

Sexually transmitted infections

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Silent sexually transmitted infections

There are 8 sexually transmitted infections that we can have without realizing it. Below you can read the infections we see in each type of sex and a comment on HPV (human papillomavirus), another silent infection.

Oral sex is THE MAIN ROUTE of transmission for gonorrhea, chlamydia, and syphilis.

We sometimes see a few cases of Mycoplasma genitalium in oral, but penetrations are its preferred route of transmission.

Transmission is most effective from throat to penis and vice versa, but we also see these infections moving from vagina to mouth and vice versa, and also from ass to mouth and vice versa.

In the throat it is very common to have NO SYMPTOMS of these bacteria, and only tests will reveal their presence.

There are also many silent cases in the penis.

However, there have hardly ever been described any cases of HIV in oral sex, with the risk being mostly theoretical.

In my satellite laboratories we have highly advanced technology to detect these infections, with an PCR test for HIV that allows detection just 10 days after a sexual contact.

If you would like to do a check-up specifically designed for oral sex contacts, please visit our shop now.

Gonorrhea, chlamydia and syphilis are also perfectly transmitted in vaginal sex. Just like in oral sex, it is very common to have these infections and not know about it.

But we also see hepatitis B, Mycoplasma genitalium, HIV and HPV (papillomavirus) transmitted in this way. All these infections you can have without symptoms and that’s why it’s important to do check-ups after unprotected vaginal sex because they can do harm or put the health of your sexual contacts at risk.

In vaginal sex we also see 4 other infections that you can have without knowing it, but there is an important difference between these infections and the ones I mentioned above – if they do not produce symptoms they are doing no harm. In fact, they are so common that it’s estimated that 30% of the population have these infections in their vagina (in women) or their urethra (in men) without significant consequences. They are Mycoplasma hominis, the Ureaplasmas, Gardnerella and trichomonas.

But of course, you may develope symptoms of these infections we see in vaginal sex  and you can read more in the next section.

If you would like to do a complete check-up of all these infections please visit our shop.

Gonorrhea, chlamydia and syphilis are also perfectly transmitted in anal sex. Just like oral sex, you can have these infections and not know it. They are the most common infections in this type of sex.

But anal sex is a powerful route of transmission of hepatitis B, Mycoplasma genitalium, HIV, and HPV (papillomavirus). We also see cases of hepatitis C in anal sex, especially in the person receiving (being passive/bottom). 

The vast majority of these infections in the ass DO NOT PRODUCE SYMPTOMS, which is why check-ups are of great importance if you have unprotected anal sex.

If you would like to do a complete check-up of all these infections please visit our shop.

What these two practices have in common is that an infection can pass from vagina to vagina, ass to ass, vagina to ass, and vice versa.

The infections we see are the same as  in vaginal and anal sex (see above), that is to say, syphilis, gonorrhea, chlamydia, hepatitis B, Mycoplasma genitalium, and HIV, but in the case of shared anal dildos the risk of hepatitis C is greater.

If you have doubts about whether your own situation is of risk, we can always discuss this in a consultation, email or by WhatsApp.

The main risk here is if there is fisting contact with more than one ass, because hepatitis C can be passed in microbleeding from one ass to another. We also cases of the so-called “superchlamydia”, lynphogranuloma venereum in fisiting in groups.

Often there can also be anal penetration in this type of sex, and the infections that we see would be those mentioned in the above section. If you have doubts about the risk in your own situation, we can always discuss this in a consultation, by email or WhatsApp.

Hepatitis C almost never causes symptoms.

When we share rolled up tubes we expose ourselves to the possibility of traces of blood from the previous user’s nose.

Cases of HIV transmission have never been described in this way, but hepatitis C is well described. There are no other silent or symptomatic sexually transmitted infections that we see in this kind of practice except if there has also been sex.

Hepatitis C almost never causes symptoms.

If you need advice about tests specific to this situation, please write to me.

There are some studies that have described that deep kissing can transmit gonorrhea (from throat to throat), but, for reasons that we do not understand very well, it was only described BETWEEN MEN and with a very reduced risk compared to other routes of transmission (for example oral sex).

We don’t see other sexually transmitted infections in kissing.

The only sexually transmitted infection that is normal to have. 

That is to say, in the VAST MAJORITY of cases we get infected and IT DOESN’T DO HARM. Of course, it is linked to certain cancers, but between regular check-ups of people at risk (especially women and people with HIV) and vaccination programs that are spreading around the world more and more, we do not usually include HPV in routine tests after a risk contact.

If I can help you with questions about the papillomavirus, I am at your disposal.

Sexually transmitted infections and their symptoms

Here I review the symptoms I commonly see and the sexually transmitted infections that may be underlying.

– itching, burning, discomfort, even discharge
– 70% of these men will have an STI as the cause of these symptoms
– gonorrhea, chlamydia, mycoplasmas, ureaplasmas, trichomonas
 – the type of sex helps with the diagnosis (oral, vaginal or anal)

If the relevant contact has been oral sex, we think of gonorrhea and chlamydia.

If there has been anal penetration, you should also consider a third bacteria, Mycoplasma genitalium.

In vaginal sex, all these infections are relevant and also Mycoplasma hominis, trichomonas and Ureaplasmas.

These symptoms can also exist as part of an inflammation of the urethra not due to these infections or as part of prostatitis, a very common diagnosis in sexually active men.

I can help you reach a diagnosis because I have seen thousands of cases of urethritis and prostatitis.

Please visit my shop to book a consultation or choose relevant tests.

– herpes, syphilis, traumatic ulcers
 – we see herpes and syphilis in oral sex, vaginal and also anal sex

Herpes produces painful sores (ulcers) and has a very short incubation of just a few days.

Syphilis produces other sores that are usually not painful, and it is much more common between men. 

Many ulcers that I see are not related to these two infections and are from trauma or other infections that have occurred in sex.

I have many years of experience in how these cases should be handled if you would like a consultation with me

Please visit my shop to book a consultation or choose relevant tests.

– this is almost never due to sexually transmitted infections
– sometimes we see this symptom as part of infections such as gonorrhea, chlamydia etc.

It is very common to develop a sore throat after sexual contact, but in more than 95% of these cases I do not diagnose an STI.

Of course, in the same contact there wasprobably kissing and then viruses of the cold-type family got exchanged.

We occasionally diagnose gonorrhea, chlamydia and Mycoplasma genitalium in these patients. Treating this throat infection requires a lot of care and follow-up tests because it can turn into a resistant infection. I usethe most updated treatment protocols to avoid this situation.

You can book an appointment with me if your symptoms concern you.

Please visit my shop to book a consultation or choose relevant tests.

– gonorrhea, chlamydia, lymphogranuloma venereum and Mycoplasma genitalium

If you have had anal sex without a condom, you may develop symptoms in the anus or rectum. The most striking symptom of STI infection is tenesmus (the urge to keep passing stools but there is nothing left).

We also see these infections if someone has licked your ass, or sometimes even in protected penetrations (the bacteria were on the outside skin and got inside with the penetration).

These four infections require a lot of attention if we detect them in the ass, because they can be resistant to normal treatment with antibiotics. I work according to the most up-to-date protocols to avoid this situation.

If you have worrying symptoms, please do book an appointment with me.

Please visit my shop to book a consultation or choose relevan

– We only diagnose an STI in 40% of women experiencing genital symptoms. There are many other causes.

Genital symptoms in women that are mainly located in the vulva and / or vagina are not usually due to an STI. We think more of Candida (fungal infection), a bacteria called Gardnerella or trichomonas, but it is true that sometimes the cause is gonorrhea, chlamydia, etc.

However, the symptoms that indicate a “deeper” problem (of the cervix), such as pain during sex, bleeding that cannot be explained, pelvic pain etc, DO make us think mainly of STIs such as gonorrhea, chlamydia and Mycoplasma genitalium.

These three infections can also produce symptoms similar to a urine infection.

If you need guidance on any symptoms you are experiencing I can always help.

Please visit my shop to book a consultation or choose relevant tests.

– in only 10% of these cases we find an STI as the cause

We have all read about the symptoms of HIV primary infection (the symptoms of so-called seroconversion), fever, malaise, headache, flu-like symptoms, etc. But in my experience, people with these symptoms following a sexual contact have another type of virus (such as cold viruses).

If you really think you might have HIV because you are experiencing these symptoms, it requires special HIV tests, not just an antibody test.

I remind you that we usually see HIV in cases of anal sex without a condom, and it is much less likely in vaginal sex. If you want to know more about the risk of HIV in the type of sex that you do, do not hesitate to get in touch.

We sometimes see these symptoms as part of secondary syphilis (widespread infection). Syphilis is perfectly transmissible in oral, vaginal and anal sex.

Don’t forget that I offer an HIV tests by PCR detection that you can do just 10 days after a sexual contact of concern. Or if you prefer, you can book an appointment with me if you would like to discuss your case.

Please visit my shop to book a consultation or choose relevant tests.

– in only 5% of these cases we find an underlying STI

The vast majority of these cases have to do with fungal infections (Candida). Sometimes this is due to changes in the bacterial flora, having taken antibiotics etc. rather than a direct transmission of the yeast from person to person.

I also see cases of redness due to trauma in sex. Very occasionally we see a red penis due to syphilis, or because of skin eruptions that have decided to appear in the genital area by chance.

You can always book an appointment with me before deciding which tests are best for your situation.

Please visit my shop to book a consultation or choose relevant tests.

Antibiotics and our responsibility

Almost all sexually transmitted infections are treatable, with antibiotics or other medications.

Read some reflections of mine on an immense problem that we are experiencing – the resistance to antibiotics of certain STIs:

Get in touch if you have questions:


    25 min medical consultation: € 50