[Question #10053] STD’S

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26 months ago
I recently inquired about having unprotected sex 2 times in the same night with a very high risk male. I am a female who is 40 years old. He has committed so many crimes and been arrested many times. Drinks alcohol constantly and I know that alters a persons way of thinking.  I just know some history and I’m sure there’s a lot I don’t wanna know. He did take the oraquick test when I asked him to. Not sure if he swabbed his mouth completely right but that came out negative. 
1) Is the oraquick test reliable?  
2) I am also very worried now about hepatitis and herpes and all other stds after knowing his history so when is the best time to test for other things like herpes and hepatitis?  
3) Are the chances high of having some type of std from this encounter?  
4) Is it common and easy to get hepatitis from this encounter?  
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H. Hunter Handsfield, MD
26 months ago
Welcome back. I'm taking this question, but I reviewed your recent discussion with Dr. Hook. I agree with all he said.

Smart move, asking your partner to be tested for HIV -- and I'm glad he agreed. Directly to your questions:

1) The oral fluids HIV test (Oraquick) detects about 98% of HIV infection, so his negative result is highly reliable; almost certainly he doesn't have it. Since it's not quite 100%, it would be wise for you to have a final AgAb (4th generation) HIV test after 6 weeks. But you can stay mellow in the meantime:  it will be negative.

2,4) Even if your partner had HIV, or if he has genital herpes or HBV, the chance of infection from a single exposure is very, very low. Were you vaccinated against the hepatitis B virus (HBV) in childhood? You're of an age when many but not most kids were immunized. If, so you are not at risk. And the frequency of heterosexual transmission of HBV is extremely low anyway. Even if not vaccinated, the chance of hepatitis from the exposures described is extremely low. As for herpes, the blood tests are not very accurate, and false and misleading results are common. Assuming you do not have symptoms of herpes (painful genital blisters or sores), I would recommend against being tested. And like HBV, the average risk of new genital herpes is under one chance in thousands, maybe millions.

3) Those comments largely answer this question. It would be wise for you to be tested for chlamydia and gonorrhea, if not yet done. As Dr. Hook said, the tests are reliable once 4-5 days have passed since exposure. You can expect negative results.

The style and tone of your questions, both the previous thread and this one, indicate a far higher level of fear and concern than is warranted. I agree your partner seems to be at high risk, and it seems he's not a highly responsible personality. (But maybe his agreement to be HIV tested suggests he's not all bad!) Try to separate your obvious emotional response to him and the sexual events from actual STD/HIV risk. Transmissible STDs are a lot less common, even in the most sexually irresponsible persons, than you might assume. Statistically, it is unlikely he had anything of concern; and even if infected, most sexual exposures do not result in transmission. (For example, I cited the very low risk for HIV above.) Try to take a level-headed, analytical approach to all this. The odds are very much in your favor, i.e. unlikely you have any STD.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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