[Question #10056] Transmission of STDs

26 months ago

I am back here again despite my better judgment as I could not get in with an infectious disease doctor until July and I am out of sorts.

If you recall from last post, I was positive for chlamydia on 5/18, as well as my partner, we both went through a round of doxy. He finished his tested/finish meds 5/26 and all his results came back negative, even chlamydia - I have the papers. He was out of the country 5/28 AM to 6/3. We tried to make the relationship work and had sex 6/3, we used condoms twice and the third time, the condom broke and he was inside me for probably less than a minute and realized when he pulled out to ejaculate on me. I freaked out.

Two days later from the encounter, it has felt very off down there for me. There was a tear following the sex because it was rough, which resolved with Aquaphor and deep hot baths 2 days later. But it was sort of itchy on the outside and still has been. On 6/9, I asked my OBGYN to culture me, and she said I had a small amount of normal discharge, faint odor that was more in line with BV, but my vulva looked perfect via speculum. She said it’s not impossible to have another STD, but she can’t quantify the risk for any of them besides it being low. How likely is chlamydia, gonorrhea, trich, HSV 2 likely? It’s been 10 days since we had sex and I do not see any lesions. Again, he was tested 5/26, so he would’ve had to have sex unprotected between 5/26-6/3 before he saw me. And Thank you in advance for your help.

Edward W. Hook M.D.

26 months ago

Welcome back to the Forum. I can't help but note that this is your 8th set of questions in the past 10 months, most of which have dealt with your concern that you might have gotten an STI (you've mentioned several) rom your partner who give you chlamydia. Since your last visit to the site your partner has been tested and found to be negative, you've had unprotected intercourse a single time, and you've been seen by a doctor who felt an STI was unlikely. Given that you were seen regarding STI concerns, I would suspect that your doctor took tests. When were you seen? Do you know the test results?

My sense is that you have come back to our Forum more because of trust issues with your partner than anything else. From the sounds of things, he has done things right-gotten treated, gotten tested after treatment and shared the (negative test results with you). Your remain concerned. Perhaps your genital soreness following sex is contributing to your concerns.

Not sure what more there is to say here other than, IF your partner had sex while he was traveling (again, this is a trust issue- he says he did not) having been infected is unlikely. Even the most common STIs are transmitted, on average about 20% of the time a person has an unprotected exposure to an infected partner (in other words, 80% of the time you would NOT be infected if exposed).

These are my reflections. I that, having been infected, you are worried but unless you have concrete reasons to think your partner has been unfaithful, I think you need to try to move forward. I look forward to hearing what your tests for STIs showed. EWH

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26 months ago

Hi Dr. Hook,

I realize it’s been a lot of questions, but I’ve had several partners in that time frame - not one. Two of which gave me chlamydia on separate occasions. I was seen 6/9, still awaiting results. She did not state STDs were unlikely, she said that she suspected BV but “has been wrong many times before” and cannot quantify my risk, so she didn’t rule out STDs entirely. She wants to believe it is “ low risk.” My partner, that I dated for 5 weeks, did admit to sleeping with two other women while we were together, one of which he was not protected with at all, and the other partner he was, so when the condom broke, I was very and still am very concerned. To your point, I do not trust him, and do not know who he was with from 5/26-6/3 and am just trying to understand if I should get additional blood testing. Or if I should have concerns. I’ve made some poor emotional decisions but he is also a person who is reckless with his sexual health, as he just disclosed today.

Edward W. Hook M.D.

26 months ago

I think given your situation, testing is the right thing to do.

Please note, BV is NOT an STI. It is caused when the bacteria in the vagina get out of balance, in much the same way that can happen with yeast infections which are not an STI either.

I think the fact that your partner was truthful about his poor choices is a good sign. I certainly hope that your tests will show that you were not infected. The results should be available tomorrow or the day after. Please let us know the outcome of your tests. EWH

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26 months ago

Hi Dr. Hook,

Thanks for your continued patience and understanding. I will be taking a break from here and dating for a bit!

The test confirmed BV so I am starting treatment, negative for trich, chlamydia and gonorrhea. The nurse practitioner does not believe the single act warrants a blood test, but is happy to perform one. She believes since we were both tested recently, it’s not necessary. She said she only recommends testing for HSV2 if I am showing symptoms and doing a PCR, and if I am not, at the now 2-week mark, while it is not impossible to be infected, “infection is most unlikely.” But the other OBGYN in the practice on a separate occasion said that sometimes HSV2 can lay dormant without symptoms and can show up weeks/months later on an IGG test.

What is accurate and which information do I move forward with to put this behind me? Do I need more testing? I’m exhausted from the emotions and would like to move on.

Edward W. Hook M.D.

26 months ago

Thanks for the follow up. Those are the results I had hoped for and anticipated. Just a reminder, that, as I told you, BV is not an STI and so you cannot blame that on your partner.

It sounds to me like the nurse practitioner you interacted with is on top of things and well-informed. I agree with her regarding her recommendations for when to test for HSV two I am that testing is not warranted at this time. The PCR test is the proper test to do when lesions are present. The IgG blood test is helpful in certain situations, but also has problems with false positive results and, as you already know, can take a long time to become positive. My advice is to put your fears about HSV-2 aside and move forward.

As you know, we provide up to three responses to each clients questions. As this is my third response this will complete this thread. Take care. I wish you the best. EWH.

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