[Question #10097] Syphilis risk
 |
25 months ago
|
Dr's HANDSFIELD/Hook, I have what may be a stupid question. I read on your various posts that transmission of syphilis between heterosexuals is rare in the US. 12 days ago I met an old friend and had sexual contact. I did not see any sores or feel anything. Most of the time was rubbing/fingering her vagina. I did insert my penis in her vagina several times and took it out each time. All told I was inside her for about 1 minute. She is a US citizen but lives most of the time in Costa rica. I just read an article this morning that said syphilis is rare in the US. But that one of the highest incident rates for Syphilis is Central america. I do not know if she has sex with Costa Ricans or sex with expats who live there. What are the chances of infection given this scenario? Does anything change the risk of syphilis infection because she lives most of the time in Costa rica? Should I take some type of antibiotic? Should I get tested? I do not have any symptoms at this point. Thank you
 |
H. Hunter Handsfield, MD
25 months ago
|
Welcome back. Thanks for your confidence in our services.
There's obviously no way to predict the likelihood of active, transmissible syphilis is any particular individual, assuming no direct knowledge of symptoms, exposure to a known case, etc. National origin statistically can tell what proportion to expect to be infected in say 1,000 random people, but not for just one person. But even if syphilis is ten times more prevalent in Costa Rica than in the US (and I doubt it's that high), still fewer than one in a thousand people would be infected at any point in time. I would further guess that most American ex-pats in CR socialize (and have sex with) other North Americans than with local citizens. All this is guesswork, but all things considered, I would consider this an extremely low risk exposure for syphilis.
Another aspect is that the data are quite clear than having sex with people one knows personally is generally low risk for all STDs. People at serious risk tend to be especially careful to protect those they know and care about. In other words, your characterization of your partner as "an old friend" suggests low risk.
I certainly would not advise treatment to prevent syphilis. You might consider a urine test for gonorrhea and chlamydia, which are far more likely than syphilis. Urine testing is any time more than 4-5 days after exposure and so would be valid at this time. Assuming no typical syphilis symptoms in the next week or so (up to 3 weeks after exposure) -- i.e. a painless penile sore (chancre) -- you could have a blood test at 6 weeks. And while you're at it, probably also test for HIV at that time. That's even less likely than syphilis, but usually is routine when any STD testing of any kind is done -- and even though the chance is near zero, better safe than sorry, right?
I hope these comments are helpful. Let me know if anything isn't clear.
--- |
25 months ago
|
Dr hansfield, thank you for the quick reply. Your response is very reassuring. At least when I use to spend time with her she was very careful about her health. I suspect that is still the case. It doesn't seem like you're recommending any testing, although that if I wanted to be sure I could do that. What are the odds of her having chlamydia or gonorrhea? I guess the reason I'm asking, is I don't have health insurance and to go get tests for HIV chlamydia gonorrhea and at 6 weeks syphilis, might cost a bit. Would you advise on doing those things? If you do I'll pay the money and go have those tests thank you
|
H. Hunter Handsfield, MD
25 months ago
|
I can't predict the odds she has gonorrhea or chlamydia any better than syphilis or HIV; but my comments above are consistent with very low risk. In absence of symptoms, I consider testing optional for anything. Perhaps you could be in touch with your "old friend" for a reassuring conversation. You might find she is just as concerned about STD/HIV risks as you are. After all, on average women are more at risk from their male partners than men are from women. Why should she be any more confident in your sexual lifestyle and safety than you are in hers?
In many communities in the US, there are health department STD clinics that offer cost free testing, if you'd like to check out such options.
--- |
25 months ago
|
Thank you doctor. I forgot to ask one thing in my reply, does the duration, about 1 minute, of penetration lesson the chances of infection from any of the STIs we're talking about? Also I will see if I can Broach this topic with her and perhaps see if there's a clinic where I can have these tests done. Thank you
|
H. Hunter Handsfield, MD
25 months ago
|
Reduced duration of contact undoubtedly lowers the transmission chance, if one partner is infected, but there are no detailed data on it.
That concludes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.---
Be clear: I'm not recommending testing, only as an option for you to consider for reassurance. The odds you acquired any STD are very, very low. If somehow I were in your situation, would have the conversation with your partner friend; and if she confirms she has no known transmissible STD and has not been at significant risk, I wouldn't be tested at all and would continue unprotected sex with my wife without worry.
---That concludes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.---