[Question #1036] STI Risk

81 months ago
Hi there,

I recently had an experience that I am quite worried about. First off; I am a white male, 30 years old. 3 partners in my life, one as my wife of the last 10 years.

My exposure was with a 25 year old female and caucasian nutritionist I met on a camping trip and was exposed on the second night of meeting, while veryou intoxicated. We are both western Canadian.

The exposure: unprotected vaginal, oral, and cunnilingus. 

1. If I test negative for Chlamydia, Ghonerea, can I continue unprotected sex with my wife without too much worry?

2. As this is likely a high risk situation, any other tests recommended now and in the future?

3. Any other advice? Besides the obvious; condom and limitation of alcohol.

81 months ago
Would like to add; I have been tested (full plate) about 6 months ago with all negative results. And each event was quite brief: 2-4 minutes if that matters.
H. Hunter Handsfield, MD
81 months ago
Welcome to the forum. Thanks for your question.

All STDs are transmitted inefficiently -- i.e. most exposures don't result in transmission. Therefore, the risk of any STD is pretty much always quite low for any single exposure. On that account, it is unlikely you were infected. However, the risk also depends on the likelihood your partner was infected. You don't say anything about her sexual lifestyle, and you may not know. But if casual sexual encounters like this are common for her, and give her age (25 is peak age risk for STDs), you are right to be concerned.

My routine recommendation for testing in situations like this is a urine test for gonorrhea and chlamydia, which is valid any time more than 3-4 days after exposure; and blood tests for syphilis and HIV, usually at 6 weeks. Ideally you should be examined professionally, preferably around 1-2 weeks after the event; among the most common STDs is nongonococcal urethritis (NGU), which often is due to bacteria not detected by routine lab testing, only by exam plus urine testing for white blood cells. If those early evaluations are negative (gon, chl, NGU), you could safely resume sex at home at that time. The chance of syphilis or HIV is extremely low (especially in western Canada or the US) and if I were in your circumstance, I would feel comfortable resuming sex with my wife without waiting on those results, although I still recommend testing. In general, the risk of any other STD is low enough to really not justify testing, in the absence of symptoms -- i.e. I would not recommend testing for HSV2 or hepatitis.

Of course the other option is to have a discussion with your casual partner. You may find she is just as worried about possible STDs and you are. She might be able to reassure you of her low risk and/or recently negative tests; or, like you, she might get tested now and you could share your results. If you are able to contact her, I would strongly recommend this approach.

The only potential STD we haven't mentioned is HPV. However, there is no test for it; and all sexually active people are infected at one time or another, often several times; and it is almost never possible to trace any particular HPV infection to any known exposure. So in the event you or your wife developes an HPV problem in the future (warts, abnormal pap smear, etc) there will be no implications for other recent partnerships by either of you. And anyway, since everyone gets HPV, your chance of being infected is not materially higher on account of this particular event.

I hope this information is helpful. Let me know if anything isn't clear. Best wishes and stay safe--  HHH, MD

81 months ago
Thanks for your assistance,

I am not entirely sure about how promiscuous the partner is unfortunately.

I went for urine and blood tests today (9 days - results in 5 days) and will repeat in another 5 weeks. 

If initial esults return as negative, I will begin to continue my life.

Take care

H. Hunter Handsfield, MD
81 months ago
No blood test at 9 days will be useful, except as baseline to show you didn't have those infections before this exposure. All blood tests require at least a few weeks to become positive. As I suggested above, the gonorrhea/chlamydia results are probably the most important. Also, since you apparently have not been professsionally examined to check for NGU, be on the alert for discharge of mucus or pus from the penis; if nothing by ~10 days (about the time you'll get your urine results), it should be safe to resume sex with your wife, without waiting for the follow-up blood tests in a few weeks.