[Question #10975] Advice Needed on Potential STD and HIV Exposure After Recent Sexual Encounter
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18 months ago
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Dear Doctor,
I recently had a sexual encounter with someone I met on a dating app in the Netherlands, and I have a few concerns regarding potential exposure to HIV and other STDs. During our encounter, we engaged in unprotected oral sex (she performed oral sex on me) and had protected vaginal intercourse twice, with ejaculation each time. This happened about 17 hours ago.
I am particularly concerned because, based on our conversation, the girl revealed she has never been tested for STDs and has had multiple sexual partners. I would greatly appreciate your advice on the following questions:
1. Given the nature of our encounter, should I be worried about the risk of HIV or other STDs?
2. Considering the timeframe of 17 hours since the exposure, would you recommend taking Post-Exposure Prophylaxis (PEP)?
3. Does this exposure warrant getting tested for STDs? If so, when would be the appropriate time to do so?
Thank you for your guidance and assistance in this matter.
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Edward W. Hook M.D.
18 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. I agree with you that your recent partner's history of multiple partners and having not been tested for STIs is somewhat concerning. Even so, most people do not have STIs and most exposures to infected partners do not lead to infection. The facts that you used condoms for your vaginal sexual exposure and your only unprotected exposures were receipt of oral sex however are also to your benefit. Thus, in answer to your specific questions:
1. Given the nature of our encounter, should I be worried about the risk of HIV or other STDs?
Overall your exposures were relatively low risk. Condoms are highly effective for STI/HIV prevention. Receipt of unprotected oral sex is NOT a risk factor for HIV. Gonorrhea can be acquired from receipt of unprotected oral sex.
2. Considering the timeframe of 17 hours since the exposure, would you recommend taking Post-Exposure Prophylaxis (PEP)?
I see no need for HIV PEP. Condom use made your vaginal exposure close to no risk and there are no cases in which HIV has been acquired from receipt of oral sex from untreated HIV-infected partners.
3. Does this exposure warrant getting tested for STDs? If so, when would be the appropriate time to do so?
I would suggest getting tested for gonorrhea following your receipt of unprotected oral sex. The value of testing too soon after an exposure is questionable. A urine test for gonorrhea (tests for chlamydia are typically done on the same specimen as tests for gonorrhea) 3-5 days following your exposure will provide reliable results. Should you become symptomatic before then (this is unlikely), then you could test then.
I hope that this information is helpful. You've done things well through using condoms and by asking your partner about her testing history. Good job! Overall your risk for STIs including HIV from this exposure is relatively low risk. EWH
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18 months ago
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Hi doctor, thanks for answering. Does that mean I shouldn't worry about hiv at all? Because that my primary concern
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Edward W. Hook M.D.
18 months ago
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Correct, I would not be worried about HIV given the fact that you used a condom for vaginal course and only unprotected exposure was receipt of oral sex. EWH.---
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18 months ago
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Doctor just one last question, I might have had the condom worn Inside out, but when I ejaculated it was still intact and didn't break. If I actually had the condom inside out would it's effectiveness reduce ? Or it would be the same amount of protection hence It covered my oenis
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Edward W. Hook M.D.
18 months ago
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As long as your condom was intact throughout the encounter, it did its job. Condoms work just as well inside out as right side out. I would not worry.
As you know, this completes this thread. Take care. EWH
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