[Question #11308] STI scare

15 months ago

6 days ago I went to an Asian massage parlor. Had oral sex ( with a condom) then vaginal penetrative sex with the same condom. She put the condom on. No breaks at all. She removed it herself

It was my first and last time. Now I'm just paranoid of HIV and syphilis. Condom was intact.

I'm so freaked out I already ordered a HIV PCR Test 9-11 exposure one

And a RPR that supposedly will be accurate at 14-21 days. Now my questions

1. What are my chances of contracting HIV and syphilis, given I used a condom

2. Will the tests above be accurate if I get the HIV rna NAT test at day 9 and then the RPR at day 14?

3. am I overthinking this? Do CSW at Asian massage places have high rate of STI's in the U.S.

Thanks

H. Hunter Handsfield, MD

15 months ago

Welcome to the forum. Thank you for your confidence in our services. And thanks for succinct questions; I'll go straight to them.

1) You describe a very low risk sexual exposure, with very low chance of HIV or syphilis. Condoms work, and how they are applied (or who applies them) doesn't make any difference.

2) Both tests were a bit too early. I would estimate the HIV NAAT at 9 days would detect 80-90% of HIV infections. You might consider another test when 12-14 days have passed. The RPR was way too early -- it would rarely detect syphilis after only 14 days. Assuming you do not develop a chancre (syphilitic ulcer) of your penis within the next week, that will be good evidence you didn't acquire syphilis; but for a conclusive test result, you'll need to wait until 6 weeks after the exposure.

3) Yes, I would say you are overthinking the risks. However, I am unaware of any data on the frequency of STIs in massage parlors, Asian or otherwise. I would guess it's quite low.

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

HHH, MD

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15 months ago

Do you think it's warranted I take the rapid syphyilis test?

Or any earlier screening test or you think I am fine and continue to just get screened during my annual physicals,

I have a partner and I just don't want to give her any STI/STD, that's my major concern as we have unprotected sex

H. Hunter Handsfield, MD

15 months ago

If somehow I were in your situation, I would feel no need to test for either HIV or syphilis and would continue unprotected sex with my wife without worry. If such testing is included in your routine physical exams, it absolutely is OK to wait until that next occasion.

That said, sometimes people choose to be tested strictly for reassurance -- they feel more confidence in test results than professional opinion, no matter how expert. (We don't take it personally!) So feel free to test if you find yourself still wondering and worrying about it -- strictly for reassurance, not because of actual risk.

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15 months ago

Everywhere on the internet, said condoms do not protect against syphilis and that's why I was so freaked out

H. Hunter Handsfield, MD

15 months ago

I'm sorry, but you're flat out wrong: while you certainly can find such information on the internet, it's nothing like "everywhere". There is plenty of internet advice about how effective condoms are against syphilis or other STIs. Condoms indeed are most reliable in preventing infections transmitted through genital fluids (gonorrhea, chlamydia, HIV) and somewhat less effective against those transmitted by skin-skin contact (syphilis, herpes, HPV), but still over 90% effective against syphilis. Like many or most anxious persons, your online searching probably leads you to selectively see the information that inflames your fears. You'll do better if you limit searching to sites run by professional organization (like CDC, public health, academic sources) or professionally moderated ones (like this forum); and avoid those run by and for people at risk (like Reddit, for example).---