[Question #11466] Risk of STD

14 months ago

Hello, thank you to the doctors and professionals on this site answering our questions - I've read through a lot of posts, but still would like clarity.

Went to see a csw at a motel. We engaged in protected oral, vaginal, and anal sex. I changed condoms 3 times very carefully. Also wore boxers and put my penis through the hole in front to prevent skin to skin contact.

I'm not worried about HIV - sounds difficult to acquire from this episode.

1. What is my risk for HPV wearing boxers and using condoms? I was vaccinated 10 years ago with Gardisil.

2. What is my risk for Gonorrhea or Chlamydia? If any fluids happened to touch the base of my penis around the condom, would there be a risk of transmission? Or only if her fluids touched my urethra or glans?

3. Is there any chance of hand to genital innoculation if I touched the outside of the condom (after anal/vaginal) and then my penis for a few seconds by accident?

4. If no skin to skin contact was made - what are the STD's I'm at risk for regarding any fluids that might have touched the base of my penis?

5. How accurate is a urine test for Gon/Chlamydia at 3 days after exposure?

6. If I already have HSV1 (no symptoms ever, but test years ago said I have a high HSV1 value) does this lower my risk for HSV2?

7. Would any fluids that touched my boxers still carry disease? Or do most of them have a short life outside the body?

Thank you, I will be scheduling tests for the next few weeks post exposure regardless.

Edward W. Hook M.D.

14 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The encounter you describe was low risk- most CSWs do not have HIV (or other STIs) and most exposures do not lead to infection (on average, the risk for infection following a single episode of UNPROTECTED vaginal intercourse with an untreated, HIV infected person is less than 1 in 2000. In your case, correct and consistent condom use would reduce your risk much more on top of that. Thus, in response to your specific questions:

1. What is my risk for HPV wearing boxers and using condoms? I was vaccinated 10 years ago with Gardisil.

The HPV vaccine provides more than 97% protection against the vaccine types of HPV and perhaps some cross protection against other, non-vaccine types. In addition, you used condoms- condoms provide about 60% additional protection from HPV. I would not be concerned if I were you

Virtually zero. Most CSWs do not have STIs, condoms are highly effective. Gonorrhea and chlamydia are not acquired from contact of genital secretions with the base of the penis.

3. Is there any chance of hand to genital inoculation if I touched the outside of the condom (after anal/vaginal) and then my penis for a few seconds by accident?

No risk. Hand to genital STI transmission is a myth

4. If no skin to skin contact was made - what are the STD's I'm at risk for regarding any fluids that might have touched the base of my penis?

None

5. How accurate is a urine test for Gon/Chlamydia at 3 days after exposure?

Your gonorrhea or chlamydia test results 3 or more days following an exposure would be conclusive.

6. If I already have HSV1 (no symptoms ever, but test years ago said I have a high HSV1 value) does this lower my risk for HSV2?

Yes, persons who have HSV-1 are at reduced risk for acquisition of HSV-2. Your risk for HSV-2 is negligible

7. Would any fluids that touched my boxers still carry disease? Or do most of them have a short life outside the body?

STIs are not transmitted by contact with contaminated material-

Overall your risk for STI acquisition is negligible. Personally, I would not feel a need to test. EWH

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