[Question #12031] Anxious

Avatar photo
10 months ago
Hello, I am a middle aged male from Canada who engaged the services of an escort exactly one week ago.  She performed brief oral on me, i performed oral on her and we had about 10 minutes of unprotected intercourse.

She assured me she was clean.

An hour afterwards i took a doxypep.

I have an anxiety disorder so had a panic attack on Wednesday and got and took 1g azithromcyn amd 800g cefixime.  

Ive experienced loose bowels simce taking, also experincing some discomfort from my prostate and slight stinging at the opening of my penis intermittently.  No discharge or pains in testicles or pelvis.

What are my infection risks? 
Avatar photo
H. Hunter Handsfield, MD
10 months ago
Welcome to the forum. Thank you for your question.

You overreacted to a very low risk sexual event -- probably truly zero risk. You should not have taken doxy-PEP or the additional antibiotics, which undoubtedly are the main (or only) causes of your current symptoms.

Escorts -- usually meaning expensive female sex workers by appointment -- generally are among the safest sex partners other than a co-monogamous spouse. For the most part they care about their health and take steps to proect it, like frequent HIV/STI testing and most use condoms consistently -- except sometimes with partners they consider risk free (men like you!). That said, of course I cannot know for certain about her infection status, but even if she had one of the common STIs, your risk from the oral sex was near zero; and only a bit higher from a single episode of vaginal sex. 

Doxy-PEP is advised only in much higher risk circumstances than these -- specifically for men having unprotected anal with other men who recently had other STIs; and having had the doxy-PEP, the azithromycin and cefixime were even more superfluous. And as implied above, almost certainly the antibiotics explain your loose stools (no STI does that); and even if not advised, they prevented any STI that could cause the minor urianry discomfort you describe. And that too might be from the antibiotic (e.g. a bit of yeast overgrowth).

My advice at this point is to do nothing. No testing of any kind; and if you have a regular partner, you continue your usual sexual practices without worry.

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

HHH, MD
---
Avatar photo
10 months ago
Thank you doctor, this really is a fabulous service you provide.  I'll look into how to make a donation to the ASHA, this is important work!

Last question would be, this escort wasn't necessary that high price ($500/hr), would your answer still apply?
Avatar photo
H. Hunter Handsfield, MD
10 months ago
Thanks for the thanks. I have no judgment about escort pricing. $500 sounds substantial to me, but I have no personal experience by which to judge either the norm or correlation with STD risk. Sorry.---
Avatar photo
10 months ago
Thanks again.
Very last question, meant to ask before, how many days for all this medication to flush through my system (ie when is the GI issues expected to subside?)
Avatar photo
H. Hunter Handsfield, MD
10 months ago
It isn't presence of the medication that is responsible for the symptoms. Antibiotics mess up the natural bacteria in the intestine. Usually things return to normal in a few days, but it could take a couple of weeks or more.

That completes the two follow-ups included with each question and so ends this thread. Thanks again for the thanks. Best wishes and stay safe.
---