[Question #1219] Am I at risk of an STD?

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91 months ago
Hello Doctor, 
I am a 32 yo male and couple of month ago had protected sex with a sex worker. Maybe a couple of minutes vaginal then change of condom and oral. All of it wearing a condom. 
I urinated right after and washed my penis off with soap. Washed another time a couple of hours later. Same day started feeling sort of warm sensation on tip of my penis and sligjt discomfort. I know that it usually takes longer for any STD to show up so tried to dismiss it. The discomfort stayed and grew, so did anxiety. 
I went to see a doctor after 7 days and tested for STDs urine(pcr) and blood. All came back negativr and whatever symptomes i had faded away. I was just making sure to wash my genitals with special soap and keep clean. 

Now 7 weeks later my girlfriend developed symptomes of a mild UTI , something that happends from time to time but didnt happend for over a year probably. I started worrying that I could give her an infection, got anxious and same discomfort feeling came back. At the same time, I developed hemorroids. I was scared that it could be proctitis but looks like I can rule it out since I Could get it only through anal sex, right? 

Basically my question is, how reliable my test results were after 7 days of exposure? Especially for ghonorrea and chlamidiya. And if I could be at risk. 

Also, probably worth mentionning I never developed any symotomes of urethrit like burning while peeing/ discharge/etc. 

Thank you in advance
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H. Hunter Handsfield, MD
91 months ago
Welcome to the forum. Thanks for your question.

You had safe sex, with little risk of any infection. You are exactly right that the "warm sensation" could not possibly have been due to an infection acquired only a few hours later -- much too soon. (No infection can start to cause symptoms sooner than 1-2 days after catching it.) And your urine tests a week later also were conclusive.

As you apparently know, UTIs are common in women. This is a coincidence that has nothing to do with your sex worker exposure 7 weeks earlier. And as you seem to know, you cannot get a rectal STD except by exposure of the rectum itself. And hemorrhoids and procttitis are entirely different.

In other words, these are coincidental events; none of them caused the other. Don't worry about it! All is well.

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

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91 months ago
Thank you for your reply!

If you dont mind, for my piece of mind,  can you tell me how conclusive my results are after a week of exposure?

From my understanding chlamidia is not very well detected under 2 weeks of exposure. Is it with pcr as well or some other tests?

My main worry is my girlfrieds UTI, she says that it is mild and slightly going away but are there any alarming signs that I should watch for? Duration of an UTI , severety or anything else?

I apologize for maybe repeating same questions in different words but I have a great deal of anxiety and guilt about this and trying not to get to paranoid.

Thank you again for your help!
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H. Hunter Handsfield, MD
91 months ago
The urine tests are conclusive. It takes several weeks for blood tests to become positive; negative results at 1 week only show you weren't infected as of 4-6 weeks earlier.

I don't know where you read that chlamydia testing isn't conclusive until 2+ weeks. Wrong. Your negative result at 7 days is conclusive. Anyway, chlamydia almost never occurs from oral sex. If it had been positive, you would have had to look back to some other exposure.

As for your partner's UTI, re-read my reply above.

All is well. Don't confuse your feelings about a sexual exposure you regret and your anxiety about it and STD risk. They aren't the same. Deal with the former as you need to, but forget the latter. It's not an issue.

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91 months ago
Hello Dr,

And thank you for your answer.

After all, I went to the clinic to discuss my test results and make an appointmenet for rectal itch that I had. I want to make sure if it is hemorroids.

After listening to my concerns, the doctor made me do another urine test (clamidya and gon) and quick blood test for VIH. With a repet VIH test in 3 month to be by the book.

I just walked out of the clinic and a bit confused, so , maybe you can help me to answer some questions:

1)my first urine test two month ago if I am not mistaken was "mid -stream" , meaning first in the toilet then in the cup.  This time I was told to pee in the cup right away. Doesnt it make a difference? Which of these methods is correct? How reliable and could they give different results?

2) i hd a conversation about my girlfriend cystitis and from what she told me it first started in the beginning of september,  then disappeard to resurface two weeks late.r. After that it lasted for a bit longer than two weeks. Now its gone in terms that it doesn hurt/burn while peeing and urine doesnt smell but she often has a feeling that she needs to go even if it is not true. Should it be alarming? 
She also got an yeast infection at the same time, which is sort of a chronic condition for her(gets it few times a year)

3)I had a scratchy throat that would come and go , and before yesterday i inspected my throat with a flashlight and found mee small pus pockets. Could it be ghonorrea?/clam?Was it possible that i could give the jnfection to my gf through oral and then acquired it through kissing?

I am sorry for the long message but i am seriosuly worried. I dont know if I can trust these tests. Also, i keep getting this warm ( i wouldnt call it burning but noticable ) sensation around penis tip and rectum, which adds to my anxiety.  I rcently started feeling that my scrotum is warmer than usual and light pain in trsticles that seem to come and go.
Is it all anxiety or are there real grounds to be worried about? 
I am at 11 weeks after exposure. What is the best course of action?

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H. Hunter Handsfield, MD
91 months ago
I think your doctor overreacted -- although I imagine you pressed and talked him into further evaluation. I would not have recommended additional testing. And there is definitely no need to wait until 3 months for conclusive HIV testing. Three months is old news, going back to older HIV tests.

1) Although ideally urine gonorrhea and chlamydia testing should be the initial urine flow, midstream specimens probably are just as good. There is no realistic chance an infection was missed.

2) Your partner's cystitis doesn't change my opinions or advice. There is no reason to suppose it has anything to do with your outside sexual exposure.

3) Sore throat from STD is rare -- far less common than garden variety respiratory viruses, allergies, etc.

As for your other symptoms, I could use them to teach medical students about the physical manifestations of anxiety. Your fears and anxieties are magnifying trivial symptoms or normal body sensations that you would otherwise ignore or maybe not even notice. I can't say for sure that's the cause, but I AM absolutely certain they are not due to HIV, STD, or any other infection from the sex worker.

As for "best course of action", keep working with your doctor if you remain concerned. But in the long run, you may need to just live with your symptoms, knowing they don't mean anything serious. Or maybe consider professional counseling, which I raise out of compassion, not criticism.

In any case, that winds up this thread. Best wishes and stay safe (as you have done until now).