[Question #1232] Risk Assessment with escort

50 months ago
anything? I'm also not showing any symptoms. I had a cold for like 2-3 weeks(coughing and congestion) but I don't think that had nothing to do with anything. I thought I had swollen lymph nodes and my jaw was hurting. Should I go for further testing?
50 months ago
Hello. Six weeks ago I had protected sex with an escort. I'm positive there was no skin to skin contact. It was protected oral and vaginal sex. The whole thing may have lasted like 5 mins. I'm worried about HPV and other STDs. I got a HIV RNA test at 17 weeks and it was negative. I also tested for clamydia, gonhorria, trictomasis, and syphillis at 16 days and it was negative. Then my anxiety got the best of me and I took a 4th generation HIV Antibiotics test at 5 weeks. Is there more testing should I do to have ease of mind and a clean bill of health?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Welcome to the forum. Thanks for your question.

First, congratulations on the wise decision to make this a very safe exposures, especially since you used a condom, even for oral sex. As described, your exposure was very low risk for any and all STDs, both because most escorts (expensive female sex workers by appointment) are believed to have low rates of infection and because you had entirely safe sex. In addition, you had highly reliable tests. Your HIV test results are definitely conclusive. The standard tests for chlamydia, gonorrhea, and syphilis also are conclusive; for sure you caught none of those. The available trichomonas tests are designed for use only in women, and their performance in men is uncertain. However, they probably are highly reliable.

As for your symptoms (I'm not sure why your follow-up question appears first), no STD causes cough and nasal or chest congestion. I agree that it had nothing to do with the sexual exposure.

So you should not have any more tests. You acquired none of these STDs during that exposrue. You indeed have a "clean bill of health" and certainly should have "ease of mind".

I hope this has helped. Best wishes and stay safe--   HHH, MD

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50 months ago
Thank you!!! This has helped me ease my anxiety. So to clarify, I shouldn't do another round of testing at the 3 months mark in order to be conclusive results? I don't need to worry about herpes, hepatitis, or HPV from this exposure? Thanks again for the reassurance 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Three months is old news in regard to HIV. The 4th generation tests are conclusive at 1 month and afterward. You also had the negative DNA test at 17 days (I assume you meant days, not weeks).

In my reply above, I was very careful to say "you acquired none of these STDs", meaning the ones you were tested for. The chance of any of these additional viral STDs always is very low after any single exposure, especially one that was condom protected and in which you were careful to avoid skin to skin contact. Even without those protections, in our STD clinic we would not test someone for HSV or hepatitis after any single exposure unless there are symptoms.

As for HPV, there is no available test anyway. But the chance you were infected is nil.

All in all, you can go forward without further testing for anything and with confidence you weren't infected.

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50 months ago
Thank you so much!!!!! I did mean days. Sorry about that. I think this might be my last follow up question, if not you can close this thread. Is there any symptoms I should be looking out for since it has been six weeks since my exposure? I  think I am experiencing weight loss or loss of appetite but then again I could be stressing and having anxiety attacks. My neck feels swollen and sometimes it is hard to swallow if I'm laying on my back. Am I just stressing myself out? Can I take a test for these other STDs to have further piece of mind or would that be a waste?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Those symptoms do not suggest any STD at all and I would not attribute them to the sexual exposure, except possibly through the psychological connection you mention yourself. Whenever someone suspects his or her own symptoms have an emotional/psychological origin, usually s/he is correct.

All humans are evololutionarily and psychologically predisposed to link sequential events causally; and to overemphasize some events over others. You are focused on the sexual exposure, but in the past 2 months you have also had innumerable nonsexual interactions with other people, environmental exposures that you dismissed or were unaware of, and large numbers of foods, perhaps restaurant meals, etc. There is absolutely no biological reason to suspect the sexual event as the cause over all these other much more numerous events, except perhaps for some anxiety or regret about a regretted sexual decision. I cannot say whether additional STD testing would help you get beyond these worries or your symptoms, only that there is no reason to suspect any STD as the cause. Even if one of those tests were positive, I would chalk it up as coincidence. A positive result for, say, HSV2 or hepatitis B would not explain your symptoms and would probably not be the result of this particular exposure. At a personal level, if somehow I were in your situation, I definitely would not have any further tests of any kind. But I'm not you and cannot make the final decision about it. Medically I don't recommend it.

If your symptoms continue, it would be wise to see a doctor. In that case, I suspect s/he will also agree that no physical illness is the cause.

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