[Question #12849] Single incident unprotected vaginal
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4 months ago
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I had a casual relationship with an out of state business colleague over 10 years ago. We often slept together when traveling. Since then I became married with children. While traveling for business again, I made the huge drunken mistake of having unprotected vaginal sex with her as we had done in the past, years ago, with no issue. I’m deeply traumatized by this mistake. She is 58 yr old white and I am 49 year old white. She has been divorced for many years and has a high role in her company.
I am scared of going home and infecting my wife with something. I’m sure I won’t be able to hold off on sex too long without being overly suspicious. The event Happened 60 hours ago and i have no symptoms.
1) deleted it was repetitive.
2) Based on our previous experiences and our demographic info, would this be considered low risk?
3) what are the odds of sti transmission for one event like this, roughly lasting 20 min.
4) if you recommend testing, how quickly can I do it prior to returning home?
5) when would I see symptoms, and what are the odds of being asymptomatic? If I had to test, the window for me to do so would be 4.5 days after exposure, prior to me returning home.
6) if I came to your office, would you highly recommend testing?
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Edward W. Hook M.D.
4 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. Overall this was a low risk encounter. You did not get STI from this partner years ago and, if anything, the risk of infection is lower from an epidemiological standpoint (STI risk, in general, decline with age). Further, even if she were infected, which seems unlikely, most single encounters do not result in transmission of infection. Further comments related to your specific questions below:
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1) deleted it was repetitive.
2) Based on our previous experiences and our demographic info, would this be considered low risk?
See above. I would characterize this as a low risk encounter.
3) what are the odds of sti transmission for one event like this, roughly lasting 20 min.
Low- if she were infected there would be, at most, a 30-40% of becoming infected.
4) if you recommend testing, how quickly can I do it prior to returning home?
Testing for the most common STIs, gonorrhea, chlamydia, and trichomonas can be performed on a urine specimen any time after more than 3 days and will provide reliable results.
5) when would I see symptoms, and what are the odds of being asymptomatic? If I had to test, the window for me to do so would be 4.5 days after exposure, prior to me returning home.
If symptoms were going to occur they would typically begin at 3-7 days after the encounter.
6) if I came to your office, would you highly recommend testing?
Testing is always a personal decision. You are clearly anxious about this encounter and despite the low risk for infection, I suspect a negative test would provide relatively quick reassurance. If you are still on the road, you may be able to access testing at this time. If you test, I anticipate that the results will show that you are not infected.
I hope this information is helpful. EWH
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4 months ago
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Thank you for the detailed, rapid reply! I feel some relief reading through your thoughts. My testing concern is visibility in the quest portal. Even with negative, I’d then be spooked there is a trail of my efforts that could be seen.
My question, if I do not test, and I do not have any discharge, burning or itching symptoms of the urethra, would you then change the risk from low to none? How often could something like chlamydia be asymptomatic?
I’m debating taking the 7 days to for the reasons stated above, if indeed no symptoms coupled with the low risk would be all the confidence I should need.
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Edward W. Hook M.D.
3 months ago
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Sorry for the delayed response. I would have confidence in the confidentiality of the Quest site. Given the low risk nature of the encounter you describe, I do not feel strongly that testing is required. EWH---