[Question #12941] Question about STIs risk

3 months ago

Dear Dr,

I am a male. On April 9, I hired a female escort to come to my house and provide me with protected vaginal intercourse and protected oral sex (I confirmed that the condom was not broken). She showered with me before and after the service.

I read many forum answers. I also consulted my doctor friend, who told me that the probability of contracting STIs through protected sex is almost zero. He told me that this description is implies that no risk of my behaviour, but they (as a clinician) usually don’t tell patients that it is 100% safe.

(1) Do I have any risk of contracting any STI?

(2)Since I use my sheets, pillows, and bedding, am I at risk of contracting STIs indirectly through these items?

(3) About 7 days after the sex, my penis became itchy and painful when urinating, not sure if there is pus discharge. The pain disappeared after about 7 days. These two days I feel pain in the lower left abdomen. Could this be due to gonorrhea or other STIs?

(4) I consulted doctor about question (2), and he thought it was just my excessive use of soap to wash and that was not a symptom of gonorrhea. I would like to know what the common symptoms of gonorrhea are? What are the consequences if the acute stage is missed?

(5) Do I need to do any tests?

3 months ago

Correction:

Here is "I consulted doctor about question (3)". I am sorry for the typo

Edward W. Hook M.D.

3 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The encounter you describe was virtually no risk. Most commercial sex workers do not have STIs and most single exposures do not result in transmission of infection. You further increased any risk for sTI (including HIV) from low risk to virtually no use through use of a condom which did not fail. I would not be worried. In response to your specific questions:

(1) Do I have any risk of contracting any STI?

See my comments above, this was a virtually no risk encounter.

(2)Since I use my sheets, pillows, and bedding, am I at risk of contracting STIs indirectly through these items?

No, STIs are not transmitted through indirect contact with an infected person, even if there are genital secretions present.

I would tend to agree with your doctor. The symptoms of STI would not just go away. If there was truly a penile discharge (which would have been obvious) testing might be warranted but it really does not sound like that is the case

The typical symptoms of gonorrhea are a purulent discharge from the penis which is obvious and possible slight burning on urination. Pain on the outside of the penis is NOT a sign of gonorrhea. There are few common complications of gonorrhea in men.

(5) Do I need to do any tests?

Testing is always a personal choice. As I've already said, your risk is quite low-virtually zero. Some of our clients chose to test for the reassurance that a negative test provides. If you chose to test, a urine test for gonorrhea will provide accurate results at this time.

I hope this information is helpful. EWH

---

3 months ago

Dear Dr. Hook,

Thank you for your comments.

Regarding (3), there might be some errors in my statement. I did have slight burning on urination at that time, but I'm not sure if there was purulent discharge. My doctor's evaluation is similar to yours. He thinks that if there is any, it is very difficult to ignore it (he thinks it is easy to distinguish between urine leakage and purulent discharge). Furthermore, he believes that the symptoms will not simply disappear within 7 days. Even if they spread, the above-mentioned symptoms should still exist. Is his statement correct?

I understand that my behavior is actually very safe. My concern stems from problem (2). Because I didn't replace these items in time, I only thought about the possibility of potential indirect infection when I had similar symptoms. Your answer alleviated my worry.

My doctor suggests that I can skip the test, but if I haven't had the relevant test this year, it can be regarded as an annual test. Should I have the gonorrhea test first or wait until 6 weeks for all the unified STIs tests?

3 months ago

Supplementary question: how long do the symptoms of gonorrhea last (typically)?

Clinically, is there any infection with gonorrhea/non-gonorrhea/chlamydia when using condoms?

Edward W. Hook M.D.

3 months ago

I think you are overreacting. Clearly you are worrying more than is needed. For that reason, instead of worrying, just test and prove that you were not infected.

The symptoms you describe occurred later than is typical for gonorrhea and gonorrhea symptoms would not go away in 7 days. While data are lacking as to just how long the symptoms of untreated gonorrhea would last, they would certainly last more than seven days

You are concerns about exposure to potentially contaminated bed, clothes, sheets, etc. are scientifically groundless. Please reread my original response. That answer is not going to change just because you repeat your questions.

You have one follow up question remaining. Repeating your earlier questions or asking what if questions will serve no purpose and will not help you. EWH.

---

3 months ago

Dear Dr. Hook,

Thank you for your generous support and patience!

I will schedule a test after 6 weeks or include it in my annual health check.

While reading posts on this forum, I would like to ask several questions:

Is my understanding correct that kissing or licking any body part (e.g., breast, nipple, face) except genitals carries no risk of STIs, and that saliva poses no risk?
Does frottage between genitals (with condom, no penetration) pose any STI risk? Is there a risk if genital fluid contacts skin outside the condom? If so, what is the approximate level of risk?
Do syphilis chancres appear only in the mouth, genitals, and surrounding genital areas? I noticed a 1mm black spot resembling a mole beneath my nipple. After closer inspection, it appears to be normal pigmentation beneath the epidermis (I haven't found any STIs that cause such symptoms on Internet).

I apologize for the many questions! Thank you again for your patience and for providing such a valuable platform to help people understand STIs and reduce anxiety.

Sincerely

Edward W. Hook M.D.

3 months ago

Final responses. Following these responses, the thread will be closed. As your own doctor has already told you, because new discoveries are being made on a daily basis, there are no absolutes in medicine and science. That said, the risk of the encounter you describe was virtually zero. As for your specific questions:

Is my understanding correct that kissing or licking any body part (e.g., breast, nipple, face) except genitals carries no risk of STIs, and that saliva poses no risk.

Correct

2. Does frottage between genitals (with condom, no penetration) pose any STI risk? Is there a risk if genital fluid contacts skin outside the condom? If so, what is the approximate level of risk?

There is a theoretical risk that STIs like syphilis, herpes and HPV might be transmitted in this way but transmission in this situation is virtually non-existent.

3. Do syphilis chancres appear only in the mouth, genitals, and surrounding genital areas? I noticed a 1mm black spot resembling a mole beneath my nipple. After closer inspection, it appears to be normal pigmentation beneath the epidermis (I haven't found any STIs that cause such symptoms on Internet).

Syphilis chancres do not appear as black spots. They are shallow, open, painless ulcerations. Chancres can occur at any site of direct contact with a partner's lesions howver most occur in the ano-genital regions or more rarely the mouth. If the lesion you describe were a chancre, you would most probably have a positive blood test at this time

I continue to think that you are worrying entirely too much. I hope that the information I have provided will help you to move forward. EWH

---