[Question #13156] STD risk, testing and moving on

2 months ago

Hi doctors,

Thank you for your service and expertise. Your answers helped me calm myself down.

I'm a male and made a mistake, visited a female sexworker in Belgium. I had 2 minutes of protected vaginal sex, received unprotected oral and gave unprotected oral.I had following tests:

- 5 days after exposure: urine test for chlamydia, gonorrhea and t. vaginalis. Blood test for HCV, HIV and "screening T. pallidum".

All negative.

- 19 days: urethral swab in penis test for: chlamydia, haemophilus ducreyi, mycoplasma genitalium, mycoplasma hominis, neisseria gonorrhoeae, treponema pallidum, ureaplasma urealyticum, ureaplasma parvum, trichomonas vaginalis, cytomegalovirus, herpes simplex type 1, herpes simplex type 2, varicella-zosterAll negative.

- 35 days: urethral swab in penis for same tests as above. Tested blood for HEP B, HCV, HIV 1 & 2 (antibodies and P24) and Lues screen.

All negative, Lues 0.0799

- 73 days: urine test (1h45 after last pee) for same tests as above. Tested blood for HEP B, HCV, HIV 1 & 2 (antibodies and P24) and Lues screen.

All negative, Lues 0.0918

My questions:

- Given your experience, have I forgotten anything? I know I haven't tested for HPV and haven't had any blood work for HSV 1 or 2, just urine test and swabs for HSV.I haven't had any symptoms on my skin (mouth or penis). I checked everyday but might have missed something.

- How probable is it that I got HSV 1 or 2? Would you advise to test my blood?

I'm so scared to transfer anything to my wife.

I learned a lot from this experience and I'm ready to move on for good. I just want to know if I'm still at risk for any STD and if further testing is required.

Thanks.

Edward W. Hook M.D.

2 months ago

Welcome to our Forum. Thanks for your confidence in our service. I'll be glad to comment. By way of background, let me inform you that most commercial sex workers do not have STIs and most single encounters with infected persons do not lead to transmission of infection. Further, in your specific instance, you used a condom for the vaginal sex and oral sex (giving or receiving) are biologically inefficient means of transmission. Your testing validates these statements. You have tested extensively at times when your tests are entirely reliable and have proven that you were not infected. It is time for you to move forward.

There is no need for further testing

Your wife is not at risk

We advise against blood tests for HSV in these situations as your risk of getting a falsely positive result is far higher than your risk of having been infected.

It's time to move on. I hope that my comments will help you to do this. EWH

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2 months ago

Thank you again for your reassuring words. You cannot believe how much misinformation is on the internet and how much anxiety that loophole can give.

Am I safe to assume that my lack of symptoms from HSV within these 3 months mean that I have a very low chance of having contracted HSV from receiving an unprotected blowjob?

And that I am also at low risk from contracting HSV from giving oral (cunnilingus)?

Just trying to tie up loose ends in my head.

Thanks again.

Edward W. Hook M.D.

2 months ago

Yes. Be confident that your risk of acquiring HSV was very low, both from giving and receiving oral sex. It’s time to put this behind you and move forward. EWH---

1 months ago

Thank you. One final question, as the western blot test is not available in my country. Could I do the IGG test to be sure of HSV1 or 2? I would be good to rule it out completely. I'm now at 12 weeks, is that too soon?

What is the chance that I got it (1 or 2) without showing symptoms?

Edward W. Hook M.D.

1 months ago

We recommend strongly against blood test for HSV in situations, such as this. Ifyou have never been tested in the past, like most of the population, there is a greater than 60% chance that you already have HSV 1 and are unaware of it. Thus, you could have a positive test which would be unrelated to the encounter you have described. Even more importantly, these tests have relatively common falsely positive results and your likelihood of having a false positive test is substantially higher than your risk of having acquired herpes from the encounter you described.

As I recommended previously, I encourage you to put this encounter behind you and move forward without concern or further test testing.

As you know, we provide up to three responses to each client questions. This is my third response, and therefore, the third will now be closed without further responses. EWH.

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