[Question #13398] Unprotected exposures no symptoms, test coming tomorrow

4 hours ago

Hello doctors,

I’d appreciate your opinion regarding a few recent exposures and what my upcoming STD panel may or may not cover.

I had unprotected vaginal and oral sex on the following dates:

August 8: with an old friend (retired CSW), she assured me she hasn’t been with anyone in months.

August 22: with another woman I've known for years (CSW), she said she’s regularly checked and clean.

September 2: with a longtime acquaintance (CSW), also said she’s clean.

September 4: with a woman I met recently. Initially, there was very brief unprotected penetration, but I put on a condom immediately afterward. No oral sex.

I have no symptoms now and never have, but I’m worried and regretful. I’m scheduled for a full STD test tomorrow (Sept 6).

My questions are:

1. Which of these exposures will the test likely cover at this stage?

2. I'm assuming tests will be conclusive for gonorrhea and chlamydia from the Aug 8 and Aug 22 encounters, but not others. So follow up is needed?

Thank you for your time and guidance, especially during my stupid choices.

Edward W. Hook M.D.

1 hours ago

Welcome back to the Forum. Thanks for your continuing confidence in our service. My comments today are similar to comments I made when we last interacted about 5 months ago. You've had several encounters with different apparently low risk partners. You have no symptoms but, as has been your practice, you plan to get tested to be sure that you were no infected. You are correct that while being asymptomatic also makes is less likely that you are infected but, particularly if, like you, your some or all of your casual partners have other partners, you could have been asymptomatically infected. Testing in this situation is entirely reasonable. The testing you have planned for Sept 6 will detect most infections although I would not be entirely confident that an infection acquired during your encounter on Sept 4 might be missed.

As a generalization, the STIs you are most at risk for are gonorrhea, chlamydia and trichomoniasis, all of which should be detectable after 3-5 days following an exposure. To be thorough I would suggest a urine test for gonorrhea, chlamydia and trichomonas and throat swab for gonorrhea (chlamydia testing is typically done on the same specimen and is reasonable but testing for trich is at the throat is not needed. These tests would provide conclusive results for the encounters you had in August and on September 2 but might not detect an infection acquired on September 4.

I hope this information is helpful. It sounds as though your Sept 4 encounter was with the partner you know least about. Whether you tests again i a few more days is, of course, a personal choice. Overall the likelihood that y0u were infected is low but not zero. EWH

---