[Question #13473] One time Unprotected Vaginal Sex STI Risk

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1 months ago
You nervous, professional, healthcare worker divorced and dating 40-something returning to the forum for comfort (I appreciate your services so much navigating my way through sex in the past couple of years after a completely faithful marriage of 15 years). I have learned so much from this forum and use it actively while being single and dating, but 16 days ago I did something completely human, but out of my nature. I had unprotected vaginal sex with a 43 year old divorced man with limited partners and no STDs according to his report that I had been seeing for a few weeks before. We also engaged in reciprocal unprotected oral sex. VERY shortly after, this man ended our relationship extremely abruptly, which immediately made me upset and anxious and is likely fueling my fears of a non existent STI. No symptoms. Negative for Chlamydia/Gonorhea/Trich 4 days after the encounter via vaginal swab. No herpes lesions (have checked religiously) in 16 days, so breathing a sigh of relief there in that window passing and then some, and have moved onto Syphilis as my latest obsession. Looking daily for the chancre. Not worried about HIV as my brain does not have the capacity to, but know the odds from Dr. HHH especially. Can either of you just shoot me some statistics to ease my mind about Syphilis and HIV, and take my annual dating donation as my thank you? lol. Thank you docs, appreciate you so much.
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H. Hunter Handsfield, MD
1 months ago
Welcome back. Thanks for your continuing confidence in the forum and your kinds words about it.

All in all this was a very low risk exposure, and you've already tested negative for the most likely STIs.It's often a mistake to rely on statistics of STI risk because such figures depend so much in unknown information, like where you are; where and how your met this partner; his past sexual lifestyle (which at least you know a bit about); and local frequencies of HIV or syphilis. But in most of the US or other industrialized countries, I would guess the chance your partner has untreated HIV or syphilis as well under one chance in a thousand. But even if he is infected, oral sex is virtually risk free. Vaginal sex has a risk for HIV to the female partner of about 1 chance in a thousand, so your overall risk of HIV is no higher than one in a million. Syphilis maybe a little more likely, maybe one chance in half a million?

From a medical/risk standpoint you don't need testing for either of these infections. But I understand that testing has reassurance value even when the risk is nil, so I assume you'll be tested. HIV RNA PCR test is conclusive 11 days after exposure, so you could do that now. Or wait until 6 weeks after the event and have a routine HIV AgAb (4th genetration) blood test and a test for syphilis. In the meantime, you can be completely confident your tests will be negative.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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1 months ago
Thank you Dr. Hunter! I'm in the suburbs of Michigan, and met this man on a dating app. Like me, is a divorced professional, 43 years old, was in a long marriage with a woman and has had limited (2) female partners since his marriage. We had a pretty open talk about STDs in which he said "oh I absolutely have not ever had anything like that" which I have learned from here and elsewhere that people usually are quite honest in that question (unless they truly are just unaware). We are both Caucasian and of good socio-economic status. I'm so glad to not feel the PRESSURE to get tested as quickly as you don't even recommend it, but just as part of sexual health and in the case of meeting a new partner, I'll likely do it around the six week mark to feel totally relieved and have "papers" should I start to see someone else seriously. I would assume from previous threads that Herpes from a one time encounter with no visible sores is also relatively low risk, though I know statistics on this are not as clear? Otherwise, with those answers from this second response, I won't reply any further and would only return to the forum with a positive test (which you have never had lol) and more questions.
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H. Hunter Handsfield, MD
1 months ago
You describe a partner no more likely to have HIV than you. You really shouldn't be at all worried about HIV!---