[Question #1486] one night stand

45 months ago
I had a one night stand about 3 weeks ago. The guy I was with said he had been tested and cleared a month before and hadn't been with anyone since, and he always uses condoms. Unfortunately, the condom somehow came off in the middle of the things, and while he didn't ejaculate inside of me, there might have been a minute or two of unprotected intercourse. At the two 1/2 week mark I took a full STI panel with herpes blood test as well and am awaiting results. 

I have experienced some tingling sensations on my vulva and tightness in my hip flexors/groin, but this has happened to me before and I think is more anxiety related. How worried should I be about a few minutes of exposure? I don't have any symptoms of lesions, discharge, or anything else. Just some irritation (but I've dealt with vulvodynia on and off in the past, and have noticed flareups after making stupid sexual decisions that cause anxiety....there's definitely a pattern and I think anxiety is involved.) 

How high are the transmission risks for a one time encounter? Should I be concerned of any STIs or herpes? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Welcome to the forum. Thanks for your question.

This sounds like a low risk situation and I would expect your pending STD tsts to be negative. However, a "full STD panel" probably included tests too early to mean anything. Blood tests for all STDs take 1-4 months to become positive; 2 ½ weeks is too soon, except as a baseline to know you weren't infected before the exposure. But assuming your tests included a urine specimen or vaginal swab for chlamydia and gonorrhea, those results are conclusive any time more than 3-4 days after exposure.

But as I said, I doubt you have anything. Despite all the media attention these days, at any point in time even the most sexually active people usually aren't infected. And even when STDs are present, they are transmitted inefficiently:  most exposures don't infect partners. Indeed, generally we STD experts recommend against STD testing after any single encounter; the risk is too low. And your risk was even lower, given the apparent brevity of the unprotected part of the event. Of course the risk isn't zero, but in general it's better for sexually active singles to get tested on a regular schedule (anywhere from every 3-4 months to once a year, depending on number of partners, etc. Of course there are exception, e.g. after an exposure to a known infected partner.

So from what you have said, you can expect negative result for the pending tests. If you want extra reassurance because testing was early, you could have repeat tests for HIV and syphilis about 6 weeks after the exposure. In the absence of symptoms, I would recommend against testing for anything else.

I hope this has helped, but let me know if anything isn't clear. Best wishes--  HHH, MD


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45 months ago
Hi Dr Hansfield, 

Thank you for this information. I just got all my test results back and I am negative on everything. I guess I will retest herpes in a few months to be sure.....I have no sign of lesions or anything like that, and it's been about 3.5 weeks. 

I am still experiencing some of the pinprick-y sensations I mentioned earlier....sometimes when I am actively thinking about this whole situation, but oftentimes unprovoked by thoughts or anxiety. However, in the two other times in my life I have slept with people of unchecked status, I ended up having the same exact symptoms--tingling, burning, tightness in my groin and hips, and periodic pinprick sensations. Eventually, after enough testing and peace of mind, those symptoms seemed to fade away, so I am trying to convince myself that all of this is just anxiety induced. 

More than anything, I am confused by everything I read on the internet, and in my unhelpful conversations with my gynecologists over the years.  On one hand, I am told that it's not worth testing for herpes since the bloodwork can be unreliable and CDC does not recommend, and that a false positive will just cause unnecessary emotional distress. On the other hand, I am told that "well, you can only really know you are safe from your partner by getting tested and he likewise." So what gives? I just keep coming up on unhelpful explanations. If it were your own niece or daughter, what kind of advice would you give? My anxiety over STDs and viral infections like herpes is affecting my ability to date happily and get involved with people.  I read the high stats on herpes, and it prevents me from trusting people or enjoying intimacy. 

I met someone recently (not the same person from the aforementioned encounter), and the paranoia is already creeping in. Should I just stick with condoms, and then have us both get full bloodwork done in a few months for the extra precaution? He says he's never had anything, and I believe him completely. But that could mean he just doesn't know. My sister contracted herpes probably from an ex-boyfriend (who had never had symptoms, and she's never had symptoms), so in a way I guess that is useless knowledge since she hasn't shown signs of anything, but it's still an informational burden she has to shoulder.  I don't want the same thing to happen to me. 

I would appreciate any direction you can provide. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Glad to hear bout the negative tests.

There's really not much conflict about HSV testing. Almost all experts would recommend against testing because of any single exposure unless especially high risk, e.g. a known infected partner with an active outbreak. I would advise my daughter in your situation to not be tested. The main reason for testing is in people with ongoing risk (e.g. regular partner of an infected person) and in event of symptoms suggesting herpes, for diagnosis. There indeed is debate among experts, some of whom would promote routine testing of people with high risk sexual lifestyles -- but that doesn't include most average single people. As for herpes preventing intimacy, I would remind you that most herpes is so mild people don't know they have it; and symptoms and outbreaks can be controlled. It usually isn't as big a deal as some people fear. Don't get me wrong -- nobody wants genital herpes, and I understand your sister's concern. But it's not something that should seriously interfere with romance, commitment, and sexual health.

There's no right and wrong answer to STD testing in people in new relationships. But it sounds like your partner and you are both at low risk. Testing might make sense before you forego condoms, but these are individual/couple decisions.

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44 months ago
Thanks for your insights Dr. H. In regards to this continued pinpricky and burning sensations on my vulva.....do you think there is any chance this is related to herpes? It's been going on since literally a day after the encounter, and has persisted for over a month on and off. I have dealt with similar situations in the past, and ultimately attributed it to anxiety and sort of psyching myself into physical pain, if that makes any sense. Given my low risk encounter, and your perspective, an uninfected partner, and my pattern of vulvodynia, I am telling myself it's probably just the same thing again and anxiety induced. 

Would six weeks of these symptoms be related to anything? Or would they only point to herpes if followed by lesions? 

Sorry to bother you one more time, I appreciate any thoughts you might have on this. Not sure how much you know about vulvodynia/generalized pain....seems easy to confuse with STD symptoms so I'm having trouble separating fact from fiction here. Thanks! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Herpes simply does not cause symptoms like yours. You'll find websites and personal testimonials saying it does, but there is no scientific evidence for it. This originates when people have tests for HSV, turn out to be positive, and then think back "Well, I've had tingling/itching/"pinprick"/ or what ever sensations you would like to fill in. They then conclude herpes was the cause. In fact, there is no proof herpes is the cause. As you suggest yourself, anxiety is a much better bet for the cause. There are no STDs that mimic the burning pain and discomfort typical for vulvodynia.

I don't meen to sound insensitive. But the fact is you're barking up the wrong tree in looking to herpes or other STDs to explain symptoms like yours. Continue to work with your doctor(s) about it.

As you may know, each question comes with two follow-up comments and replies, so that concludes this thread. Sorry I can't be more helpful. Very best wishes to you.

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