[Question #1705] STD Risk assessment for Dr. Handsfield

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86 months ago
Hi Doctor Handsfield, I very much appreciate what you do. I'll make my question simple. 

Over the last 1.5 years, I've had vaginal sex with 9 different women (I'm a heterosexual male). 6 of these were protected with a condom. The other 3 is what I'm concerned about 

Incident #1- condom breakage- Hispanic women, mid 20's, met on a dating app, had two dates before sex. Not sure how long the condom was broken for. 

Incident #2- condom breakage- middle eastern women, mid 20's, also met on a dating app, had sex first date. Not sure how long condom was broken for. 

Incident #3- unprotected vaginal sex- Caucasian women early 20's. Dated for almost a month before having sex. 

Also, I've had numerous episodes of unprotected oral sex performed on me by women, but I know you said that is very little to zero risk. 

My biggest worries are HIV and herpes. I've had no symptoms other then minor itch in groin area occasionally-- no lesions, bumps of any kind. 

What are your thoughts?
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86 months ago
One more thing I forgot to add--  my location is the northwest suburbs of Chicago. Thanks. 
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Edward W. Hook M.D.
86 months ago

Welcome to our Forum. On this Forum, all questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing your questions today.

Congratulations to you on your commitment to condom-protected sex.  It will help to keep you safe although, as you experienced, occasionally condoms do break (typically about 1% of the time). To summarize, you have had three episodes in which condoms have broken with three different sex partners. You have also had multiple episodes in which you have received unprotected oral sex. You are asking about you risk for HIV and other STIs. 

Let's deal with HIV first.  Statistically your risk for HIV is low.  There has never been a case of HIV proven to be acquired as a result of receipt of oral sex.  As for the condom breaks, it statistically unlikely that any of your partners had HIV.  Substantially less than 1% of women in the U.S. have HIV.  Even if a partner did have HIV, the risk for infection is low since HIV is transmitted through unprotected genital sex only about once in every 1000 exposures.  the possibility of HIV can easily be ruled out with a confidential blood test.

As for other STIs, if you had herpes, you would have most likely experienced an outbreak which you would see.  since have not mentioned this, it is unlikely that this has occurred.  Some common STIs such as chlamydia or gonorrhea can be acquired through exposures such as yours and such infection can often be present without symptoms.

Given your history, I recommend the following:

1.  I suggest you have a blood test for HIV.  If your last broken condom has occurred more than 8 weeks ago, your results will be reliable and only a single test is needed.  If your most recent condom break was more recent, then your HIV test results will not be definitive until 4-8 weeks after the event, depending on which test is used.  If you wish, a blood test for syphilis can be done at the same time as your HIV blood test.

2.  I suggest that you have a urine test for gonorrhea and chlamydia just to make sure you did not acquire one of these infections.

3.  I strongly recommend against a blood test of any sort for herpes. These tests are often wrong and can give falsely positive test results. Since you have not had symptoms, your risk of having acquired herpes in tiny,

I hope these comments are helpful to you.  I anticipate that the tests I have suggested will be negative, providing you with confidence that you have not acquired any STI from the exposures you have mentioned.  EWH

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86 months ago
Thank you Doctor Hook! I appreciate the response. Just a quick follow up--

I think you misunderstood my first post slightly. Out of the three incidents I described,  TWO of them involved condom breakage. During the last one, I foolishly DID NOT use a condom. The girl was a 23 year old Caucasian female who I dated for a month before having sex. When asked, she said that she gets tested regularly and did not have anything. 

So again, it was 2 condom breakages and 1 fully unprotected encounter or vaginal sex. 

Also, I didn't mention in the first post that I am not circumcised. 

If any of this changes anything please let me know. Your assurance his been helpful with my anxiety over this.