[Question #172] STD Question / Anxiety

37 months ago
I had met an escort outside my marriage.  We were naked and I did not want to have sex, but got on top of me and slightly penetrated her for about ten seconds or so then I got nervous and removed her.  She did not go very deep, maybe and inch or so. But it freaked me out, so I went to get tested at 6 weeks and 12.5 weeks.  All negative for standard test then I got freaked out for Herpes and got a herpselect at 15.5 weeks.  Negative for herpes type II cause thats all I was worried about at the time.  Now im abstaining from sex from my wife because I"m freaked out. Please try to give me some closure that I'm 100% alright.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to Ask the Expert. Thanks for your question.

Honestly, you have rather seriously overreactted. I would not have recommended the tests you had, nor would I have abstained from sex with my wife all this time if somehow I had been in your circumstance. First, female escorts (expensive sex workers by appointment) tend to have fairly low STD rates. They know the score, get tested frequently, and mostly their clients are themselves low risk -- i.e. men like you. (You don't say whether a condom was in place for this event; if so, the risk was nil. But I'll go on the assumption the exposure was unprotected.) Second, the chance of STD transmission from any single vaginal sex exposure typically is low, even when one partner is infected -- and it's especially low for a brief exposure of the sort you had. Third, for sure herpes testing wasn't necessary after such an event, in the absence of symptoms to suggest you were infected. If testing were done at all in this situation, a urine test for gonorrhea and chlamydia (any time over 3-5 days after the event) and blood tests for HIV and syphilis (at 4-6 weeks) is all I would have recommended. Finally and probably most important, the various STD tests are highly accurate and your negative results are conclusive. Regardless of all the foregoing about low risk, even if the risk had been high, the test results rule. They show with certainty that you did not acquire any of the STDs for which you were tested.

So my advice is to go forward with complete confidence about it and resume normal relations with your wife. All is well!

I hope this has helped. Best wishes--  HHH, MD


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37 months ago
So I should not be worried about herpes type II with the 15.5 week herpselect test because I noticed some flaky skin recently underneath my foreskin (maybe smegma)?? And yes, it was unprotected encounter.   I was cleared of syphillis and HIV as well as gonorrhea and chlamydia at the 12 week mark, so I should not worry about these as well?  thanks again for your response. This should be my final reply if I need to not be worried anymore.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
As a guess (but an educated one), even before you were tested I would have put the chance you caught HSV2 from this particular exposure in the range of 1 in 10,000, tops. You have no symptoms to suggest it; herpes doesn't cause "flaky skin". Accordingly, I would not recommend testing for it; the odds of a false and misleading test result is far higher than the likelihood you were infected. On the other hand, if you have already started down that path -- i.e. if your tests at 6 and 12 weeks included HSV, you probably should have a final one at 16 weeks. Regardless of my advice, my guess is that you are sufficiently anxious that you'll stew about it until you have had a definitive test result. In other words, it's up to you. But truly, you definitely shouldn't be worried any more, and in my view you should not wait to resume sex with your wife.


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37 months ago
Thank you for the reply but just to clarify , I did a herpes test at 15.5 weeks after exposure which should be sufficient correct ?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Sorry, I misunderstood. That result is definitive; there's no difference in reliability between 15.5 and 16 weeks. You're good to go!---