[Question #209] Std's Herpes Possibility?

36 months ago
Im a 27 year old male 20 days ago i had a one time encounter with a 34 year female Unprotected Vaginal and oral.

I asked many times she said she was clean of all stds including herpes.

Im not 100% sure so after the incident felt regretful and worried about stds and remembered I had 2 Ciprofloxacin 1g each took one each day following incident.

I haven't  had "real" symptoms like discharge from penis, cold sore or herpes lesion. But I've had tingling on penis, burning sensation on lips that lasted about a week now comes and goes and I keep checking my lips and genital area constantly to see if i had any lesions so far haven't seen anything.

questions

1. If i did get chlamydia and gonorrhea from that exposure what is the chance the 2 Ciprofloxacin maybe cured it?
2. Is the burning lip without cold sores a symptom i should worry about? Its pretty much gone now it just comes back when i get really anxious.
3. I remembered about the 2nd or 3rd day after exposure i had discomfort on my left side by the pelvis. It just felt like my pants where too tight and creating pressure mostly on and around the bone. I had it I think for 4 days it would come and go. Im not sure if thats what they mean by sore or swollen pelvic lymph nodes.
How likely is it that that discomfort  was from herpes without lesion?
4. Yesterday the 19th day after exposure i started feeling like a rash around my anus i checked the best I could i don't see any lesions or feel bumps.
Can this be related or herpes?
5. I did get tested for Herpes the 9th day after exposure which i know its way to early came back negative and it said "Standard Range" 0.89 your value <0.90 
Is that a high value? can it mean its going up from lets say 0.50 but it hasn't reached out of negative?
6. Should I be ok to have unprotected sex with my regular partner?

Thank You in advance
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Hello Javier,
It's fine to ask people if they have an STD, but most people are not really aware of their true STD status and so may so "no" when they don't really know the whole situation.  Now some people may take that opportunity to say yes if they have an STD like herpes, but because 80% of those infected with HSV 2 (the usual genital variety) don't know they have it, asking can be of limited value.
It's really good, I think, that you have a baseline value - the one you got 9 days post exposure.  At least you know where you started.  Was that test for HSV 2 only or was it for HSV 1 also?
1.  2 grams of cipro is not the recommended treatment for gonorrhea or chlamydia, actually.  Have you also been tested for those two infections?  While cipro is likely to be helpful and may cure those infections, it is definitely not the preferred medicine and may, in fact, confused the testing for these two infections if you have it done in the near future.
2.  Have you ever in your life had a cold sore on your lip?  If yes, then it is very unlikely that you would acquire HSV 1 genitally from the oral sex.  Burning of the lip alone doesn't mean anything in particular.
3.  The discomfort that you describe in the left side of your pelvis sounds nothing like what herpes might cause.
4.  19 days is a long time from your exposure to start having symptoms.  Usually we see symptoms within 2-10 days of a new herpes infection.  Plus if you don't see anything, I would feel reassured.
5.  The fact that the testing says <.90 is just negative - it sounds like no specific negative value was listed.  It could be 0.1 or it could be 0.89 - no way to know and at this point I would not spend time worrying about that  It's negative.

The risk of acquiring HSV 2 with a single encounter is quite low.  You've had no sores up until now is good.  Can you have ex with your regular partner?  I have no way to know what else might be going on here specifically and it is too early for an accurate HSV test results at 9 days.  That's your call but you really can't know at this point what is going on without having the other partner get tested now and seeing all of her test results.  Sorry I can't give you advice on that one with any sense of certainty.

Terri
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36 months ago
Thank You so much Terri!

1 I did get tested same time as for herpes everything was negative
2 I've never had cold sore on my lips 

I read other questions where Dr H. Hunter says after 3 weeks of exposure with no lesions or cold sores most likely you didn't catch herpes is that also correct on my exposure? Anxiety and depression are getting the best of me and the 3 month wait to test  after exposure is driving me crazy! 

Also read 60% of people get positive results after 1 month of exposure?

In your opinion how likely is it that i acquired herpes from what Ive told you about my exposure and symptoms?



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
The research by Dr.  Rhoda Morrow and her group show that 70% of people who are going to be positive on the ELISA will be positive by 6 weeks from the contact, 50% at 3 weeks from the exposure.
I think that it is unlikely that you contracted herpes at this exposure given 1) no lesions and 2) it was a single encounter so it was statistically less likely but I am not confident that you did not acquire herpes given the statistics on the test and our knowledge that 80% of those infected with HSV 2 don't know they are infected.  I would like to tell you something else with more certainty but I really cannot.  I can just say that I think it is unlikely. 
It's good news that everything else was negative at 9 days. 
Do you think you could ask this woman to get a herpes test to help you feel less anxious? 

Terri
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36 months ago
Unfortunately The most I was able to ask the female partner was when the last time she was tested she said 5 months and she hasn't had sex after that. But obviously I can't 100% believe that. 
 
You got me a little more worried due to the fact I read a lot from Dr. H Hunter and he told many people if they don't see lesions within 3 weeks they are most likely clear he sometimes tells them no need for further testing.

1. Is there a certain reason why it would be different for me?  Dr. H Hunter says the people that don't know have herpes usually is because they have mild symptoms but I've been very aware of body after exposure.
You told me that maybe the 2 ciprofloxacin I took day 2-3 after exposure may have made my test for chlamydia and gonorrhea negative.
2. How can i know if i do have chlamydia or gonorrhea?
3. Can the rash like burning around anus be due to any of this ant std's? Should i go get the rash checked?
4. Is there any Clinic that you would recommend in Los Angeles that specializes in stds? I don't have insurance at this time.
The clinic where i went to get the test done the doctor didn't seem to know much about stds in fact he told me my test at 9 days for herpes where accurate so Im looking for a different clinic where i can see someone more experienced in that area.
5. Anything else i should be looking out for? And how long

Thank You


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
I'm sorry that I have worried you more, that was not my intention.  I think that Dr. Handsfield and I agree that herpes is unlikely here - I don't believe either of us would say it isn't possible.  And yes, I would agree that most people who have herpes don't notice symptoms or misinterpret their symptoms as something else but I know there are also people who simply have no symptoms of herpes.  As I said before, I think it is unlikely that you acquired herpes in this situation for the reasons I mentioned.

I would suggest, since you did take some antibiotics that may reduce the amount of bacteria present but perhaps not cure an infection, that you restest for gonorrhea and chlamydia in a few weeks, just to be certain. 

If there is nothing visible to see, I"m not clear how having it checked would be useful.  If there is anything to see, I would encourage you to have it looked at just to be sure.
There should be county clinics in LA that do this kind of testing.  That's one of the main functions of county health departments.  Also Planned Parenthood clinics are another option that often offer sliding scale charges, based on  income. 

The things you should be looking for are discharge, pain with urination and changes in the genital skin like sores. 

Please let me know further questions that you might have, OK?

Terri
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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Javier, can you tell me the question you are referring to where Dr Handsfield said  that about if you have no symptoms within 3 weeks your likely don't have herpes? I think we can work together to clarify this.  Thanks so much Javier!

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36 months ago
Yes here is the link to 2 questions that Dr Handsfield answered similar to my exposure.

http://www.medhelp.org/posts/STDs/Brief-Unprotected-Sex/show/1434351
http://www.medhelp.org/posts/STDs/Unprotected-sex-one-night-stand/show/2070497

By the way i do have a couple of questions regarding your answers to me.
1. Isn't pelvic lymph nodes a common symptom for herpes? 
2. Can that be what i was feeling then i told you i felt my pants where applying pressure on my left side pelvis area?
3. You said retest for gonorrhea and chlamydia in a few weeks if that from today or after i got tested? i took 2 antibiotics the last one about 17 days ago.
4. The  "rash" around anus still persisting you didn't answer if that can be a side effect of a std even if no lesions.
By the way i read usually first outbreak for herpes would be where there was contact and there was no contact at all with my anus 
5. Around what percentage of people get outbreaks after 3 weeks of contacting herpes?

Thank You for your help and for trying to get my situation clarified I REALLY appreciate it!
 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Javier, I ran your question by Dr. Handsfield and he says  that since the treatment is about 90% effective against gonorrhea, you'll probably be fine.  However, it is not effective against chlamydia, so I'm thinking you should likely test once more in a couple of weeks to be safest.

Terri
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