[Question #2125] Risk Assessment

47 months ago
Hello Doctor

Three days ago I met a CSW in US. Acts were protected oral for two minutes and protected vaginal for less than 5 min. I haven't noticed any symptoms. Should I be concerned or do you think I should be tested? Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Welcome to the Forum.  I'll be pleased to comment.  This was an essentially no risk event and nothing you have said suggests a reason for concern about HIV.  Less than 1% of U.S. CSWs have HIV and the risk of HIV from a single UNPROTECTED exposure is less than 1 in 2000 exposures.  Condoms reduce that risk more than another thousand fold.  Hence your risk for HIV on a statistical basis is less than 1 in 200 million.  Your risk for other STIs is also very low and not something to be worried about.  I hope this comment is helpful.  EWH
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47 months ago
Thanks doctor. My question was more for other std like gonorrhea, chlamydia, and syphilis. One thing I forgot to mention is that I'm on a daily regiment of doxycycline 75mg twice per day for acne. Would that be enough to prevent the above? I know recommended amount is 100mg twice daily for seven days. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Even if you were not taking doxycycline, following a single condom protected sex act I  would not be the least bit worried.  Further, because it takes less doxycycline to prevent infection than to cure infections, this provides an additional element of protection.  The is an additional, theoretical risk of acquisition of herpes from contact of  a portion your penis that was not covered by the condom with the her vagina but again this risk is quite low.  I do not see a reason for testing based on your description.  EWH
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47 months ago
Thank you. So to be clear, risk of chlamydia, gonorrhea, and NGU would be hard to get with an intact condom? 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Correct, as long as the condom is worn for the entire sexual encounter and does not break, there is virtually no risk for Gonorrhea, Chlamydia or NGU.  (Incidentally, when condoms fail, they break wide open, leaving no doubt that they have failed.  They do not leak "just a little".)

This is the 3rd response to your questions.  As per Forum guidelines this thread will be closed later today.  I hope my responses have been helpful.  Take care.  EWH
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47 months ago
Thanks. I'll try to put this behind me and take your recommendation of no testing