[Question #2150] Mandatory STD Reporting

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91 months ago
I'm submitting this as a new question since it was embedded in a previous thread now one month old. I'm thankful for the non-judgmental approach to the responses here. Going to need it on this one. My wife and I are adjusting to life without intercourse due to extreme discomfort for her. of course, there are other ways to give and receive pleasure. However, as my precious post reveals, I am having difficulty adjusting, which is not made easier by heavy travel schedule. I am making sincere effort to maintain fidelity but on the infrequent occasion when I'm not successful, they are very low risk for stds (erotic massage). However, I am wondering if in the unlikely event I ever acquired a reportable std (chlamydia, gonorrhea, syphilis) would notification include my spouse if we were no longer having intercourse or if infection occurred subsequent to our last encounter? I would not want to hurt her either physically or emotionally. Your answer would help me consider/establish behavioral boundaries. Thank you!
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H. Hunter Handsfield, MD
91 months ago
Welcome back. You could have avoided the new posting fee by waiting for my reply to your follow-up question in the other thread, which would have come at about this time.

Sorry to hear about your wife's continued dyspareunia (the medical term for painful intercourse). Most such cases can be effectively treated; I hope she is continuing to work actively with her physicians to figure it out. I forget your age (or hers, if it was mentioned) -- but if she is beyond age 40, the most common explanation is reduced estrogen levels that occur naturally with menopause but often precede menopause by a few years. That also could contribute to a vaginal discharge problem, as she had when you posted your first question a few months ago. Yeast infection also might be a consideration and easily treated.

If you were to acquire an STD from your anticipated extramarital adventures, for most STDs whether your wife would need to be notified and treated depends a lot on the specific infection and your sexual practices with her. For example, urethral gonorrhea or chlamydia require penile penetration (vagina, rectum, mouth) for transmission, but no risk if no such contact after the exposure at which you were infected. But syphilis, for example, could be transmitted by oral sex to her, i.e. cunnilingus, and perhaps by kissing. Herpes and HPV occasionally are transmitted without insertive sex.

As i said in one of your previous threads, partner management for STDs isn't nearly the draconian process you seem to have in mind, and nobody would ever contact your wife without your knowledge and permission. The infected patient is always given the option of contacting their sex partners themselves; and if you say you had not had sex with her since the exposure at which you were infected, they won't press for the details. Of course if you had such an infection and had possibly exposed your wife, it would be in her interest to get diagnosed and treated, and you wouldn't be tempted to hide it from her.

In any case, this is all very theoretical. If you have only the sorts of extramarital exposure you have described, you will be at little if any risk and these issues will never arise.

Best regards--  HHH, MD
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