[Question #3171] Concerned

39 months ago
Hi doc .
Last night I was at a party and made the mistake of having unprotected oral and vaginal with a female . All I really know about her is that she is over 50 years old and always lived in the United States . After it was said and done I got paranoid and asked her when was the last time she had gotten tested . She had told me it was 3 months ago and reassured me that there’s nothing to worry about since she just got out of a 25 year marriage . However I don’t know if that’s true or not . What are the chances I got something ? Also what should I be looking out for the next couple of days . Thank you doc
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to the Forum. I'll try to help.  Any time a person has sex with a new partner, there is always a risk that they may have an STI of some sort that they are unaware of and that the STI could have been transmitted to you.  You did a good job on asking your partner when she had been checked last and her response is somewhat reassuring.  OTOH, you do not know how many partners she has had since she was checked an so there is some low risk to the exposure you describe.  To provide context, I would also add that STIs are relatively uncommon (but do occur) in women over age 40.

The STIs that you are at highest risk for from the exposures you describe are chlamydia, gonorrhea, and perhaps trichamonas.  The likelihood that your partner had HIV or syphilis is far lower.  I presume that if she had herpes, she would have told you and thus your risk for herpes is also quite low.  The most common STI symptoms in men to the common infections I mentioned are burning on urination or an obvious penile discharge (if it is there, you will notice it.  You do not have to exhaustively self-examine yourself for discharge or other STI signs and in fact, extensive self examination is more likely to lead to concerns over otherwise normal findings which have been present for some time but you have not noticed- we see this a lot).  These symptoms would typically be expected to appear in the next 3-10 days after exposure. 

I should also add that some of the infections, I mentioned, particularly genital chlamydia and trichamonas, may be asymptomatic.  Further, virtually all oral infections are asymptomatic.  thus if you are concerned, the most direct way to rule out the most common STIs would be to be tested, using a urine test for gonorrhea, chlamydia and trich and possibly a throat swab for gonorrhea and chlamydia- trich does not infect the throat (it is not clear whether you performed oral sex on her or not, if you did, a throat swab should be done) any time more than 2-3 days after the encounter.  If you feel the need to test for syphilis or HIV, while official recommendations would tell you to wait until 6 weeks for definitive testing, in the low risk situation you describe, testing for both a 4 weeks would pretty much rule out the possibility of infection.  We strongly recommend against routine testing for herpes- the tests are not designed for this sort of testing, are often mis-leading due to false positive results.  there are no recommended tests for HPV.

I hope these answers are helpful.  I have tried to answer comprehensively.  Overall, I suspect this was a rather low risk exposure- you partner was in a low risk group (women over 40), had been checked within the past three months, and even if she were infected, most exposures to infected persons do not lead to infection.  Were I you, I would not worry too much or feel a need for immediate testing.  At the same time, we routinely advise all clients with multiple partners or whose partners may have multiple partners, so have a sexual health check up which includes testing once or twice a year, even in the absence of signs or symptoms.  EWH
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39 months ago
Thank you . She performed oral on me .Do you think it’s worth getting PEP to make sure I’m okay ? The only thing I’m worried about is weather she was telling the truth or not . I use protection all the time and get tested yearly . Also today I noticed I have 2 small red  painless spots on the shaft of my penis and i’am almost positive it was not there before . I’am seeing a girl right now and wanted to know if i’am safe to continue sexual encounters or not . I will also go get tested this week . Thanks in advance 
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
I see no reason to seek PEP for the encounter you describe and would not prescribe it if you asked me for it.  The encounter was very low risk for HIV.  As for the spots you saw, less than 48 hours would be quite unusual for an STI  to appear.   See my earlier comment about extensive and excessive self examination. 

 Your safest course of action would be to abstain from sex with your regular partner until you are tested. I suspect that the tests that you obtain will be negative and prove that you were not infected but that is the safest course of action.  EWH
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39 months ago
Okay I will do that . One last question and it’s about hsv 2 . I’ve noticed that women 40+ Have a big chance of being infected . Is that something I should worry about ? And when would the first outbreak occur ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
 Although herpes rates go up in all groups with age, I really would not worry too much about the genital herpes. If you were to acquire genital herpes you would be expected to have an outbreak of lesions within 10 to 14 days of your exposure. 

 I hope these responses have been helpful to you. As you know we provide up to three responses to each clients questions. This is my third response. This this thread will be closed later. Please don't worry and take care.   EWH
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