[Question #3221] I'm HOPING this is my last post ever.

39 months ago
Hi Doctors, to cut a long story short, I engaged in protected vaginal sex with an expensive Escort back on the November the 26th 2017(See my previous posts)  I also received protected oral sex from the worker, however I did perform unprotected cunninglus and analingus on her.  I have NOT had any sexual encounter since this episode back in November, 2017. I know you informed this is low risk and you wouldn't recommend testing.

Today out of anxiety, I visited a private clinic here within the UK. The doctor I spoke to also stated this is a low to zero risk situation for HIV and STD's. He informed if my tests come back positive he would be 'gobsmacked'. Here is a link to the clinic- https://www.epmpractice.co.uk/fees#sexual-health-service  If you scroll down to Full Male Sexual Health Screen (£245)- this is what I had. 

I am currently awaiting the results, so I am a little nervous.  The reason I did a full screen is due to the fact I plan I get back with my ex-partner and want to do it with a clear conscience and also to put my anxiety to sleep.

I have been tested for the following STD's- HIV, Hep B, Syphillis (Blood tests) Chlamydia, Gonorrhoea (Urine and a Throat swab ) Ureaplasma and Mycoplasma.

My questions are

1) I have researched Ureaplasma and Mycoplasma and they seem confusing. Is this something I should be worried about? Is there a possibility I could be positive for these?  If so, what complications will they or have caused?

2) IF positive for these, would that mean I would need to hold off from engaging in unprotected sex with my partner?

3) I took 1g of Azithromycin back in May as me and my partner was diagnosed with Chlamydia (See my posts from May time) would this of cleared infections such as Ureplasma and Mycoplasma? Or could it of returned and I've had it all this time? We assumed the Chlamydia may have came from my partner that went undetectable as the infection may have persisted in her GI tract. 

Thank you and Happy New Year. 
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Like you, I also hope that this will be your last post.  It is disappointing to see that you continue to worry about the virtually no risk encounter that you have previously interacted with both Dr. Handsfield and I on.  I did review your earlier posts and our assessments and advice have not changed.  In addition, it appears that you have been searching the internet for additional information on STIs.  This is a bad idea as so much of the information found there is out of date, taken out of context, or just plain wrong.  Please stay off the internet- it is not going to be helpful to you.  Further, asking the sort of "what if" questions you are asking likewise is of little benefit to you.  As a result, after I provide brief answers to your questions above, I will not answer additional, follow-up questions until you have test results to comment upon.  For your questions, in the order you made them:

1.  Both Ureaplasmas and Mycoplasmas are normally found in the genital tract and have no proven role as pathogens.  The possible exception to that is an organism called Mycoplasma genitalium which may cause persistent urethritis in men but is still the subject of intensive research.  If your tests are positive for these organisms (other than for M. genitalium) no treatment is warranted.

2.  See above.  They are normal.  Laboratories test for them because people will pay for them but they at not pathogens.

3.  More "what ifs".  Azithromycin may suppress the presence of normal mycoplasmas and ureaplasmas but they return, because they are NORMAL.  Azithromycin is about 98% effective against chlamydia.  I anticipate that your chlamydial tests will be negative.  please wait for your test results!

EWH






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39 months ago
Hello Doctor Hook,

Results 

HIV (4th generation, p24 antigen) negative
Syphillis- negative
Hep B- negative
Chlymaydia- negative
Gonorrhea - negative (Throat swab and unrine)

Ureaplasma and Mycoplasma results not ready till Monday however the clinic believe these are 'minor'

Could I continue unprotected sex with my partner without worry or should I await the results of the Ureaplasma and Mycoplasma tests? 

Also, a big thank you to you Dr Handsfield for your commitment within this field over the last 40 plus years. You really do put things nto perspective and educate folk about real facts sourrounding HIV and STD's. 

I realise my risk was low but sometimes anxeity takes over but that in itself is a different issue. Never the less, thank you again! 




Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Thanks for sharing your test results.  No surprises there, are there?  Similarly, it would not surprise me in the least if either your mycoplasma and/or ureaplasma tests were to come back as positive however, as I said above, these organisms are normally found in the genito-urinary tract and there is no evidence that they cause disease.  Thus there is no reason to abstain from sex with your regular partner, just as there is no reason to seek treatment should the tests for mycoplasma and/or ureaplasma are positive.    Take care.  EWH
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39 months ago
Hi Doctor Hook, 

Just an update, my Mycoplasma and Ureaplasma tests also came back negative.
 
For now, that is all. 

Thanks for your advice and persective. 

Best regards, 

Jason.
39 months ago
Dear Dr Hook, 

I feel like I have put myself back to square one!

I appreciate you are getting fed up with me and I realise I may need to seek counselling for my anixety, this is my next step. 

In reference to my previous post,  I have been in a bad situation with my partner. After a difficult weekend I got intoxicated visited another Escort in the here in the UK (Birmingham) today.

She was Brazailian, aged 25 and claims to be tested every 3 months for STD's. She has only been in the UK for 2 months. 

I recieved unprotected oral sex from her. 

Do I need to test for any STD's as this was unprotected oral sex?

Will my partner be safe If I engage in unproteced oral and vaginal sex with her?

Once again I'm sorry but your advice is all I have. 

I only worry as I have a regulr partner and do not want to put her at risk. 

Thanks, 

Jason.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
This does not seems like a "next step".  It is a repeat of what you have done previously.  You really could have looked at prior replies and other posts on this site and found the answers to your questions.  Thus your answers to this follow-up will be brief.

Most commercial sex workers do not have STIs and oral sex only relatively rarely leads to infection of any sort.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  This sort of non-chlamydial NGU is not clearly and STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications.  Given the information you have provided if there are no obvious signs of infection (penile discharge) the only reason for testing would be to address your anxiety.  No risk for HIV. 

Thus, following logically from my comment above, there is no medical reason for your to abstain from sexual contact with your regular partner

This is the 3rd and final reply as part of this thread.  Please remember that the forum does not permit repeated anxiety driven questions by the same users. This will have to be your last one; future new questions on this topic will be deleted without reply and without refund of your posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties, when the real answer normally should be professional counseling; and because such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.  EWH


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