[Question #3308] Risk assessment- hetero
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90 months ago
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Dear Dr's: Hope you can help. I have had protected sex with 7 women over a 10 year period. I am heterosexual and only contact with women. I have never noticed a breakage of a condom but have had seborrheic dermatitis from time to time in nose area and armpit. My girlfriend who I am having sex with got a flu over the winter that lasted 3 days and she had a fever for less than one day with a really sore throat that cleared with antibiotics. I worry about what if's like if I passed HIV to her. Can you please assess my risk and the chances that she had ARS? I have had about 5 other instances of oral but used a condom every time receiving from women. I have had no other symptoms over the years. Can you let me know what you think my tests and her tests will be with these risks? Thank you.
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Edward W. Hook M.D.
90 months ago
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Welcome to our Forum. I will be happy to assess your level of risk (very low) and to provide a bit of additional commentary regarding STI risks and sexual health.
Your question- Your risk for STIs is quite low. Nothing in the information you have provided suggests andy meaningful risk for STI, including HIV. The average american male has had 6-8 sexual partners and in your case, your commitment to safe, condom protected sex will go a long way towards preventing STIs. Condoms remain the most effective tools for STI prevention. For the most common treatable STIs such as gonorrhea, chlamydia, etc. in the absence of incorrect use of breakage (condoms break about 1% of the time- when they do it is typically quite obvious as they break wide open) condoms are close to completely protective. For some of the viral STIs, (HPV, herpes) while the protection is a bit less, condoms still reduce STI risk dramatically. Further, it is important to also point out that most women do not have STIs and even when they do, even most unprotected exposures do not result in infection. Putting all of this together, your risk of having HIV is extraordinarily low as is your risk for other STIs. That does not mean however that you would not benefit from STI testing unless you have been tested in the past year or so.
we often suggest that it might be good for both you and
your partner to go (together if at all possible) to go for a sexual health
check which includes screening for STIs. This is not an accusation or a reason to worry but
simply acknowledgement that both of you probably have had other partners in
the past, that many STIs can occur without symptoms, and that while it is
unlikely that either of you are infected, knowing this based on mutually
negative tests will provide a measure of confidence and trust as your
relationship moves forward. We routinely recommend this for new
relationships and suggest that such testing should include testing for
gonorrhea, chlamydia and for the woman and sometimes the man, depending on the
test performed, tests for trichamonas using either vaginal swabs of for the male
a urine test. Testing for HIV and syphilis, while far, far less likely
can be easily added with a blood test if desired. We specifically
recommend against blood tests for herpes unless one partner has a history of
the infection as they have relatively frequent false positive test
results and can be misleading. In the US confidential testing can be
obtained for little cost at health departments.
I hope this information is helpful., If anything is unclear or generates further questions, you may follow-up with up to two focused follow-up questions. EWH
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90 months ago
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Thank you Dr. Hook!
Does the Seborrhea and her very brief illness make you feel any differently? Just googling symptoms. My family doc said almost zero hiv risk but still concerned. Thank you for the info. We are in Canada.
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Edward W. Hook M.D.
90 months ago
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No, seborrheic dermatitis is a common problem and most persons with seborrhea do not have HIV. Same for your GF's brief illness- flu-like illnesses are widespread.
I would however advise you to stay off the internet. All too much of what is said there is misleading, either because it is taken out of context, out of date, or just plain wrong. EWH
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