[Question #3710] Some advice please

35 months ago
Hi Doctor,

Almost week ago I went out celebrating with some friends and ended up getting drunk. This led to a bad decision. I had sex with a sex worker.  Something I hoped not to do again. 

A few things:

- we used a condom the entire time, and although she worried me by putting it on with her mouth, I watched closely and she never made contact with my penis. 

The sex was brief and from behind. Lasted literally about 3 minutes. As I was in a rush to go, I withdraw instantly so little opportunity for contact from becoming too limp inside her. 

I did not see any issue with the condom, and through paranoia, I took the condom with me after we finished. Further paranoia made me test it about an hour later, with some water. Albeit a little bit. I filled it up by about an inch. The fact that I did not fill all the way is one of the things nagging at me. Is it possible that I missed a hole as I did not fill entirely? If so, am I at risk from fluid making contact higher up the penis? That it held water at all suggests the head was ok, I'm assuming?

The next issue is that, about 14 hours later I had unprotected sex with my regular partner. 
Is it possible to get infected and become infectious that quickly if u had caught something? Gon, chlam, hiv, etc ?

About 48 hours later (maybe less) and since, I'm convinced I  am feeling all sorts of sensations in, on and around my penis. Is it true that when it occurs these are severe? What I have is not, and doesn't happen when I urinate, but before/after. I feel a general increase in sensitivity and awareness. Could these be early symptoms of something?

Please doctor, how would you assess my risk from contracting anything? From having passing it on so soon, and having developed symptoms in the stater time line? I am going crazy as I didn't think the above possible, but cannot shaken what I am feeling and all the doubts I have. 

Lastly how soon could I test and get a meaningful result?

Many Thanks!! 

35 months ago
Hi Doctor,

At the risk of losing a later response, I have been checking the steps religiously and it has updated 1 hour ago, but shows no response?

The same is true for another question asked after mine. Is something wrong with the system?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome back to the forum. Thanks for your continuing confidence in our services.

Any activity on the forum generates notification. In this case, it was assignment to me. Replies can come later.

First, congratulations on your wise decision to have safe sex in this situation. As a result, you really needn't be worried about HIV or other STDs. In most areas of the US, the large majority of sex workers (99% or more) do not have HIV. But even if your partner is infected, the condom appears to have been effective. The business about potential microscopic leaks in latex that might allow infection, which might be detected with the "water test" like you describe, is an urban myth. If the condom did not break wide open, protection was complete. In any case, it appears your water test showed no leaks; the amount of water used probably makes little difference. 

As for other STDs, condoms also are highly effective in prevention, especially against infections transmitted through body fluids (gonorrhea, chlamydia, trichomonas, HIV, hepatitis B). Protection is less complete, but still very good, against those transmitted by skin-skin contact (HPV, herpes, syphilis). So the odds are strongly in your favor for these STDs as well as for HIV. And even if you happened to have been infected, probably you would not be infectious for your regular partner only several hours later. Infectiousness for other persons is very low until the infection has time to develop, e.g. 2-3 days for gonorrhea, somewhat longer for chlamydia and herpes, not for a couple of weeks for syphilis, and several weeks or months for HPV. The risk may not be zero, but it is very low less than 24 hours after exposure. So it is very unlikely you put your partner at risk.

Finally, as for your symptoms, no STD causes the vague sort of "sensations" you apparently are feeling; and 48 hours is too soon for STD symptoms as well. Such symptoms are highly typical for genitally focused anxiety -- i.e. worry over a regretted sexual decision magnifying trivial symptoms or entirely normal body sensations that you otherwise would ignore or not even notice.

So my advice is to do your best to stop worrying. I don't recommend testing for anything. However, if you would like the reassurance of negative tests, you could have a valid urine gonorrhea/chlamydia test any time 5 days or more after the exposure, and could also consider blood tests for syphilis and HIV after 6 weeks. This recommendation does not mean I believe there actually was significant risk. I do not, and suggest you consider testing only because anxious persons often are more reassured by test results than by expert opinion.

I hope this information is helpful. Let me know if anything isn't clear.