[Question #3990] gono,Chlam&hsv-2 risk one protected encounter

31 months ago

39yrs,vasectomy,married. I had protected oral and anal sex with a prostitute in South America. Encounter lasted maybe 15min. Symptoms @ 4 days started with left testicle discomfort and epi tenderness to the touch.@ 7 days I took 1gm of azitro.. and 250mg injection of cef. (Clinic in SA) @ 8 days took 500mg of azitro.. five days after antibiotics I had unprotected sex with my wife. Left testicle discomfort stoped a week after that and started on the right that lasted for about 2 weeks. My wife mentioned some irregular bleeding around the same time. Also I notice she is using panty liners almost every day(this could be normal and I’ve never paid attention before) she hasn’t mentioned anything about any alarming discharge. Approx a month after encounter I tested negative for chlam& gono, positive for hsv-1(19.00) I have had since kid and equivocal hsv-2 (1.00) I also took 1000 mg of echinacea and 2000mg of garlic for 10days some time before testing. Shortly after test results testicle discomfort disappeared. But know I feel like there is discharge but I can’t confirm I see a little watery on the tip mostly before and after urination but I feel randomly during the day. Also a pimple on the shaft has appeared.(not the first time but weird coincidence)

1. Could I have contracted gono/chlam cured with the antibiotics but infected my wife before the it was cured? I waited 5 days but they recommend 7 maybe now Im re- infected?

2. Can chlam or gono afect the epi 4-5 days after encounter with out any urithral symptoms. Would my vasectomy make me more likely for this?

3. Should I be concerned about the equivocal hsv-2 results? Does having Hvs-1 make me more likely to get hsv-2?

4. Could I have contracted the sti during the Placement,removal of condom? Or cleaning up? 

5. Could this have to do with a reaction to latex? Or soaps while washing after encounter( I was very anxious)

6. Could this be a crazy coincidence and all in my head? If so any suggestions on help to get over regret and anxiety?

This tends to be what I think abou 80% of the day now 

Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to our Forum. Thanks for your question and for your confidence in our advice.  Congratulations as well to your commitment to safe, condom protected sex.  My best guess is that you did not get an STI from the encounter you describe. Even among CSWs, most persons do not have STIs and even most unprotected exposures do not lead to infection.  further you used a condom (throughout the sex acts I presume) and condoms remain the best means of reducing risk for STI acquisition if a partner is infected.  Finally, the treatment you took would have certainly been curative if you had gonorrhea, chlamydia or most other STIs. 

My suspicion that you are feeling a bit guilty and anxious over your actions and as a result are looking harder for signs of STIs than you have in the past.  Testicular discomfort of the sort you describe is not a common complication of STI and when it occurs, it usually is accompanied by a penile discharge or burning on urination, neither of which you report.  Withthis preamble, let me address your specific questions:

1. Could I have contracted gono/chlam cured with the antibiotics but infected my wife before the it was cured? I waited 5 days but they recommend 7 maybe now Im re- infected?

See above.  Most unlikely.  I would believe the negative tests you mention above. 

2. Can chlam or gono afect the epi 4-5 days after encounter with out any urithral symptoms. Would my vasectomy make me more likely for this?

Again, most unlikely.  Further, if anything, your vasectomy would have protected against epididymitis. 

3. Should I be concerned about the equivocal hsv-2 results? Does having Hvs-1 make me more likely to get hsv-2?

No, your results are negative, you have not had an outbreak.  In fact, false positive tests for HSV-2 are relatively common among persons with antibodies to HSV-1 as you do.  I would not test further and would not worry. 

4. Could I have contracted the sti during the Placement,removal of condom? Or cleaning up? 

Unlikely.

5. Could this have to do with a reaction to latex? Or soaps while washing after encounter( I was very anxious)

Interesting question.  About 9% of the population is allergic to latex and some soaps can elicit inflammation and discomfort.  When these symptoms occur they typically occur soon after exposure (within 24 hours) and then resolve over the next few days.  I think your symptom onset was a bit late for a latex reaction.

6. Could this be a crazy coincidence and all in my head? If so any suggestions on help to get over regret and anxiety?

Certainly I think you are looking harder for abnormalities and symptoms than you did before your exposure and that this may be part of what is going on.  My advice to you, based on the information you have reported and your test results is to do your best not to worry further and to move forward without concern.  No additional testing is needed.  I hope my comments will help you to do this.  EWH

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31 months ago
Thanks your answers are re assuring. The condom Was on through the acts. 
I just wanted one more question that may put me at ease. As you said the antibiotics would have cured most sti including gono and chlam. In your opinion was the 5 days I waited to have sex with my wife enough to kill the infection( in the unlikelihood I contracted something)? And is there such a thing as taking the antibiotics too early after encounter? Was 7 days too early? 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
 There is no such thing as taking antibiotics too early following an encounter of the sort you describe. You should be comfortable that even if you were Infectious (which was virtually certainly the case) by the time you had sex with your wife you would be no longer infectious. You do not need to worry. EWH ---
31 months ago
Thank you. I will try to put this behind me and move on 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
I think that is a good plan.  My additional advice to you is to stay away from the internet as I anticipate that is will only increase your concerns and anxiety through the large amount of confusing and misleading information which is all too common there.  EWH
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31 months ago
Dr sorry I’m still having a bit of trouble putting this behind me. I just maybe need a little clarification on on e of your comments “ even if you where infectious (wich was virtually certainly the case)” are you saying that in your opinion I was virtually certainly infected? Or virtually certain that I wasn’t infected? Sorry English is my second Language and sometime I have trouble truly understanding. I know I didn’t get to describe of the encounter it was with a condom the whole time but she did put it on with her mouth. I try to think of how unlikely it would be for me to get something from a onetime protected encounter. But I seem to still focus on what going on down there during the day. At night I sleep fine with no ‘symptoms’ you would think that would be enough to confirm that it’s all in my head. I have read a lot of the post on the forums and I see a lot of people that seem to be struggling with anxiety type issues for years due to their worries about stds. I do not want to live my life worrying about this every time something I may think is a symptom happens to me or my wife. If I was to keep ignoring these most likely mental symptoms I’m feeling. 

What would you say would be a red flag and that I would need to go to the doctor and be checked?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
I apologize, I was rushing when I typed that, the phrase you mention should have read "even if you were infected, which was virtually certainly not  the case..."

I think your plan to ignore the sorts of things you mention is a good idea.   I would worry about only truly obvious symptoms not "possible" symptoms. 

 Our firm provides for up to three responses to each client. You have had three responses and thus this thread will be closed later today. Please don't worry. Take care. EWH
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31 months ago
Thanks for the clarification. I will follow your advice.