[Question #4118] Worried and testing

32 months ago
Drs, Im a male heterosexual and had a one night encounter of unprotected sex in Reyk., Iceland with a female from Finland who I believe was also on vacation with a group of her friends. I dont believe she was a sex worker. After having way too much to drink we had unprotected sex and I also believe there was some anal penetration as well which is what has me most worried. I've read many of your responses on other websites before finding this service but I still have questions. Would you recommend testing because of this encounter? This encounter happened in late April. I developed a very sore throat 3 days ago (Aug 10/11) that remains sore. Is this a symptom? I hope you can add more as you answer those questions for me. Also, I have no way of contacting this person to ask if shes healthy. Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
 Welcome to our forum. I will be glad to comment. The single encounter that you describe was low risk for acquisition of STI's including HIV. Most people do not have STIs and even when they do a single exposure leads to infection and only the minority of cases.   For HIV the risk of acquiring infection with anal penetration is higher than for vaginal sexual contact but still is less than 1% per sex act. For other STIs the risk of infection appears about equivalent to the risk associated with Vaginal sex.   Thus,  on a purely statistical basis your risk for having acquired any STI is very low. The absence of symptoms over this period of time makes the likelihood lower still. 

 Your recent sore throat does not suggest an STI. Oral STIs are typically asymptomatic.  You do not mention oral sex with your partner but even if you had oral sex, most oral STIs  are asymptomatic and for an infection to become apparent  more than three months after an exposure would be most Unusual.

 While we recommend regular STI testing on about an annual basis for persons with multiple partners, or whose partners may have other partners as part of good sexual health maintenance, there is nothing in particular about the encounter that you describe that suggests a need for testing.    If you do choose to test at this time we would suggest testing for gonorrhea chlamydia and perhaps Syphilis or HIV. We specifically recommend against testing in these situations for herpes infections as the blood tests have relatively high false positive rates.   Further, should you choose to test at this time your test results will certainly be definitive in relationship to your April and counter. 

 I hope this information is helpful to you. Take care. EWH  
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32 months ago
Dr. Hook,

Thank you. My biggest concern is hiv which is why the anal penetration alarms me. I should mention I reside in the U.S. and I'm not an iv drug user. I'm also circumcized. Like i said, this female stated she was from Finland. White. Blonde. Anywhere from 25-35 yrs old. I dont think she was a sex worker but I'm not sure. I suppose the long night at the bars followed by intercourse in which she never propositioned me for money should answer the question however I can't help but feel concerned. My sore throat is of a variety I cant remember having before. Hurts to swallow, looks red, and thats it. Also a slight discomfort to it. A little bit of a burning/irritated feeling. Otherwise it doesnt bother me. 

I suppose I should take the current info and feel good about it but does this additional info change anything? I'll be holding on to this quote for my mental health's sake for the time being...

"While we recommend regular STI testing on about an annual basis for persons with multiple partners, or whose partners may have other partners as part of good sexual health maintenance, there is nothing in particular about the encounter that you describe that suggests a need for testing."

Thank you
32 months ago
I don't think I asked a follow up question there so let me add here. Do you recommend testing in light of the additional info I've provided? Countries of origin, approximate age, etc. I'm unfamiliar with std symptoms so I'm unsure if I have any of those symptoms. I think it does tingle slightly when I urinate but I'm often dehydrated due to a high caffeine intake. I haven't noticed any abnormalities in my genital area however I'm sure most of this stuff is internal and not noticeable to the naked eye. Could you add a follow up to this info and thanks again for your time. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Thanks for the additional detail.  This information however does not change my opinion or advice.  Your sore throat now is occurring far too long after the exposure to be a sign of recently acquired HIV.  The sore throat of HIV is severe, accompanied by high fever, and muscle/joint pains and typically occurs within a month of exposure. 

If it will help your anxiety you could go and get tested at this time but I can tell you what the results will be-negative. The results for all STIs, including HIV will be definitive. 

One additional piece of advice- I urge you to stay off the internet.  It will only fuel your anxiety and mislead you.  EWH
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