[Question #4319] Chances of Getting STD/STI

30 months ago
Drs, On August 30, I had a one night ecounter with a Cuban CSW (Not CSW) but the girl that handles the CSW, I had a though time 2 hours convincing her, for sex. I got really drunk and we got in to the Jacuzzi, and I was so drunk I have doubts of what happened, Im 90% confident, we only had foreplay, and I licked her vagina for about 2 seconds. I starteed getting anxious so I calle here, she told me everything was ok, that we did not had a sexual encounter, and just foreplay, and that I could be assured she is clean and that she is not a CSW. She even told me here real name and shared some pics of her family and told me more than me she also had to take care of her. That Cuba has a very strong culture of testing. 14 days prior to the encounter I got a 10 test STD Panel from Quest Diagnostics and Early HIV PCR RNA test, everything came back negative. Syphillis, Gonorrea, HA, HB, HC, Clamidya, HIV, HSV1 below .90 HSV2 below .90, 23 days after Exposure I got Hepatitibs B core came back negative, Hep B Antibody S came back 42.59 Hep B antigen  Neg, Hep B Antibody e neg,  Hep C antibody neg,  HSV1 negative, HSV2 Negative, Clamadya IGG and IGM Negative,  I got the P24 negative, and the Antibody negative for HIV, plus Western Blot negative. Im planning on 28 days to go again  for FTA ABS, VDRL RPR, hvs1 lgG, hsv1 lgM, hsv2lgG, hsv2lgM, HIV Antybody and HIV P24 (For conclusive results). I have not had any Herpes Symptonsn nor genital nor vocal  at all, nor any Syphillis  chancers, I have double checked every day. I have had some hemorroides problem, that scared the hell out of me, but I double checked and with hemorroide,medicen it went away. What are my risk of having and STI or STD, and what would you do if you were on my shoes? Mainly my concern is about passing out something to my wife or kids. Im more worried about Herpes and Syphillis at this point. Thank you very much. (Sorry for my bad english I speak spanish as my primary language)
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
Welcome to the forum. Thanks for your question.

Cuba has an effective and respected public health system, and is generally believed to have low STD rates. I'm not aware of recent data, but that's my understanding going back several years. For sure you are correct about excellent HIV prevention and control services, with very low HIV rates. In addition, it sounds like you had an entirely safe exposure. Neither HIV nor any other STDs are transmitted by oral-vaginal contact (cunnilingus), hand-genital contact, fingering, etc ("foreplay"). Also no risk from kissing. Having hemorrhoids does not increase risk. 

For those reasons, you did not need testing for any STDs. However, the tests you had all were negative and were done long enough after exposure to be conclusive for all practical purposes. You can safely continue to have unprotected sex with your wife and you should do so. No additional tests of any kind are necessary.

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

HHH, MD
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30 months ago
Dr Hunter I really want to congratulate you and the other Doctors in this forum. You are really great, and your knowledge and answers are so clear and help with the anxiety, on cases like this. The internet is not a good source, because you can find all kinds of things, but seeing your answers and the ones from the Dr. of this forum is amazing. Thank you very much for your time. Ansiety can really kill you. I consider from all of the information since the night that this happen to know I have learned a lot and also learned about how uncounsious one can be about the consecuences. I just have a last question for you, Herpes Hsv 1 and hsv 2, and Syphillis, from this encounter, I know my test were to early, but I have not experienced any symptoms, will you just let them go and carry on? If you were in my shoes, will you test again on 3 to 6 months just to make sure they are not there, or if they were there just wait for the symptoms and deal with them? More than me I feel the guilt of transmiting any of this two to my wife, in case, they are there.  I know the risks are very low,  I know you give a lot of statistics to your patients, found this site, dont know how accurate it is, but sounded about right, if it works for you and your patients, I found some relief when I saw it https://srconstantin.wordpress.com/2015/04/30/std-statistics/  again thank you very much you and all of the Doctors in this forum are great. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
"Herpes Hsv 1 and hsv 2, and Syphillis, from this encounter, I know my test were to early, but I have not experienced any symptoms, will you just let them go and carry on?" Yes, that is exactly what I would do, given the no-risk exposure you describe.

"If you were in my shoes, will you test again on 3 to 6 months...?" I would not have had the initial tests and certainly would not have any more tests.

Thanks for the thanks, and for the kind words about our services and expertise. I'm glad to have helped.

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30 months ago
Thank you very much Dr. for everything this gives me so much peace of mind.