[Question #4591] Assessment and Advise Pls

28 months ago
Here's my background/history: Im 100% Straight male in my 30's, Never  an IV drug user, Not promiscuous. I only had sexual relationships with my past two (2) Girlfriends (Monogamous Relationships) and all protected. Those relationships ended in 2004 & 2012. I had an HIV, HEP B and C test also last 2013 for work related purposes (a year later of my last relationship), & results were all negative. Current Situation: I am now in relationship with a female,we started our relationship last March of 2018. We are still together as of now and we are practicing unprotected Vaginal/Oral Sex on a weekly basis. My girlfriend's background: She only had one boyfriend in the past 10 yrs. monogamous rel. She admitted that they do practice unprotected vaginal sex. Since this is her 1st relationship, this is the only person she had sex with. She also believes that her past BF never cheated on her, Not Promiscuous, Not BI/Gay, Not IV drug user, & she believes that her ex BF didnt do sex outside the relationship. 1) What are my and my girlfriend's chances/risks to get HIV/STDs based on our background I gave you? 2) Do you recommend us to do testing? What are those tests (All STD tests)? 3) My current girlfriend obviously has never been tested, and she is really not educated on this matter. I tried to open this topic with her but obviously she dont understand & I'm worried she might be offended too. What's the best way I can discuss & encourage her to do test? 4) Am i just overreacting with my anxiety? Or Im just on safer side? 5)If I cant convince her to do test, Im planning to change our sexual behaviors and start to wear condoms. Im planning also to do a test soon for my own peace of mnd. What safe sex practices do you recommend for a person who enagages sex (vaginal) w/ a person of unknown status (low risk type of a person). 6) Can I do a test home kit test at 6 week mark (post unprotected )? I have been reading alot and it really causes me anxiety.  Thank you so much Dr. HHH!
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
W
elcome to our Forum and thanks for your questions.  I'll be glad to comment.  Before I get to your specific questions, let me make a general comment or two.  From your descriptions, you and your GF sound to be very low risk for STIs of any sort.  However, low risk is not no risk and strange things happen.   Second, testing not only sometimes finds infections but negative tests provide reassuring information which help to resolve any slight  anxiety that may be present and allow monogamous couples to resolve any small doubts they might have.  In other words negative tests provide good, reassuring news about your sexual health in the same way that finding that your blood pressure is normal and that you are not hypertensive does.   With this as background let me address your questions:

1) What are my and my girlfriend's chances/risks to get HIV/STDs based on our background I gave you?
Your risk for having an STI is very, very low. 

2) Do you recommend us to do testing? What are those tests (All STD tests)? 
My own personal bias is that given the fact that you even asked the question, you should both be tested with the expectation that you will both find that you do not have STIs.   I would hope that the negative test results that I anticipate you would have would be reassuring.  STI screening (i.e. testing persons to make sure they do not have STIs) should include tests for gonorrhea, chlamydia and blood tests for syphilis and HIV.  No need for testing for herpes or HPV.  

3) My current girlfriend obviously has never been tested, and she is really not educated on this matter. I tried to open this topic with her but obviously she dont understand & I'm worried she might be offended too. What's the best way I can discuss & encourage her to do test? 
Every major medical organization such as the AMA and every public health agency such as the CDC recommends the every woman under age 26 who has ever had sex should be tested once yearly until they reach age 26.  If your GF has not been tested, she should be, at least once.  Again, this is not with the expectation that you will find she is infected but because it is part of recommended practices for determining that one is healthy.  Wanting to assure her of her health should not be offensive.

4) Am i just overreacting with my anxiety? Or Im just on safer side? 
I see no reason for you to be anxious but I do not think you should feel bad about your interest in testing.

5)If I cant convince her to do test, Im planning to change our sexual behaviors and start to wear condoms. Im planning also to do a test soon for my own peace of mind. What safe sex practices do you recommend for a person who engages sex (vaginal) w/ a person of unknown status (low risk type of a person).
I'm not sure this makes sense.  You have already had unprotected sex.  No reason to start using condoms at this time.

 6) Can I do a test home kit test at 6 week mark (post unprotected )?
Yes, the results you will receive will be reliable.

I hope that these comments are helpful EWH
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28 months ago
Thank you so much Dr. Hook and Dr. HHH for your advices and replies.
I will follow what you advise and hopefully results will be okay.
Last Question: In your years of practice and expertise, were you able to encounter a similar case like mine (like example my A sed partner with a background, wherein she/he only had one partner whom she knows very well and believes they are monogamous) and turned out to be positive? Do you believe that results will be negative.

Thank you so much and Best regards!

Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
I am confident that if you and your partner seek the testing I have suggested, the tests will be negative.  I have never seen a similar case in which that has not been the case.  EWH---
28 months ago
Hi Dr. Hook! Good Day! Thanks for your reply.  Im not sure if Im still allowed to post a question.  Just reply if Im still allowed.
I would just like to ask your opinion and advise.  I tried to talk to my GF regarding testing of STDs. But she really got offended and cried, she told me that why will I think of STDs to a person like her who was monogamous only with one partner (ex BF) for ten years  and they were both virgins when they start having sex. She told me also that her Ex BF was not promiscuous and really a good person. I understand her also because a lot of people in my country lack awareness and knowledge with hiv. HIV cases in our country are concentrated with MSM and IV sex workers and drug users.  Our rate right now is 60,000 confirmed cases at 100M population.  Hope you can give advice, since Im still having anxiety and cant move on. Thank you so much dr. Hook! 
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Clients are permitted a total of three responses to their questions. This is my 3rd response to your questions, thus this will be my final response.  The thread will then be closed later today.

I'll suggest several things that may be helpful but  only you can judge if this would be helpful:
1.  As mentioned above, annual testing for all women under age 26 is recommended by every major medical organization in the U.S., irrespective of factors such as partner number, marital status, etc.
2.  Most STIs in women are acquired despite monogamy.  They are infected by males who have other partners
3.  Most persons who transmit STIs do not know that they have STIs
4.  Testing with the expectation that the tests will be negative is an assuring and trusting way to start a relationship.

Perhaps some or one of these approaches may be helpful, telling her that you are asking because of your own anxieties and that you are confident that the tests will be negative.  If you do not hink it will work, you may choose not to make the request.  I hope some of these comments are helpful.  Take care.  EWH

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