[Question #4761] Reliability of Quick Testing / General Risk Question

27 months ago
Doctors,

Thank you for your time and patience. I am 30 and have no previous STD infections. Like many of the other posters on this website, I have an elevated fear of STDs. On New Year's Eve, after some moderate drinking, I had a sexual encounter with a mid-20's white woman. It involved mutual masturbation, she performed oral sex on me for approximately 3 minutes with no condom, and then there was brief penetrative vaginal sex with a condom. There was at no time penetration without a condom, though its possible there was exterior genital touching before the condom. She told me afterwards that she had no STDs ("was clean"), but I obviously can't verify that.

My questions are:

(1) Due to upcoming travel out of the country, I am trying to go have a preliminary gonorrhea/chlamydia NAAT test conducted on Friday, approximately 75 hours after the exposure. I know that is the lower end of the range for testing, but do you think results would be somewhat reliable at that point? I will follow up with more thorough testing at the 6-week mark, as recommended in other posts, but would like to try to assuage my concern with that Friday test first.

(2) From other postings, I understand this to be a low-risk encounter, but what statistical chance do you think this type of encounter creates for me contracting any STD (Chlamydia, Gonorrhea, HIV, Syphillis, and HSV)?

Thanks again for your time.
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to the Forum.  I happened to be on the Forum soon after your question arrived so you are getting my reply somewhat earlier than is typical..  Thanks for your confidence in our service.  Congratulations as well on your commitment to safe sex- the exposure you describe is quite low risk since, there is no risk whatsoever from mutual masturbation despite the fact that there is typically some superficial contact with partner's genital secretions, since condom protected sex is safe sex, and since few STIs are transmitted through receipt of oral sex.  further, that your partner said she was STI free is a good thing although for future liaisons a better question might be "When were you last checked for STIs? as the answer provides more useful information.  In answer to your specific questions:

(1) Due to upcoming travel out of the country, I am trying to go have a preliminary gonorrhea/chlamydia NAAT test conducted on Friday, approximately 75 hours after the exposure. I know that is the lower end of the range for testing, but do you think results would be somewhat reliable at that point? I will follow up with more thorough testing at the 6-week mark, as recommended in other posts, but would like to try to assuage my concern with that Friday test first.

Your 75 hour tests for gonorrhea and chlamydia will be entirely reliable.  If you wish, the same urine specimen can be used to test for trichomonas.  If you desire to be tested for HIV (I really do not think the exposures you describe make this important), your 6 week test will be reliable.  Please do not test for HSV- blood tests are not helpful in your situation.

(2) From other postings, I understand this to be a low-risk encounter, but what statistical chance do you think this type of encounter creates for me contracting any STD (Chlamydia, Gonorrhea, HIV, Syphillis, and HSV)?

The data after few but given the nature of your exposures, your condom use and what data you have provided about your partner, I would gauge your risk for a positive test for any of these STIs as being less than 1%

I hope this information is helpful.  EWH


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27 months ago
Dr. Hook,

Thank you for the very speedy reply. I'll phrase my question with future partners more clearly, and I'll go in for the 75-hour test and the 6-week follow up for Syphilis and HIV (just for piece of mind).  Just out of curiosity, when you mention that HSV blood tests are not useful in my situation, I'm taking that to mean the potential of a false-positive Ig test, combined with the low-risk for HSV in my interaction means that the test would be unnecessary. Is that correct?


Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
You are right on target.  I hope this is something you've learned from reading other posts.  If so, thanks for reading them.  EWH---