[Question #4982] Need Suggestion
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78 months ago
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Hi Doctor,
I had protected vaginal ( 5 mins) and UNPROTECTED oral (2 mins) with a white lady in her 20’s ( research triangle, NC). She has a professional job but does this on the side. My friend is a customer and recommended her, and said she is clean. I also personally ask her and she said she was tested recently (but I can’t verify it).
Questions:
- Any STD risks and what symptoms to look for?
- If there are no symptoms do I still need to test?
- Regardless, what tests I should do and what type - blood or urine?
- The other thing is that she gave me a towel to clean after I had ejaculated. But I don’t know if the towel had anything from previous customers ( if any). Her bathroom wasn’t that hygienic either and I saw a towel in the sink. Any STD/STI risk from towel use to clean my penis?
- If you were in my shoes would you have tested and refrained from unprotected relationship with the regular partner?
Regards,
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Edward W. Hook M.D.
78 months ago
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I could not help but notice that this is your 13th post of the Forum in the past two years. Most of these posts have been in regard to low or no risk events and in them you have received much information regarding STI risks and testing. I would urge you to consider why you are back to the Forum so often and whether or not you are using this Forum to try to deal with anxieties related to sex and sexually or are due to an unrealistic fear of STIs. The fact that you did not use a condom for the exposure you now report suggests to me that you are taking risks, then regretting having done this. As a repetitive pattern this is not good for you. Please consider why you are retuning to the Forum so very often. I am not sure we are the right persons to be seeking help from.
The exposure you describe was relatively low risk. You do not say how long it has been since the exposure. Your partner said she had recently been tested. Most people tell the truth and most people, even most commercial sex workers do not have STIs. Even if she had an STI, most single unprotected exposures do not lead to infection.
In answer to your specific questions:
- Any STD risks and what symptoms to look for?
The STIs you are at greatest are non-gonococcal urethritis (NGU), chlamydia, and gonorrhea. All are most often symptomatic and can be typically diagnosed using urine tests. Symptoms of these infection would be a penile discharge or burning during urination. If these symptoms are present, they should be relatively obvious- repeated self-examination, squeezing to look for discharge, etc. is not needed or recommended.
2. If there are no symptoms do I still need to test?
Any of the infections noted above, while usually symptomatic, can be asymptomatic
3. Regardless, what tests I should do and what type - blood or urine?
Urine tests are generally reliable. Blood tests would be for syphilis or HIV, both of which are far, far less likely than the STIs I mentioned and would not be conclusive until 4-6 weeks after exposure. We specifically do not recommend blood tests for herpes.
4. The other thing is that she gave me a towel to clean after I had ejaculated. But I don’t know if the towel had anything from previous customers ( if any). Her bathroom wasn’t that hygienic either and I saw a towel in the sink. Any STD/STI risk from towel use to clean my penis?
STIs are not transmitted on used towels. I would not worry about this.
5. If you were in my shoes would you have tested and refrained from unprotected relationship with the regular partner?
You have to determine your own level of concern and whether testing would be helpful in relieving you concerns. There are several very high quality public health STD clinics in the Research Triangle area where inexpensive, confidential testing is available.
I hope these comments, are helpful. EWH
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78 months ago
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Hi Doctor,
It happened yesterday and I don’t reside in NC, I was visiting.
1. Strictly from a medical point of view do I need testing pertaining to this incident? I was tested few weeks ago and all was good.
2. If I need to get tested for the common STIs NGU, Gonorhea & Clam - should I do the blood test or urine, and when?
3. I have gone through the posts on this forum and it seems HIV is not a risk for receiving unprotected oral? Is that still true? The reason I didn’t use protection for Oral was that the lady didn’t want whatever chemicals come with Condom.
Regards,
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Edward W. Hook M.D.
78 months ago
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Thanks for the additional information:
1. Again, it was low but not no risk. If you have confidence in your partner (and your friend's reassurance regarding his exposures) then you are probably OK. I thought both exposures were unprotected, sorry. that it was only the oral exposure makes your risk far, far lower but not zero. That said, testing is a decision you have to make.
2. Gonorrhea and chlamydia are very reliably are tested for using urine. The urine test is good but slightly less reliable for non-chlamydia NGU.
3. Sorry, I thought both exposures were unprotected. That it was only the receipt of oral sex that was unprotected makes your risk for infection very, very low. You are correct, there are no proven cases of HIV acquired from receipt of unprotected oral sex.
Hope this clarifies things. EWH
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78 months ago
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Yeah, only the oral was unprotected and that too for couple of mins. If I plan to do a 6 week blood test for HIV, Syphilis, Clam, Gonorhea and NGU, will that be okay? Or should I do Clam, Gonorhea and NGU earlier than that?
Thanks,
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Edward W. Hook M.D.
78 months ago
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Have you read my earlier replies such as above when I said "Gonorrhea and chlamydia are very reliably are tested for using urine."? Blood tests are of no used for gonorrhea, chlamydia, or NGU and are used only to diagnose HIV and syphilis. Testing for gonorrhea, chlamydia and NGU can be carried out at any time more than 3-4 days after exposure.
This is the 3rd and therefore final reply as part of this thread. EWH
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