[Question #540] Please inform of my risk of an STI

42 months ago

Dear Doctor,

I have a sordid/precarious situation I need medical advice on. First the situation and then if you can give me the appropriate advice.

Situation-

I am a heterosexual male (31 years) who is in a monogamous relationship for the last year. Last week I traveled out west for work and had an unusual event occur. After working-out at a popular LA gym I relaxed in the sauna and steam room before showering and heading off to dinner. I drifted-off in the steam room another guy got friendly with me and started to give me a BJ. Although I am very open-minded, it was not my thing and I told the guy thanks, but no thanks.

After the fact-

Two main things to point out. A buddy of mine (who I tell everything and is a nurse) is telling me that I might get the clap or a herpes infection from this. Obviously if he is coming on to me at the gym he probably has a lot of other people he is doing as well. Moreover, I have had issues over a year ago with being loyal to my GF (with other women) and we have both been monogamous ever since (we even got tested for everything and both of us were negative across the board). So, now I have some mental anguish and stress about having a potential infection (from an event I did not even get to enjoy…so to speak).

Questions-

  1. What are my chances of getting the clap or herpes (or other infection)?

  2. Should I go make an appointment to get tested?

  3. Since my previous track record was poor (with my GF), is this something I should mention or is it too minor to bring up (causing more issues…).

Thanks in advance for your thoughts.

Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Welcome to our Forum.  I will try to help.  Hard to blame you if the situation is as you describe and before I address your questions, I might suggest considering whether or not you feel you can tell your regular partner about this event- honesty is always the best policy and if your past does not include same sex partners, you might be able to make the case that this was beyond your control or at least not your fault.  If you can tell her about this, it will help in terms of your ongoing anxiety regarding what I am about to tell you below in response to your specific questions:

  1. What are my chances of getting the clap or herpes (or other infection)?          Few STIs are spread by receipt of oral sex.  The major risk is for gonorrhea, NGU and herpes.  Gonorrhea and NGU are typically symptomatic within 3-5 days as burning on urination or urethral discharge and if you do not experience, these, I would not be concerned further.  Herpes is a little different.  Receipt of oral sex can lead to acquisition of genital HSV-1 (HSV-2 is almost never spread through oral sex) if you have never had HSV-1 before (over 60% of adults have had HSV-1, even if they have not experienced cold sores in the past).  If you acquired genital herpes, unless you develop a rash or genital lesions, testing is not much help.  If you develop a genital rash or lesions, a PCR test (NOT a blood test) is the best diagnostic test.  Typically the lesions of genital herpes appear within 2 or at the outside 3 weeks of exposure.  If you do not develop lesions, I would not worry further as the risk for this sort of exposure is, in general, quite low.

  2. Should I go make an appointment to get tested?  See above.  If you do not develop symptoms (which you will be on the lookout for), there is relatively little to be gained by testing although both NGU and gonorrhea can, occasionally, be asymptomatic

  3. Since my previous track record was poor (with my GF), is this something I should mention or is it too minor to bring up (causing more issues…).   See above- disclosure is the best approach whenever possible.  Further, if your partner wishes for you to be tested (for GC and NGU), there is little to be lost other than minor inconvenience  and much to be gained, relationship-wise.

I hope these comments are helpful.  EWH

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42 months ago
Thanks Doc. I will consider your suggestion about sharing with her (although it is such a difficult topic historically and how to convey a man to man experience). Grr...

I think I want to get a health screen no matter what (and will do that this week) just to rule-out obvious items that might be brewing (gonorrhea, NGU). Can you elaborate on the herpes risk? I do not know if the guy had sores or even had herpes at all. If our roles were switched, would you be stress on this one?

Lastly, is there any risk of the other STDs? (HIV, etc...)

C

Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Are there specific questions about HSV?  I tried to give you the facts and figures above.  In doing so, I would say I would not worry about it.

As for the health check, I think this is both for you and for your partner.  I think it depends on whether you choose to report the event of not.  Either way it is tough but, in my opinion, in the long run, if possible best to disclose. 

finally and again as I mentioned above, the big concerns are GC, NGU and HSV.  for all the risk of a single, brief event is low and other STIs are just not a major concern.  There is no risk of getting HIV from receipt of oral sex from an infected p[person.  EWH

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42 months ago
Just the general odds of getting an HSV infection in this case. is it 50/50 (50%), 20%, etc... That would help me put it into perspective a bit better.

But, thank you for all the other info.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

As per forum rules, this will need to be my last reply. 

As noted above, your risk of getting HSV from the exposure you describe is quite low, probably less than 1%, all things considered.  EWH

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