[Question #564] Herpes/HIV/Other STD risk?

42 months ago
Had a major lapse in judgement, was buzzed, at a business meeting, got a unprotected handjob, protected blowjob, fingered her, had protected intercourse and closed lip kissing and a massage [ she was basically unclothed all the time].  She was an escort, hence I'm thinking the risk is much higher...

I forgot that I had an aptheous ulcer inside my mouth while kissing [closed lip though] which I thought was very poor judgement, did not give any oral, only got protected oral, protected intercourse, got an unprotected handjob and a long massage.

1. What are my risks?, when do I have to get tested?.

2. How much of a risk is the kissing, given that I had an ulcer inside my mouth [HSV/HIV] risk?.

3. Should I do a full STD panel including HSV1, HSV2, HIV today and then at 3 weeks, 6 weeks and 12 weeks?. 

4. Are the 6 weeks test on HSV1 and HSV2 and HIV conclusive, what are the tests that I must ask for?,if I'm negative on the 6 weeks, should I still get the 3 months test [is 3 months conclusive?] or should I move on after 6 weeks??

I am currently not dating and was hoping to start dating in a few weeks, but I'm hoping to get this conclusively closed so that it's confirmed that I do not carry any STDs. 

All help appreciated towards the right direction.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
I think your risks here are very very low, if any.  I don't really think you need testing for this situation.  However, if testing would make you feel more comfortable, I would do HIV testing at 6 weeks and none after that and HSV testing at 3 months.  Since the kissing was closed mouth, I'm not concerned about you acquiring something orally.  From your post, you just received oral sex and it was condom protected, correct?  You really did an excellent job of having safer sex with this person.  Three months for herpes testing is more accurate than 6 weeks - at six weeks, 70% of those who are going to become positive will have done so.  If you are going to start dating, it may be good to get STD testing with a new partner, just to be certain that you both know where you stand in regards to your sexual health.  Again in regards to this particular incident, I really feel like your risk of acquiring an STD is incredibly low.

Please let me know if you have other questions, OK?

Terri Warren
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42 months ago
Hi Terri,

The risks were: protected intercourse, protected oral, closed lip kissing [ I think you noticed just the protected oral], would that change what you'd written earlier? 

Also, this was in Thailand, would that mean I need to get tested for any other stds??, like Hep B , Hep  C??

I am planning to get a full std screen tomorrow, followed by full std screen 6 weeks out as an indicator for hsv, hiv and then a full std screen at 3 months timeliness to close this..

Unless you feel that given the risk, I can test again 6 weeks for gen 4 hiv test and Elisa for hsv 1, 2 and also all other stds and close at 6 weeks itself if -ve on everything.

Appreciate the advice on testing potential mates, will follow suit.

Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
I actually did see of that, I was just clarifying the oral part.  Have you been vaccinated for hepatitis B, do you know?  If not, and you do decide to test, I would include that and if negative for both antibody and antigen, I would strongly recommend that you get vaccinated for that - it's a series of three vaccines.  In the US, it is a childhood vaccine and ha been for many year but I"m not sure about Thailand. At our clinic in Oregon, we also include hep C in an STD test as it is an opportunity to grab folks who might not have been tested previously - Hep C is rarely an STI however.  We're infrequently  gotten positives, maybe twice per year and many of those are with unknown risk factors, so  6 weeks is good for most of the STI's but herpes will be more certain at 3 months, yes.  If your gonorrhea and chlamydia are negative at 6 weeks (or even now, I don't know how long ago you had this encounter), you don't need to retest for those.  I believe that Drs. Hook and Handsfield feel that 6 weeks if enough time to accurately test for syphilis as well.  As I mentioned, this is probably not necessary but peace of mind can be worth a whole lot. 
You've got one more post coming so please - feel free to ask anything more that you are wondering about here!

Best
Terri
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42 months ago
Thanks, Terri,

I have received one dose of Hep B vaccination in September 2015, does that make me immune or do I need more doses.

I just did a full spectrum STD test [Including HepB, C, HSV 1, 2, HIV, Syphilis] yesterday, waiting on the results.

My plan is to do the full spectrum again 6 weeks from now and again 3 months from now.

If all of them come back as -ve at 3 months, is it conclusive for all STDs and can I move on as STD free?.

Thanks.




Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
You need more - you actually need two more.  If you can get them all in within a year, it's OK if you are off schedule.  You should see what the antibody test says about your Hep B status - if is says you have surface antibody, that is reflecting the one vaccine but you still need the rest of them.  Yes, I think if you are negative for all of those at 3 months, you can know that you don't have any of them.  You are doing a good job of being cautious about this encounter.

Terri
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