[Question #5700] Continuation on Risk assessment

22 months ago
Dr. Handsfield,

I asked a few days ago about risk assessment of my activities. I know it's fear and anxiety that's driving this, but I forgot some details last time. The protected encounters I had were 5 and they were Cases ( which is why I made sure protection was used). The unprotected oral encounters were 5 two with the same girl. They all were a little older late 30s and 40s not that matters much. I also think one encounter was with a lambskin condom, though I am not sure because it was hers and it happened long ago. I just recently found out that lambskin condoms are not effective against STIs and HIV. All of this happen during 2 1/2 year timeframe.

Are your assessments still the same as before? I am planning to get tested this week.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Yes, my assessment is unchanged. You are at extremely low risk of any STD.

You misunderstnad about natural membrane condoms. In theory, the risk of STDs might be slightly higher than with latex or polyurethane condoms, due to microscopic pores. However, any barrier is better than none, and there is no research that shows natural condoms actually are any less effective. And given your lifestyle, i.e. only 5 partners, you would be at low risk for STDs and HIV even if you did not use any condoms at all. 

I recommended testing in our previous exchange mostly for reassurance, not because of any serious risk. I suggest you re-read that advice. If you get tested, you can expect negative results. This really shouldn't be any worry at all for you.

HHH, MD
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22 months ago
Im sure you figured it out but I meant to say CSWs not cases
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Actually, I did not realize that. But it makes no difference in my assessment of your overall low risk. At any point in time, most CSWs have no active, transmissible STDs. Whether CSWs or not, the chance you are infected is low, although not zero -- which is why I advise testing for reassurance, with the expectation the results will be negative.

Just to be clear (before someone points it out), there's a good chance you have been exposed to and infected with HPV, since over half of all people acquire genital HPV by the time they have had 3 or more lifetime sex partners; and condoms only modestly reduce the risk, because of skin-skin contact outside condom coverage. This is why everyone should be immunized against HPV, and I would advise you to be vaccinated if not yet done. Fortunately, the large majority of HPV infections remain asymptomatic, are cleared by the immune system, and never cause health problems, and testing for HPV is not recommended in males without symptoms.
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22 months ago
Dr. Handsfield,

To give you an update. So I went to get tested today for Gonorrhea, chlamydia, and trichomoniasis. When I originally contacted you I didn't have any of the textbook symptoms, but weird things were starting to happen. My penis got into a shrinkage state, like when you come out of cold water, there was no burning feeling when I urinated, but a slight burning feeling when I was done, but not painful just noticeable. The physician I saw did a physical exam and other than what I said nothing else has shown up. She had me start antibiotics while I wait for my results which will be in a week. My questions to you are, are these atypical symptoms seen with these infections? Are my chances of possibly have gotten HIV more now? It seems to coincedental that this could be anything other than an STI. However I'm not an medical expert so I really don't know. I tried to look on the internet to see if I can match my atypical symptoms with something, but to no avail. I thought maybe my fear, stress, and anixety might be contributing factors. However I'm not sure now.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
You still have no symptoms that could possibly caused by an STD and this information does not change my evaluation or advice. And whenever someone suspects his or her own symptoms have a psychological or emotional origin, usually s/he is correct. I'm certain that's the only issue here.

Your STD tests will be negative. Stay relaxed as you wait for the results.

That concludes this thread. Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions along these lines will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

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I do hope the two discussions have been helpful. Best wishes and stay safe.

HHH, MD---