[Question #574] Follow up re recent question I asked about incident with thai massage girl

44 months ago
I asked a question a few days back regarding possible exposure to hiv/std from a brief protected oral episode with thai girl at a massage. I was put on pep, given ceftriaxone injection, antibiotics and a viral pill. What stds do these medications cover, are they effective, what is the risk of developing std still and if and when should I be tested? Thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Today I happened to pick up your question and will be answering.  Before I address your hypothetical questions let me agree and endorse his earlier statement that the exposure you describe did NOT put you at meaningful risk for any STI, including HIV and that the doctor who give you these medications put you at more risk for side effects than anything else, not to mention wasting your money.

PEP would reduce your risk for HIV, had you been meaningfully exposures, by more than 80% and perhaps even more if you take the full 28 day course of therapy (which is a waste of time and money in your case).

An injection of ceftriaxone would prevent gonorrhea, syphilis, and chancroid. 

There is no known effectiveness of antiviral therapy for STD prevention other than EPE/PrEP.  It is unstudied.  Similarly since I have no idea what you mean by "antibiotics" I cannot comment.  EWH

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44 months ago
Thanks Doc. Ciproflaxcin was the antibiotic I was given. Seeing as though we are talking hypothetically, as I have nearly finished the prescribed course of these meds, plus the ceftriaxone injection, would this mean I do not have these stds as these meds effectively cure stds?? Sorry for silly questions, head is still spinning and can't speak to a local expert in australia until today regarding testing and continuing PEP. I'm a real worrier, sorry! When is the best time to be fully std tested?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Correct, following taking these meds (that you did not need) you should be confident that you were not infected with an STD from the no risk exposure that you described to Dr. Handsfield. 

Testing for STIs would depend on which STI you were interested in:  Gonorrhea or chlamydia could be tested for any time more than five days after completion of the ciprofloxacin, syphilis could be tested for about a month after exposure with reliable results, for HIV you would need to wait until at least a month after completion of your PEP.  EWH

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44 months ago
Thanks again Drs Hook and Handsfield! Probably more guilt and shame related anxieties that I am feeling other than properly being exposed. Hopefully I can speak with a local expert today to commence a plan of testing and to discuss my PEP situation. Are there any issues that you are aware of from ceasing PEP prior to the end of the course in my case? Would it still be pertinent to complete the course given it was protected oral (given I'm a worrier)? Is PEP normally prescribed for oral related exposure? Sorry for the dumb questions, feel I've wasted your time! Thanks for your help and advice though.
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

I cannot imagine a situation n which I would recommend PEP for someone whose only exposure was oral, whether protected or not.

I also see no reason for you to continue the PEP.  I suspect that when you talk to an informed health care provider there in Australia they will say the same thing.  EWH

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44 months ago
Feeling more confident thanks Doc, hopefully after speaking with an australian clinic this morning I'll be pointed in the right direction and on the way to being proved hiv negative!! Thanks for your input.
44 months ago
Hi I spoke with std / hiv expert clinic in australia today who echoed your sentiments in relation to ceasing PEP and not needing any additional testing! Fingers crossed, still a little nervous as mind plays tricks, but if you guys aren't worried guess I shouldn't be either!
43 months ago
Sorry Doc with regard to my situation, what would be the chances of catching herpes?? There was no skin to skin contact other than her briefly touching my chest with her hand and no touching of any significance outside of the area that was covered by the condom. Still anxious, don't appear to have any symptoms of sores or lesions. 
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

Forum guidelines specify that there should only be three  exchanges per question.  this is not only a new question but your 4th.  After this there will be no further replies and this thread will be closed later today.

Transmission of herpes typically requires direct contact.  Your risk, particularly in the absence of symptoms by now is very, very low. EWH



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