[Question #654] Risk of STD

101 months ago

Hello. About 14 days ago I gave and received unprotected oral sex to a woman/friend and we had protected sex outside my relationship. After seven days I started feeling nausea, pain in my right thigh, a tingly feeling in my groin but never had symptoms. I went to my doctor and received a shot and four antibotics pills in one dose. Two and fours days after my shot, I went to labcorp and was urine tested. My results were negative. So I have been staying away from regular partner because, well mainly guilt. My questions are:

1. What was my risks for hpv, hiv, herpes and gonorrhea?

2. Are my test results accurate? Meaning would the test show an infection if I had it?

3. How effective is the treatment?

4. Is my regular girlfriend at risk? Can we get back together unprotected?

5. Should I test for hiv or other stis?

Edward W. Hook M.D.

101 months ago

Welcome to our Forum. I'll try to help by providing facts about your STD risks but as you have already pointed out, I suspect that dealing with your guilt over your actions is going to be your biggest challenge. The exposure that you describe was low risk. Condom protected genital sex is safe sex and the biological efficiency of STI transmission through giving or receiving oral sex is low. You do not say much about your partner but I would also point out that most women do not have STIs and even when they do, transmission occurs with only a relatively small proportion of exposures.

1. What was my risks for hpv, hiv, herpes and gonorrhea?

Building on the comments above, it is likely that you already have HPV - most sexually active people do. The risk for herpes from any single exposure is likewise quite low and if you were going to develop symptomatic genital herpes, it would have occurred by now. I suspect the treatment you received was a shot of ceftriaxone and azithromycin pills. This is recommended treatment for gonorrhea, chlamydia and NGU and is highly effective. If you had been infected, this treatment would have cured it. I would not worry about gonorrhea, chlamydia or NGU from the exposure you have described.

2. Are my test results accurate? Meaning would the test show an infection if I had it?

In general it is better to be tested before treatment, not afterward. I have a low opinion of health professionals who test without know if and whether they are treating an STI. You were tested following taking antibiotics and this could have cured infection and made your tests negative. Thus you will not know if you were infected or not (it is unlikely that you were infected) but either way you can be completely confident that you do not have gonorrhea or chlamydia of the penis at this time. If you did not get the throat swab you were not checked for infection in the throat but the treatment would have taken care of it and thus there is no medical reason for throat testing at this time.

3. How effective is the treatment?

If you were infected and I am right about the antibiotics you received, the treatment is highly effective. No reason for concern going forward.

4. Is my regular girlfriend at risk? Can we get back together unprotected?

Your GF is not at risk and there is no medical reason to abstain from unprotected sex with her at this time.

5. Should I test for hiv or other stis?

No, there was no realistic risk for HIV. I would not worry about other STIs but rather would suggest that you move forward from here. EWH

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101 months ago

Thanks dr. A few follow ups. My partner was an 37 year white woman. Before we started she said as far as she knew she was clean. She brushed her teeth before the event, does that help?

So with the testing, it's negative because I either had an infection and it was cleared or never had it? The antibotics per se don't blind the test of the infection.

So HPV is not really a chance unless i get some sort of warts.

So if my regular partner complains of something in the future like back or stomach, it should not be related to the oral/vaginal sex?

101 months ago

I forgot to mention that yes I did receive the treatments you stated in your reply

101 months ago

And if i May correct myself, I meant to say if my partner complains of any types of pain in the future such as her stomach hurts or pain in the private area it should be of no concern to my event. I've been avoiding her since my other event. I definitely learned my lesson

Edward W. Hook M.D.

101 months ago

In follow-up. You partner was in a demographically low risk group. As far as brushing her teeth before sex, this would make no known difference in risk of any sort.

Correct about the antibiotics- they would not mask an infection.

An finally, should your regular partner have gynecologic difficulties, you should not worry that they are due to your infidelity. EWH

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101 months ago

Thanks Dr. Hook for this forum and your help in the field. We are lucky to have people like yourself. Your clarification has been very helpful. The Internet can has some misleading information. Like I read on one site you can get HIV from oral sex and another site saying antibiotics can mask the testing. Good luck!

Edward W. Hook M.D.

101 months ago

Thanks for your thanks. I agree, while the internet if great for communication, it is also all too often a source of incorrect information. I am glad I could help. Take care and stay safe. EWH
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101 months ago

Dr. Hook, I was listening on this site CDC webinar by Dr. Kemberly Workowski and yourself the US had no reported treatment failures of ceftriaxone and azithromycin in 2015. Is this correct? http://www.cdc.gov/std/training/webinars.htm#tg-overview

Edward W. Hook M.D.

101 months ago

Jason:

At present I am not aware of any gonorrhea treatment failures to date using the combination of ceftriaxone and azithromycin. There may have been one or two but they have not been reported and at worst are very, very rare.

As you know, our Forum Guidelines permit three interchanges related to each question. AAs a result, in a few hour this thread will be closed. Take care and stay safe. EWH

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101 months ago

Thanks Dr. Hook. I looked up your bio. Very impressive. Good luck with keeping America healthy and educated.

101 months ago

I was wondering if I can ask one final question or do I need to pay a new few. I saw Dr. Hunter H say that antibiotics can maybe suppress an infection for NAAT testing on healthtap? Is this incorrect? If so, do I need re-testing?

Edward W. Hook M.D.

101 months ago

If you were infected (and it is likely you were not), then the therapy you took would have reliably cured the STIs you were at highest risk for. There is no need for further testing related to the exposure you described. eWH
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