[Question #666] Risk and assessment

54 months ago
Doctors,
I have combed through the forums here and other sites like medhelp to understand what the risk of the recepient of unprotected oral sex.  I am a male and was on the receiving end. My understanding is Gonorrhea, NGU and HSV1 are the true risks.  It's been about 6 months. This was outside my normal relationship and I will never do it again.  My testing was as followed. 4 weeks neg for HIV (4th gen), Gonorrhea, Chlamydia, Syphillis, HSV1&2, the Heps.  Neg again for all 7 weeks, Neg again for HSV1&2 and Syphillis 14 weeks,   Neg for Gonorrhea and Chlamydia 15 weeks. Neg again for HIV (4th gen), Syphilis and HSV1&2 21.5 weeks.  So I assume I am in the clear for all.  Questions are, I never took any meds.  Should I have as precautionary? Seems like there are a lot of docs that give out medicine just in case. I've never disclosed this encounter to anyone.  Have more questions but probably running out of characters.
54 months ago
Other quick contextual information.  I have not had any noticeable discharges besides scant normal stuff.  No lesions or sores or anything that seemed unusual.  At least to my knowledge.  I seem to be a bit more itchy downstairs but that could be due to anxiety.  Also, just noticed I'm question 666.... May be a sign due to my encounter. I jest.  But do feel guilty. Trying to work through it.
Edward W. Hook M.D.
Edward W. Hook M.D.
54 months ago
Welcome to the forum. I had not noticed that you were question 666 but rest assured that is not a bad sign.

Thanks as well for reviewing other posts. Your interpretation is correct.  Your repeat testing has proven without any doubt that you did not acquire any of the STI's you referred to-gonorrhea, chlamydia, HSV, hepatitis,  syphilis, or HIV.  Further, at this time, so long after your exposure, the lack of symptoms is further evidence to prove that you were not infected.  It is certainly time for you to no longer worry and to move forward without concern.

As for the issue of preventative antibiotics quotation marks "just in case", I recommend strongly against this.  Anabiotic's not uncommonly have side effects, can be costly, and there is simply no need for them in your case.  Healthcare providers who give their patients anabiotic's without a good reason are not doing them any favors.  You can be 110% sure that you were not infected by the encounter you described and can now move on without any concerns whatsoever.

I hope that these comments are helpful to you. Stay safe and take care.  EWH
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54 months ago
Thank you for your response Dr. Hook.  I'd like to use the first of my two follow up inquiries.  So with the the repeated testing it seems I most definitely can put this past event behind me.  With that, one thing that still stands out to me is HSV.  There is mention that it could take up to 6 months for someone who is truly infected to become positive on a test.  I am now 26 weeks post incident. Time has certainly gone by fast.  Should I consider one last HSV test to clear any doubt when it comes to Herpes?  All of my tests have been the IgG test.  Also, why do doctors give antibiotics without an actual real diagnosis?  I will only take meds if absolutely necessary.  Even with headaches, I drink a ton of water before I consider Ibprofen.  Finally, from all of my testing, is there by chance anything I should have tested for that I didn't?  In all of my testing and a couple doctor visits I should have been honest with my docs.  Again I haven't told a soul about this encounter.  Not that that would change anything.  Thanks for your time.
Edward W. Hook M.D.
Edward W. Hook M.D.
54 months ago

At 26 weeks with no positive tests there is no appreciable risk for having acquired herpes form the encounter that you describe.  While there are no formal studies, our estimate of the risk of getting herpes from an infected partner who does not have lesions is somewhere between 1 in 1000 and 1 in 10,000 per exposure.  With negative tests, your likelihood of infection is lower still.  At this time, even with prior negative tests, your risk of having a falsely positive test is still higher than your risk of having been infected.  I see no reason for further testing and instead, urge you to move forward without further concern. 

I cannot tell you why doctors would give medications without an indication.  Perhaps they feel it is the quickest way to address a patient's concerns and misjudge the risk of giving medications that are not needed.

I see no reason for further testing and no reason for concern.  I suspect you are overthinking this, perhaps related to your guilt/shame over the event.  I urge you to move on and not worry further.  Stay safe.  EWH


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54 months ago
Dr. Hook, 
My final questions are these.  This may be due to hyper vigilance, but when I am doing my business on the toilet and sitting and urinate at times there is what feels like a slight stinging sensation.  This only seems to be when I am sitting, I don't seem to recall feeling that when I stand.  Could this be a sign of some kind on infection?  I also experience split stream urination way more frequently.  Again it's been 26 weeks.  I would think and hope that three negative gonorrhea and chlamydia tests would be a solid sign that that is not what is causing this or NGU.  This is my final question.  Thank you for your time.  As you have stated, I should feel confident in all of my results and should move on.  This is just my final two "symptoms" that I seem to experience.  Again thanks for taking time to respond.  You guys are awesome.  And again I've learned my lesson here big time.
54 months ago
I know that this forum gets slammed.  Just wanted to highlight I had a couple of other questions as seen above.  Don't want to get lost in the mix.  Thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
54 months ago

Thanks for the reminder.  I had missed your follow-up questions.

When persons have burning on urination it is not positional but is more prominent the longer the interval since last void (due to the build up of inflammatory material over time)  Similarly a split stream is one of those things that does happen from time to time and does not suggest an STI, including NGU.  I would urge you not to worry further.

I hope this comment is helpful and wish you well going forward.  EWH

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54 months ago
Thanks Dr. Hook.  I appreciate all of the information.  I will do my best to put this experience behind me and move on.   Sounds like health wise, everything is okay. 
Edward W. Hook M.D.
Edward W. Hook M.D.
54 months ago
Glad to hear this and hope that our comments were helpful.  Take care.  EWH
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