[Question #6689] Assessing Risk from recent encounter

13 months ago
Hi Dr's

I made the unfortunate mistake of having intercourse with a stripper and want to assess my risk for an STD/herpes

She placed a condom on my penis (not erect) using her mouth. She gave me protected oral for 30-60 seconds, then proceeded to give me protected vaginal for 30-60 seconds. I pulled out and masterbated with condom on to finish.

I checked my penis area for unusual marks over the following days/weeks and didn't notice anything.

4 weeks post exposure I started getting some symptoms that matched with Chlamydia.
Night 1 and 2 - Penis felt like it was on fire. Always felt like there was still a drop or 2 of pee stuck in my Urethra.
Night 3 and 4 - Penis pain went away. Now testical pain starts. Feels sore. The pain also feels like it's actually not in my testicals but right outside
Never had any discharge and no burning when I peed (actually felt better when I did).
All pains went away after the 4th day.
Full pannel STD tests all came back negative. My Urologist is taking another urine sample to test for other odd STD's that a full pannel might not catch. Waiting for those results.

I am now at 5 weeks. I occasionally feel weak in my legs and dizzy but I'm 99% sure that's my anxiety ( I don't have either feelings if I'm not thinking about this).

So my questions:

1. What's my risk at an std here? Should I continue getting tested? 

2. What's my risk for viral std's including genital herpes? What's my likeliness?

3. If I had unprotected sex 2 weeks following this encounter with an uninfected partner, how likely would it be for me to pass any of the std's to her?
13 months ago
I should add another thing.

In the last few days I have been getting a bit of a sore throat only at nights.

Also, just yesterday I noticed what looks like a papercut right next to my Urethra. I'm starting to thing that cut might be the reason for a lot of that burning pain.
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Welcome to the Forum.  thanks for your question.  I'll be glad to comment.  The risk for STIs from the exposure you describe is close to zero.  most commercial sex workers/exotic dancers do not have STIs, when they do most unprotected exposures do not lead to infection, and condoms reduce the risk for all STIs as long as they are worn throughout the sex act.  In your own case, the development of symptoms 4 weeks following an exposure would be unusual for all STIs as we-- -most typically symptoms would occur within two weeks at the most if they were going to develop at all.  The tests your urologist performed appear to validate my sense that your symptoms are not an STI and warrant further evaluation by your urologist if they are progressing or interfering with your life.  I'm quite sure that the weakness and dizzy sensations you describe are not due to an STI.  In answer to your specific questions:

1. What's my risk at an std here? Should I continue getting tested? 

See above.  Very low.  You indicate that you have already been tested by your urologist.  I see no need for further testing, including testing for HIV.

2. What's my risk for viral std's including genital herpes? What's my likeliness?

IF your partner had herpes, your isk for infection without a condom would be less than 1% and with a condom the risk is far lower still.  Were you going to develop herpes lesions you would have done so by now.  As for the other major STI, HPV, first of all most people already have it (see other threads on this forum for more information) and condoms do reduce the risk for acquisition of HPV.  I would not be worried about HPV.

3. If I had unprotected sex 2 weeks following this encounter with an uninfected partner, how likely would it be for me to pass any of the std's to her?

IF you had a classical STI (unlikely- see above), your risk for transmission through a single episode of unprotected vaginal intercourse would be about 30% (Higher for transmission from men to women than from women to men where the figure is about 20%).

I hope this information is helpful.  I doubt that your symptoms are an STI and would encourage you to look for other explanations for your symptoms, probably by continuing to work with your urologist.  EWH

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13 months ago
Thanks for your reply.

My original issues are mostly gone, so i'm not worried about it anymore.

I'm now worried about Herpes. It sounds like my chances are less than 1 percent, so i guess I can breathe easier.

You answered my question about passing an sti to my partner, but can you tell me the chances I would have passed Herpes or HPV via unprotected sex 2 weeks after i'd possibly be infected?
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
This risk would be low.  There are not specific data to give you a numerical answer.  Considering all of the factors you report, I really would not worry about having acquired  viral STI, much less transmitting it.  EWH
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13 months ago
Thanks for the response!

I've actually noticed a bit of an outbreak that seems like either Genital warts or Molluscum so  we know I at least got some sort of viral infection. 

1. Assuming I have one of those 2, could I have spread them before I actually noticed any symptoms?

2. These 2 would be much easier to acquire than Herpes correct? I'm guessing my acquisition of genital warts or molluscum shouldn't effect my worry-ness towards herpes?

Thanks for your responses. I think I'm done with questions for now. If I need to ask more I'll buy more later.
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

I would caution you not to assume that the lesions you have noticed were either herpes or molluscum.  Genital warts typically take at least two months to appear so this is a bit early and molluscum is unusual in adults.  My sincere advice is to have a trained, experienced health care provider (preferably a dermatologist) take a look and not assume that the lesions are STI.

Similarly, the timing of these lesions is wrong for herpes.  Herpes lesions typically 7-10 days after an encounter, not a month later.

Please see a dermatologist and do not assume that the lesions you have seen are an STI or related to your encounter over a month ago.  EWH 

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Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
this was my 3rd reply.  As per Forum guidelines, this thread will be closed shortly.  Please do not assume that these lesions are an STI.  EWH
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