[Question #7186] Sti exposure

9 months ago
Good morning doctors,
Thank you for providing this service.  I have read through your interactions with other folks on the forum a would like to confirm that I have correctly understood the risks that I have placed my self at for sti’s after a recent unprotected encounter.

So cutting to the point I am male and had a condom break during vaginal sex with a csw in Australia, the duration of the intercourse was half an hour.
She said she had tested 2.5 months previously and all was fine.

I Freaked out got treatment with 1 gram azithromycin 1 hour post exposure.

I understand this treatment would have taken care of any chlamydia infection.

I currently have no symptoms From reading previous interactions on the forum my chance of asymptomatic gonorrhea is approx 2%, can you comment weather the azithromycin I took would have lowered this percentage further?

Would azithromycin taken shortly after exposure reduce my chance of acquiring syphilis?

I’m Currently 5 days post exposure I’m check myself every day including looking for stains on underwear and checking for sores at what point can I relax, I’m married and have been abstaining from sex with my wife. From reading other posts the chance of catch hiv would be low in this instance?
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago

Welcome to the Forum and thanks for your questions.  I'll be glad to comment.  The exposure that you describe was very low risk for a number of reasons, even before you took the azithromycin.  Please remember that licensed CSWs in Australia are regularly tested for STIs and typically use condoms.  Condoms break approximately 1% of the time.  Thus the likelihood that your partner had an STI was close to zero. Even if she did, the majority of single exposures to do not lead to infection.  Thus, even despite this exposure, it is unlikely that you would have been infected.

The azithromycin you took reduces your already low risk for infection even more.  The azithromycin would cure chlamydia if present, cure about 70% of gonorrhea if present and prevent syphilis in at least 80% of syphilis infection. 

I would not worry further about STI risk from this exposure.  I see no reason for testing and urge you to relax an d not go overboard with repeated self-examination.  If you developed signs of an STI, you would not need to be scrutinizing your genital regions to detect it.  EWH 

---
8 months ago
Thanks for your response, just to confirm if I don’t notice any obvious symptoms in the next few days I should just forget about this and move on as there is not much of a risk of me infecting my wife? 
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Your interpretation is correct.  If I were in your situation, if I did not develop signs or symptoms, I would move forward and not hesitate to have unprotected sex with my wife.  EWH
---
8 months ago
Thank you so much for your reassurance you have saved me from loosing my mind. May I ask 1 more question if I don’t have any responses left it’s all good. Whilst I was combing the internet prior to asking my questions I found so interesting research papers on lycopene and it’s inhibitory effects on chlamydia, have you heard of this? And are there other natural compounds that would provide resistance to stis? If I have  no responses left all good
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
There are no high quality clinical trials evaluating lycopene or other natural products.  That’s not to say that they might not work, just that there are no scientifically proven benefit.

As you note, this is the final reply as part of this thread.  Sorry to take so long to reply.  EWH
---