[Question #7750] STDs risks

1 months ago
Hello Doctor,

Here is what I have done, I had an encounter last night with a Hungarian girl in France. She started by using her mouth to put on the condom and proceeded with a protected oral for a couple of minutes, then we had protected vaginal intercourse for about 10 minutes. Finally, I removed the condom and she proceeded with a hand job, she was touch herself before giving me the hand job. I wasn't worried honestly until after I was done we talked a bit and she smiled more, she didn't reveal her teeth completely before that moment. I realized the base of some of her front teeth were black, I mean the part of the teeth near the gum. I don't know her situation in life nor like to judge her but I started thinking of how drug use can lead to that and that led me to more thoughts about prevelance of STDs in drug users, I didn't ask her. 

So, my question is: did I put myself at any risk for transmitting hiv or any other STD during that encounter? And should I be worried? 

Thank you in advance. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome to the forum, your second time. Thank you for your continuing confidence in our services.

Looking back at your question nearly two years ago, the low risk nature of this recent exposure should be quite clear from Dr. Hook's replies. He spoke of the low chance of female sex workers having HIV (his comments about those in Canada also apply to Western Europe); the effectiveness of condoms for HIV protection from vaginal sex; and the safety of oral sex (even without condom protection). Non-HIV STDs are of course more common in sex workers, but still at any point in time most do not have active, transmissible STDs. The efficacy of condoms, however, is the same for STDs as for HIV. And even your oral sex exposure was condom protected. (The trick of oral application of the condom isn't believed to significantly raise STD/HIV risk.)

Having bad teeth, gum disease, or poor oral hygiene do not in themselves increase the chance of any STD or HIV, and probably not their transmission either. Having poor oral hygiene and/or dental care probably is a valid sign of someone who may take other health risks. However, any increased risk on account of her oral health is entirely mitigated by condom use.

In general, I and most STD/HIV experts do not recommend testing after single exposures unless the risk is substantial. On that basis, A better strategy is for persons having non-monogamous sex from time to time to be tested at regular intervals, e.g. every 3 to 12 months depending on sexual frequency, condom use, and so on. Accordingly, I see no need for you to be tested for anything. On the other hand, you wouldn't be here if you weren't nervous about it, and anxious persons often are more reassured by negative test result than by professional opinion, no matter how expert. (We don't take it personally!) So feel free to be tested if you'll worry less and sleep better. If you choose to be tested, I would recommend a urine gonorrhea/chlamydia test (valid any time more than 3-4 days after exposure) and, after a few weeks, blood tests for HIV and syphilis. Be clear:  if somehow I were in your situation, I wouldn't be tested at all. But if you decide on testing, stay relaxed until you are tested. You definitely can expect negative results.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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1 months ago
Thank you Dr. Handsfield for your informative response. I generally have one annual check for everything including HIV and Hep, it is part of my work requirement. You are correct in ur estimation for my worry but your response was enough to disperse my fears. I will continue to practice sex only safely as I have done for years.

Thank you so much again. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Thanks for the thanks. I'm glad to have helped. I'll leave the thread open for a few days in case other concerns come to mind.---