[Question #8002] Did I pass on any STI ?
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50 months ago
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Hi Dr's,
I had occasionally encounters with CSWs in the US. I got my self screened last August and was negative for full panel screening except HSV1. After that I was dating some one. Last November I had an encounter with one CSW, white female mid 40s in bay area California. She was kind off premium ( 300$) and I assume risk may be low ( not certain ).
Anyways, during intercourse the condom slipped off and I clearly ejaculated inside of her. I thought this was a low risk situation and did not get my self screened. I have not had any encounters with any one after that
Fast forward to today , I have a wife of 7 months. Since marriage we are in exclusive relationship. But what concerns me is that since last 3 days she's been having bad body aches, slight fever and diarrhea. She was tested as covid negative ( twice) and also vaccinated.
I'm worried that what if I had STI like HIV from my last encounter w/ o any symptoms and transmitted it to her? We were not together for 4 months after marriage and got physical since a month only for now.
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49 months ago
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My tensions just got worse, she now also has a swollen area ( lymph node) in the mid area of her throat ( on the left side). please advice.
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Edward W. Hook M.D.
49 months ago
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Welcome to our Forum and thanks for your confidence in our service. I’ll be glad to comment. I agree with you that, even despite your condom slip, the risk for having acquired any STI, including HIV, is low. Most CSWs, particularly the more “high end” ones, get checked regularly and do not have STIs and even on those rare occasions when they do, most single exposures do not lead to infection. Further, your own lack of symptoms during the more than seven months since the event also is in your favor. Your wife’s flu-like illness is most likely a non-STI viral illness of the sort most people get from time to time. None of the symptoms you describe are particularly suggestive of HIV. FYI, When at-risk persons seek evaluation for flu-like illnesses such as the ones you describe, more than 99% of them have illnesses other than recently acquired HIV.
From the sounds of things, you are anxious that this could be HIV or some other STI. If so, you may want to be tested for your own peace of mind. At this time all results will be conclusive as far as your November exposure is concerned. I am confident that if you test, you will find that you were not infected, eliminating the possibility that your wife’s illness is related to the CSW exposure 7 months ago that you describe.
I hope this information is helpful to you. If there are further questions or clarification is needed please feel free to use your opted to follow up questions for clarification. EWH
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49 months ago
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Thank you Dr. Hook for the kind reply. We are still waiting on few blood work reports of my wife from the lab to identify the root cause. Doc at urgent care thinks this might be a thyroid issue ( but is not certain obviously and hence ordered he blood work analysis).
What are the chances that I have infected her from my hsv1 ( I was positive on the 10 panel STD testing, don't know it if was oral or genital) triggering this in my wife. We don't know if she's had HSV 1 before. She never was in any relationship ( physical or any other) all her life.
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Edward W. Hook M.D.
49 months ago
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There is little here to suggest that your wife’s current illness is HSV-1. If it were, she would likely have cold sores or oral lesions which would have been recognized by her doctor. Further, your HSV may we’ll be longstanding. Most people acquire HSV-1 during childhood. EWH ---
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49 months ago
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Thank you. I hope this is not an STD that's effecting her. My last question as follow up.
1) if me and my wife decide to make this a non exclusive relationship, as long as we have a protected intercourse and unprotected oral, will it be OK? Or to make sure 100% safety while seeing others, should we use condoms all the while
2) I wasn't tested positive for HSV1 in my STD screening in 2013 and 2017. I only tested positive last year. I also don't recollect having any lesions or sores on my lips or genital area in recent times.
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Edward W. Hook M.D.
49 months ago
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Thanks for your follow up and for the additional information. As you know, as this is my third response, this will conclude this interaction and the thread will be closed shortly after this reply. Straight to your questions:
1. If you and/or your wife decide that your relationship will be non-exclusive, I recommend kind of use for all interactions outside of your marriage. While there is no meaningful risk for acquisition of HIV from receipt of oral sex or cunnilingus, performing oral sex on a male partner does have a very small risk of HIV acquisition. Even more importantly however, with unprotected oral sex gonorrhea transmission can occur not all that uncommonly. Pharyngeal gonorrhea infections may be transmissible to partners through oral sex and are typically asymptomatic. Thus, outside of your marriage I would highly recommend consistent and correct condom use for all sexual interactions.
2. HSV one blood tests are notoriously unreliable both in terms of frequent false positive and false negative results. For this reason virtually all experts recommend strongly against them. There is a possibility that if you were to retest (something I do not necessarily recommend) yet another HSV blood test would be negative.
I hope the information I have provided is helpful to you. I am confident that your wife’s current illness is not due to an STI. As mentioned above, this thread will be closed shortly. Take care. EWH
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