[Question #8164] Risk of any STI Gonnorhea, Syphillis, Chly, Herpes -CSW In Poland

48 months ago

I went to a mid-range CSW in Krakow. She doesn't undergo tests as for her it’s been 4 weeks in the business, but she always use condoms for sex.

I used a condom, but the penis wasn’t fully erected when I wore it and inserted into her. The sex lasted 5 minutes and was not rough. There was a time that my penis was deep insider her. However, after I ejaculated and started getting up, I notice I cant see my condom. When I move further out, I saw that condom was still there, but little rolled up. But, I somewhere believe that the lower end of the shaft wasnt covered and was inside her vagina. I did not see any lesions on her vagina.

I always had white little pimples under the skin of my penis, at the back of the shaft. Sometimes they grew and can burst when I press them, oozing white fluid. Then I don’t see that pimple. I have one on my testicle which is little bigger, egg shaped, under very thin skin of my scrotum. What worries me is the fact that after sex, one of the pimple in the shaft grew. It wasnt there before sex, or maybe I havent noticed. When I pressed it lightly, it bursted. I believe that during sex when I got a strong erection, the condom might not have covered that part and there may be friction there.

As far as I remember the exposed skin was bit red. After 30 mins, I washed that part with sanitizer and later with soap and water. So, I would like to ask whether friction in the non-covered penis with pimple and on testicle would lead to any STI? Please suggest.

H. Hunter Handsfield, MD

48 months ago

Welcome. Thank you for your confidence in our services.

Protection against STIs transmitted primarily by fluids (including gonorrhea, chlamydia, HIV) is complete as long as the head of the penis and meatus (urethral opening) are covered; and is considered complete when the penis withdraws from a condom that remains in the vagina. It is correct that condoms do not protect as well from STIs transmitted by skin contact (like herpes, HPV and syphilis), so your risk might have been a bit higher because of increased contact between your partner and your penile skin.

Pimples occur normally on the penile shaft and scrotum. Enlargement of an existing pimple after sex is not known to result from an STI. I cannot judge whether friction during sex made a slight difference, but I doubt it. And exposure of an intact pimple to genital fluids or skin is not known to be risky for STI.

All things considered, your risk for STI was low, but probably not zero. For further reassurance, consider being tested for gonorrhea and chlamydia (a urine test is valid any time more than 4-5 days after exposure) and also blood tests for HIV and syphilis after 6 weeks. You can expect negative results. In the meantime, of course get professionally examined if typical STI symptoms appear in the meantime: discharge from the penis, painful urination, or new superficial blisters or sores of the penis.

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

HHH, MD

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48 months ago

Dear Dr. Handsfield,

Thank you for the prompt response.

Is there a high probability to acquire herpes or syphillis based on my case? How long it takes symptoms to appear for such infections?

I had a good look of her vagina before sex to see any visible lesions. I didnt find anything unusual. Though she spoke little English, I asked her whether she has any sex problem, which she answered No. Since, she doesnt undergo tests, I dont know how much I can rely on her. What she told me that she understands the risks and therefore never does sex without condom.

I completely trust your advice, but based on medical reasoning , is testing definitely required?

Also, is Poland known for high STI rates?

Should I refrain myself having sex with anyone, like normal partner? I have recently met someone on online portals and was planning to go further towards sex.

Thanks

48 months ago

Sorry for posting again. Please advice me on my follow-up questions posted today with below information.

Should I follow any preemptive medication based on this exposure?

Is it possible that you can evaluate my risk based on numerical data?

What are the chances of acquiring STIs with single expsure such as mine?

My anxiety stems because I hardly perfom intercourse with CSW. When I do I use condoms. This is the first time that I used condom but it didnt covered lower part of my penis. Is the base of the penis can too be a site of infection based on my exposure?.

I look forward to your response.

Thanks

H. Hunter Handsfield, MD

48 months ago

"Is there a high probability to acquire herpes or syphillis based on my case?" No, very low.

"How long it takes symptoms to appear for such infections?" Herpes usually within 5 days; syphilis 2-4 weeks.

"I had a good look of her vagina before sex to see any visible lesions. I didnt find anything unusual." That makes active infection only a little less likely.

The testing I recommended is optional. But many persons anxious enough to come to a forum like this are more reassured by negative testing than by expert advice. It's up to you.

I don't know much about STI rates in Poland. I'm sure information is available from national or provincial health authorities.

I would not recommend any preventive medication after such an exposure. I have no data on which to come up with a numerical estimate of your risk, except it's probably very low, maybe under one chance in a thousand (??).

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47 months ago

Dear Dr,

This is 7th day after my exposure. So far no symptoms. What would you suggest further?

In many posts, I read in yours & Dr Hook's comments that chances of acquiring STI when condom doesnt cover a part of penis is very low. To clarify, what bothered me is that pimple on my penis that may have increased bec of friction inside vagina but bursted only when I pressed it after removing condom on my penis Also, my condom was on my penis all time, just little rolled up. I cant surely make out whether the pimple was inside the condom during sex.

You suggested that testing is optional. So do you consider my case so low at risk that testing itself isnt necessary? Does this friction sufficient enought in practical cases for single & brief exposures to acquire STI?

I also read that in your experiences you have come across cases where one partner was infected & other was not & still they didnt acquire herpes after years of unprotected sex. So, the estimates are 1 in 1000. Is it without any treatment?Is it same for Syphillis & HPV? Is it possible that you can elaborate on this?

What happens when there is a lesion. How much do the chances increase? Does lesions make women ill enough not to perform sex in the first place?

After how many days should I consider myself safe? Can I resume sex with normal partner?When should I test for HPV I am 30 and planning to get HPV vacc. Would you agree?

I apologize if my Qs are repetitive & detailed. Your answers will help me with assurance.

H. Hunter Handsfield, MD

47 months ago

You're seriously over thinking all this. But it seems obvious you're going to continue to worry and I believe testing will help convince you nothing is wrong. Therefore, I recommend you have a urine test for gonorrhea and chlamydia, which probably will be negative. And that you have blood tests for HIV and syphilis 6 weeks after the event. However, the chances of syphilis and HIV are so low that I would recommend you resume sex with your regular partner after you know the gonorrhea/chlamydia test is negative. Alternatively you could refrain from sex with your partner until then, but I do not recommend it -- if I were you I would accept the exceedingly low risk that you would test positive.

There is no test for HPV, and getting and having genital HPV is normal, and your risk of having it is not any higher after this exposure than it was before. Having had other partners in your life, both you and your regular partner probably are already infected with HPV anyway. However, if you and your regular partner are under age 26, both of you could consider vaccination against HPV -- but not because of this particular recent sexual exposure.

The tests for herpes are not always accurate in people without symptoms. I suggest no testing for it.

That completes the two follow-up comments and replies included with each question, and so ends this thread. Please do not return with further questions about this exposure. If you remain concerned, find an STI expert or clinic for in-person comprehensive evaluation and testing, which probably would be more helpful than continued questions on this or any other online forum. However, I do hope this discussion has been helpful. Best wishes and stay safe.

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