[Question #8450] recommended testing for unprotected sex
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44 months ago
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Hello,
I am a male that had unprotected sexual intercourse with a female six days ago. Not very smart I know. We had vaginal intercourse and performed oral sex on each other. We also attempted anal sex but my penis was too soft at the time and I don't think much penetration was achieved regarding the anal sex.
I haven't developed any symptoms yet but would like to get tested for peace of mind. I'm wondering what to get tested for and when. There are varying incubation periods for different STDs correct?
At the moment I'm concerned about contracting genital herpes (why this particular STD and not others I'm not really sure why). I get cold sores on my lips and think that I probably have HSV-1 although this has never been confirmed through testing. If I get HSV-2 will I expect to find the same types of lesions that I get with the HSV-1 cold sores? Is it possible for the virus to appear in different forms other than the traditional lesion (like a rash)?
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Edward W. Hook M.D.
44 months ago
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Welcome to our forum and thanks for your questions. I’ll be glad to comment. Overall your risk of acquiring any STI from the encounter you describe is rather low. Most people do not have STI‘s and even when they do most unprotected exposures to infected partners do not result in infection. Nonetheless I certainly support your plans for testing for the most common STI’s for the peace of mind it will provide you.
The STIs that you are most at risk for from these exposures are the most common bacterial STI’s encountered in the United States, gonorrhea and chlamydia infection. Both of these infections can be tested for with the expectation of accurate results anytime more than 4 to 5 days following exposure so it would be fine for you to test at this time. Your testing should include both a urine test for gonorrhea and chlamydia as well as a throat swab for these infections as well.
Blood tests for HIV and Syphilis are often included in STI screening. Your risks for these infections is far lower than you were risk for gonorrhea and chlamydia. Both infections are quite rare in heterosexual women.
Your risk for acquisition of herpes is minuscule. If you get cold sores it is almost certain that you already have HSV-1 and once a person is infected with HSV-1 they cannot acquire it at a different location. The risk for acquisition of herpes type 2 from your genital sexual encounter is likewise low. Most persons do not have HSV-2 and even when they do, in the absence of lesions, the risk for acquiring infection from an infected partner is substantially lower than 1% per encounter. Further, unless you develop lesions at a side of exposure, we strongly discourage blood tests for HSV. These tests can give falsely positive results, falsely negative results and generally caused more confusion than the information they provide in situations such as yours. Please do not get a blood test for herpes.
I hope this information is helpful. If there are further questions or any part of my reply is unclear, please don’t hesitate to use your up to two follow-ups for clarification. EWH
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44 months ago
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Thank you Dr. Hook for the very thorough reply.
I noticed 3 little bumps on my thigh near my hip and quite a ways away from the genital area. I initially grew alarmed but inspected them closer and they just look like razor rash or folliculitis. I noticed one of the bumps had a hair growing out of it so I don't think that this is HSV.
Is it possible for HSV to exist in normal skin? Or can it only exist in the mucous membranes of the lips or the penis? If I do get lesions they will most likely appear on the head of the penis and the surrounding mucous membrane area correct?
Can the HSV be expressed in forms other than lesions? Can I get different symptoms like a rash that's actually HSV? Could symptoms such as a rash exist in regular skin (not mucous membrane)?
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Edward W. Hook M.D.
44 months ago
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Herpes virus infections can occur in normal skin however what you describe sounds nothing like herpes. The presence of a hair growing out of one of the lesions is entirely consistent with folliculitis as is the location of lesion you describe. Herpes would not be expected to cause lesions/rashes of the sort you describe. Please don’t allow your concerns over the encounter you described to send you down a rabbit hole of hypervigilance. EWH
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44 months ago
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I'm not sure if you can answer this but after having sex I had what I think was a burst blood vessel near the head of my penis. It looked like blood or fluid had enlarged part of the vessel. After a few days the vessel shrank back down but I've noticed what I think is a vein or other vessel that feels hard and lumpy along my penis. I don't know if this is the same vessel or not. There is no pain but it feels hard and lumpy, something I've never experienced before.
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Edward W. Hook M.D.
44 months ago
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Without examining you it is difficult to determine precisely what is going on. Certainly the penis is a highly vascular part of the body which is vulnerable to trauma and even occasional blood clots Which may be what is going on here. My suggestion would be to observe the area for a few days as long as it is not getting worse. If it persists you may want to see a urologist.
This completes this thread. I hope the information I provided has been useful to you. EWH
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