[Question #8465] STDs - CSW and General Safe Conduct
44 months ago
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44 months ago
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I'm sorry for the shitty formatting, something went worng at the end and it all became jumbled up.
And thank you in advance for your time, dedication, and efforts.
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H. Hunter Handsfield, MD
44 months ago
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Welcome to the forum. Thanks for your confidence in our services. I don't see anything wrong about the formatting of your question, by the way.
Your opening statement is correct. The exposure described indeed "carried neglible risks of transmission for virtually all blood borne STDs...". I would also describe your risk as minimal for the STDs transmitted skin to skin. To your specific comments and questions:
1) "As far as I understand, these kind of activities did not carry significant risk to require irregular testing?" I'm not sure what "irregular" means in this situation, but I would not have recommended any HIV or STD testing at all after the events described.
2) Given the sexual lifestyle you describe, a smarter approach is to just have routine testing from time to time, as you apparently have been doing for HIV and the hepatitis C virus. In fact, I would delete HCV testing entirely. It has been oversold as an STD, and in fact hetersexual transmission is exceedingly rare if it occurs at all. The only proved sexual transmission scenario for HCV is among men having potentially traumatic anal sexual activities (i.e. with potential blood exposure) with other men. The 20-year spouses of HCV infected persons are at no higher risk of HCV than anyone else in the general population, unless they also share drug injection equipment with their spouses.
3) As the foregoing implies, you correctly state our recommendations on this forum -- which are consistent with the advice of most STD/HIV prevention experts. But don't overread the reasoning. There are two broadly used measures of condom performance: biologic and use effectiveness. Biologic is what you cite: no infectious agent can pass through intact latex or polyurethane (and rarely if ever through natural membranes either). Use effectiveness takes human error, condom breakage, and so on into account. And even with 100% biological effectiveness and no known misuse, why take the chance? Routine testing from time to time just is common sense.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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44 months ago
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Thank you so much Dr. Handsfield for your detailed response.
By irregular I meant testing out of my normal routine. Good to know about the HCV. I will certainly restart my annual checkups and will add STD panel for sure.