I had an unfortunate lapse of judgement and had encounter on March 4th with a stripper in Mexico in which we briefly had unprotected intercourse. I tested negative last month for all of the following: Chlamydia trachomatis; Neisseria gonorrhoeae; Trichomonas vaginalis; Mycoplasma hominis; Mycoplasma genitalium; Ureaplasma urealyticum; Ureaplasma Parvum.  On March 15th I experienced some slight penis discomfort and minor cloudy discharge in my underwear.  I started to feel a bit better by the 17th but went to get tested anyways that day. The test results came back today (March 23rd) and I am positive for:  Chlamydia trachomatis; Mycoplasma hominis; and Ureaplasma urealyticum. 

5. How concerned would you be about Mycoplasma and Ureaplasma? Do those often go hand in hand with Chlamydia?

Thanks in advance for your time!

6. What are the chances of HIV with this sort of encounter?  The intercourse with the stripper lasted about 20 seconds and I did not ejaculate.  And when is it best to test for HIV?

1.  Recommended treatment is doxycycline, 100 mg by mouth taken twice daily for seven days. In patients to take all their medication more than 98% of infections are cured.

2.  Chlamydia is transmitted through penetrative sexual contact. In the absence of penetration there is virtually no risk of transmission of the infection.

3.  Results for chlamydia tests are conclusive on specimens taken at any time more than five days after contact.

4.  False negative test for chlamydia are very uncommon. The most sensitive test for detection of chlamydia in women is to test a specimen collected using a vaginal swab.

5.  Mycoplasma hominis and Ureaplasma are micro organisms which are normally present in the normal genital tract and are not STI’s. No treatment for these infections is required. Most experts recommend against testing for these organisms.

6.  Risk for acquisition of HIV does not change based on whether or not ejaculation occurred. Even so, most strippers and commercial sex workers do not have HIV and even when a partner has untreated HIV, the risk for acquiring HIV is less than one infection for every more than 1000 sexual encounters. In other words there is a more than 99.9% chance that you were not infected in the unlikely circumstance that your partner had HIV.

I hope this information is helpful. If any part of my responses unclear or there are further questions, please don’t hesitate to use your up to follow up questions for that purpose. EWH

There was another partner that I had in the days after the contact with the stripper in which there was unprotected sexual penetration, no oral.  I have already told her about the results and she’s getting tested today because I assume she definitely has it. 

Questions:

1. Is transmission certain for this encounter?  Or are there any cases in which a male who is positive for Chlamydia has had unprotected penetrative sex and not passed it on?

2. In mexico, it seems that the standard testing method is with urine.  How much less accurate is that sort of testing compared to a vaginal swab?  And if results come back negative with urine two weeks after contact, how sure can you be of a negative result?

Thank you!

Transmission from infected men to uninfected women through vaginal sex occurs between 20 and 40% of the time following a single episode.  Irrespective, having been exposed, the recommended approach tis to treat exposed partners even before test results are available.  

Urine testing in women will miss about 5% (one in twenty) infections.   As I said above, irrespective and preferably even before test results are available, your partner should be treated without delay

Hope this helps.  EWH

I am now wondering about the risk of hsv-2 transmission.  I’m already a carrier of Genital HSV-1. I caught that nearly 6 years ago and only had one initial outbreak. Nothing since.  

1. How concerned should I be about hsv-2?  

2. Since my exposure to the stripper was 20 days ago, I’m assuming I can get tested now?

3.  Back to HIV.  If I want to get tested for HIV, what type of test do I take and how soon can I take it to expect conclusive results?  Right now I’m at 3 weeks post encounter.

Thanks again for everything you three do!

Your risk of acquisition of herpes from the exposure you describe this quite low. First, most persons do not have herpes. Secondly even when they do transmission is a relatively rare occurrence, Occurring in far less than 1% of exposures to infected partners.. Third you have not experienced an outbreak and had you acquired HSV-2, you would have most likely developed an outbreak within 10 days of exposure. We strongly recommend against using blood tests for diagnosis of genital herpes in circumstances such as yours. False positive tests are quite common, particularly in person who already have HSV-1. Given your tendency to worry, I fear that testing for herpes is likely to only miss lead and fuel your anxiety.

If you wish to test for HIV which is also very, very unlikely, testing using currently available combination antigen/antibody tests will provide conclusive results six weeks to follow your exposure.

I hope the information I provided is helpful to you. Take care. EWH