[Question #9005] STD Risk?
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37 months ago
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I’m a 32 year old male. Last night I got very very drunk. I’m straight. Ended up at a homosexual male’s apartment. He gave me psilocybin mushrooms is the last thing I remember. I basically blacked out and woke up without any clothes on (his shorts). He was touching my penis. I knocked his hand away and left immediately in the morning. So there’s about 10 hours I cannot account for, we may have had sex. But I’m hoping I wouldn’t be able to maintain an erection under the influence of that much alcohol and psilocybin. But maybe I was so gone that night that I thought he was a woman. I don’t have any anal pain.
In your opinion, what is my risk of STD from this encounter? Would you recommend PEP?
Thank you.
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Edward W. Hook M.D.
37 months ago
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Welcome to the forum. Obviously, it is difficult to assess your risk for having had sex, or of acquiring an STI during your black out. That said, I agree with you it is unlikely that you were able to maintain or sustain an erection during your blackout. Further, had you engaged in receptive rectal intercourse, you would have felt it in the morning. It is most unlikely that this occurred.
Even if your partner had an STI, it is unlikely that you were infected. Most exposures to infected partners do not result in infection. Although taking postexposure prophylaxis is a personal choice, I doubt that you need PEP following this possible exposure. If you do choose to pursue PEP, please remember the sooner you start, the better and that there is little value to taking his medication more than 72 hours following an exposure. Once again however I am not recommending PEP.
In my opinion, the best course of action would be, if possible, to contact this person and ask him about the events of the evening. EWH
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37 months ago
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Thanks for answering! Unfortunately, I don’t know this person’s full name and did not get their contact info. I guess my best course of action is just get tested in a few months to be sure?
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Edward W. Hook M.D.
37 months ago
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I would agree with that plan, testing as follows:
1. Testing for Gonorrhea and chlamydia will provide reliable, conclusive results at any time more than 4-5 days after the possible event. To be absolutely sure, I’d suggest both a urine test for penile infection and a rectal swab.
2. Blood tests for both syphilis and HIV will provide strong evidence as to your infection status at four weeks but will not be entirely, 100% conclusive until six weeks
I anticipate that all tests will show that you were not infected. Hope this helps. EWH
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37 months ago
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Thank you. Is a rectal swab really necessary? Wouldn’t a urine sample be enough?
Also, isn’t here an HIV test out there that would be conclusive much sooner?
Thank you.
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Edward W. Hook M.D.
37 months ago
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The reason I suggested a rectal swab is because of your stated concern about possible although not detected rectal penetration. A urine specimen would not detect rectal infection. If you have concerns about rectal penetration you should have a rectal swab.
In terms of earlier HIV test results, many experts state that a HIV RNA PCR test taken 11 to 13 days following an encounter provides near definitive/conclusive results however those same experts also recommend a follow up test at six weeks using a standard HIV antigen/antibody test for complete conclusivity. I have never seen or heard of a person who had a negative HIVRNAPCR test anytime after 11 to 13 days who went on to develop a positive test.
I hope this perspective is helpful. As you know, we provide up to three responses to each client’s question. This is my third response. Therefore this thread will close shortly.
Take care. I urge you not to worry. EWH
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