[Question #9371] STD Risk

33 months ago

Hi Doctor,

I recently had a protected vaginal intercourse with a high end escort in Thailand. I am not concerned about HIV as my condom was intact throughout. Please note that I do not even let anyone touch me without a condom.

Questions:

Do I need to worry about getting tested for Clamaydia and Gonorhea ? It has been 7 days and I have no symptoms. Both vaginal and oral were protected.
What about Syphillis and herpes ? Strictly from a medical point of view.
Regardless of the particular situation above, but due to the life style that I have chosen if I use protection with my regular partner and I don't see any visible outbreak (Chancre, sore or painful urination), is it safe to assume that my partner will not be infected ? I am thinking about the worst case scenario where I do get infected and I am not yet aware of it. Please note that I always use protection with my regular partner due to pregnancy issues

H. Hunter Handsfield, MD

33 months ago

Welcome back, but sorry you found it necessary. All these are repeats, in spirit if not in all details -- so my replies are brief.

1,2. For this particular exposure, no: testing isn't needed for any of these infections.

3.This opens the discussion I was planning even before I read your questions. Over your multiple questions for several years, every one asks for confirmation that a particular exposure was safe and that, for the most part, testing wasn't needed. On the other hand, even when the risk is as low as possible (low risk escorts, consistent and proper condom use, etc), the risk of HIV and other STDs is never zero. Every single one of the encounters you have described could have resulted in an STD, with very low risk. But of course risk accumulates: a thousand near-zero risk exposures still results in many STD transmissions. For example, undoubtedly you have been infected several times with HPV and probably have transmitted HPV to your regular partner. And that could have happened with other STDs as well.

There is no way to follow your sexual lifestyle with zero STD risk, and everyone with your sexual lifestyle needs testing for common treatable STDs and HIV from time to time, i.e. gonorrhea, chlamydia, syphilis and HIV, maybe every 6-12 months, even if there have been no known lapses in sexual safety. Ideally your regular partner should be tested with similar frequency as well. And you both need to be on alert for HPV symptoms (warts in either of you and routine Pap smears for your partner).

Now that you clearly understand these facts, there is no point in continuing to ask about the level of sexual safety after particular encounters outside your regular relationship. Assuming you continue your current care in selecting partners and condom use, you can expect identical answers to the many you have had so far; plus repeat of the advice just given, to have periodic testing to be on the safe side, and also be alert to symptoms in yourself and your partner. In addition to the limited need this implies for you to hear the same answers yet again, ASHA is not keen on collecting fees for repeated questions with obvious answers. Finally, such questions have limited educational value for other users, one of our main purposes. For these reasons, future questions will be subject to deletion without reply, and without reimbursement of the posting fee. This policy is based compassion, not criticism.

Thank you for your understanding. I do hope the many discussions have been helpful. Best wishes and stay safe.

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33 months ago

Thanks Doctor. I have had got tested for all the exposures (except this one) and all negative. It is a different discussion if testing was warranted each and every time (or not) :)

I see your point and thanks for reaffirming it.

You may close the thread.

Regards,

H. Hunter Handsfield, MD

33 months ago

I understand that each time you have asked about testing advice. But the same kinds of exposure will always produce the same advice. Thanks for your understanding. Best wishes and stay safe.---