[Question #9746] Std risk
29 months ago
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Hello doctors,
Me male 28 and female 23
We have been talking for a while but yesterday we had our first encounter. Unprotected oral sex and one minute of unprotected vaginal sex.
What is my realist risk , this happened yesterday and well I thought we were exclusive and we are not. She denies having stds in the past ? For the oral she had no symptoms of blisters in the lips and I’ve tested for all stds including herpes in the past. Thanks ! What should I look for In the next days ? Should I test again in 6 weeks ?
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Edward W. Hook M.D.
29 months ago
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Welcome to our Forum and thanks for your questions. I'll be glad to comment. The exposure you describe was low risk. Most people, even those in non-exclusive relationships do not have STIs and even when they do, most single exposures do not result in transmission of infection. Having said that, I have some suggestions:
1. Despite the low risk, testing is reasonable, just to be on the safe side. The most important STIs for you to test for would be chlamydia and gonorrhea. I suspect if you seek testing testing for syphilis and HIV may be offered and this is also reasonable but your risk for either of these infections in the situation you are in is vanishingly low.
2. If this relationship is going to go forward, one way for both of you to have confidence in each other going forward is to go get tested together. This is not a matter of suspicion but instead, a way for each of you to be able to move forward with confidence.
Your risk for herpes is tiny and not a concern. If you had acquired herpes, I would expect herpes lesions to appear within the next week to 10 days. If no lesions in that time, I would not worry further.
I hope these comments are helpful. If any part of my answer is unclear, please feel free to use your up to 2 follow-ups for clarification. EWH
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29 months ago
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Dear Dr hook
Thanks for your answer and I appreciate your opinion. Just to make sure.
The real risk are let’s say chlamydia and Gonorea. HIV and syphilis could also play a Role. If I do not develop blisters within the next 14 days I shouldn’t worry about herpes. I will not pursue this unfortunately since she is looking for an open relationship and I am not into that. The oral sex was given and received for a good 20 min and the vaginal sex was really 45 second at most. If I was your patient would you suggest that I do a whole panel or just chalmdyia and gono, if yes, when?
Once again thanks for your help.
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Edward W. Hook M.D.
29 months ago
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Your summary is correct. The tests that I would want the most are tests for gonorrhea and chlamydia. Personally, I have little concern in your case about syphilis or HIV but the decision to test is yours.
Testing for gonorrhea and chlamydia will provide an accurate result any time more than 3-5 days after your encounter.
Take care, please don't worry. EWH
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29 months ago
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Dear Dr hook
Thanks for your kind words and experience. I appreciate your help. Since I have a last follow up. I would like to use it.
I live abroad in Spain and they recommend 2 weeks for the urine chlamydia and gonorea what do you think ?
Should I just take it at 4/5 days ? Or wait the two weeks ?
Also when would you recommend the hiv and syphilis test? Most doctors here at say at least six weeks even for herpes to. Do you agree with the time frame ? Or are they being conservative? So far it’s day two and don’t have any symptoms so I think I should be fine and not to worried. But still for mental peace since I thought she would be more into exclusivity. Anyways thanks for you help and for helping us get better
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Edward W. Hook M.D.
29 months ago
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Waiting 2 weeks to test for Gonorrhea and chlamydia is overly conservative. Testing at 3-5 days will give accurate results.
Testing for HIV and syphilis will be accurate at 6 weeks although some experts suggest that it may take up to 3 months for syphilis tests to be entirely conclusive.
We specifically recommend against blood tests for herpes in situations such as yours. The tests bot uncommonly give falsely positive results and even out to six months tests for HSV-2 detect only about 92% of infections. Your risk for herpes is much lower than your risk of an inaccurate result.
I’m glad you found my comments helpful. EWH
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