Health Concern - STI's

[Dolorian]

Dear Dr's;

Thank you for the great work you do here.

I (30y.o male) engaged in unprotected oral (insertive) with a female russian escort of unknown STI status. No anal, no vaginal.

I do have an undiagnosed probably chronic viral infection of the skin at the base of my penis & scrotum due to which my penlie skin is often chaffed/cut.

Very anxious about STI's now as i have a regular partner.

My question is what STI's do i need to test for and at what time intervals given that the incident described above occured a few hours ago?

Can i continue unprotected sex with my regular partner?


Thanks.

[Edward W Hook, MD]

Condom protected sex is safe sex.  In the absence of symptoms, there is no medical reason for testing or for you to worry about unprotected sex with your regular partner.  EWH

[Dolorian]

Dear Dr.Hook;

Thank you for your feedback, i was wondering if you could add one last medical opinion for me.
Over the last 9 months or so, i've engaged overall, in about 20 different sessions of vaginal intercourse, with 20 different csw's & all with either one or double condoms in place. I never visited the same csw more than once & never checked the condom(s) after withdrawing after ejaculating within the vagina. And about 4 diffrent sessions of unprotected insertive oral each with a dfferent csw. I have no visible lesions on my penis this far & no penile discharge.

Medically speaking, regardless of symptoms; do i need any testing & for what in particular?
Would you continue unprotected sex with a regular partner if in my place.

Thanks again.

[Nads2345]

Hi doctor i have a simillar situation i had sex with a lady with a condom she was not meant to be on her period but when i withdrawed my penis there was some blood on the condom i dont know if this was due to her iud she has in place i do not know her hiv status, i checked the condom after words and the sperm was still in the condom at the tip so im pritty sure it did not break, however she did perform unprotected oral on me for a min or so but she didnt go deep she just had my head in her mouth, also before i put my penis in her i did finger her whilst licking her clitoris for about 15 secs i know that is gross but i didnt know... After the whole incident i did notice sum dried blood on my finger nails there was no cuts i am so worried please help....

[Edward W Hook, MD]

No, you do not need tesing for hepatitis B, syphilis or HSV.  If you were to develop genital sores it would be advisable to seek evaluation but, in the absence of lesions, testing is not advisable or recommended.  EWH

[Dolorian]

Thank you Dr. Hook.

Does this mean i do not need testing for Hepatitis B, syphilis or herpes simplex 1 & 2 given that as of now i'm negative for all of these (never exposed)?

[Edward W Hook, MD]

Welcome to our Forum. This was a low risk exposure. most people, including most commercial sex workers do not have STDs, particularly oral STDs and most exposures do not lead to infection.  Furthermore, oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you would most likely develop symptoms of urethritis (penile infection) such as burning on urination or penile discharge within 3-5 days after your exposure.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  

If you feel testing is important, all you really need is a test for gonorrhea and for NGU.  NGU is diagnosed by the demonstration of increased numbers of white blood cells in a swab from the penis or on a urine specimen collected just as you begin to urinate.  

If these tests are negative I would not worry about having sex with your regular partner.

I hope this comment is helpful.  EWH