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Unprotected Oral Advice & Risk Assessment
Dear Doctor,
Need your help & advice on my exposure.
Demographics:
I am hetro male in early 30's living in Northern California (Silicon Valley). Happen to engage in the service of an escort on May 4th. She was a white female in the mid to late 20's (not sure if it matters much, she was expensive than average & by appointment)
Exposure:
I had 2 activities that could be of concern,
a.) Unprotected Oral for about ~2 mins, didn't feel rough.
b.) Protected vaginal for ~2 mins.
Unprotected Oral is the most worrying part for me. After the event I checked with her, she insisted that she is clean.
Symptoms:
Fortunately, its been ~5.5 weeks with no discernible symptoms despite high level of anxiety, stress. No abnormal pain, discharge..
Tests:
11 Days after exposure did a full STD panel ( Chlamydia, Gonorrhea, Hep B, Hep C, HSV I, HSV II, HIV, Syphillis ) all came back negative.
21 Days ( ~3 weeks) for "HIV-1 Antibody & HIV 1/O/2 Abs, Qual" came back negative.
33 Days ( 2 days shy of 5 weeks) for "HIV-1 Antibody & HIV 1/O/2 Abs, Qual" came back negative.
Questions:
1. I try to put this behind, but the odds & 'what ifs' play into my mind immediately. I have come clean with my wife. She insists me to move on & not to worry about it. I really want to put this behind and move on, it is safe to do so ?
2. Now it's ~5.5 weeks, can I disregard any symptoms that may show up to be related to this event ?
3. I have developed a fear of repeat testing may end up resulting in a false positive, can't believe how many tricks mind can play. I am in California could not locate a DUO Test offering, is there any test that I could combine with antibody to make sure I can close this testing once & for all ?
3. Despite the facts presented above how much likely my result will stay negative for this event ?
4. Is it safe to be intimate with wife, any other type of psychical contact other than unprotected sex (mutual genital contact) ?
Appreciate your help & advice..
Need your help & advice on my exposure.
Demographics:
I am hetro male in early 30's living in Northern California (Silicon Valley). Happen to engage in the service of an escort on May 4th. She was a white female in the mid to late 20's (not sure if it matters much, she was expensive than average & by appointment)
Exposure:
I had 2 activities that could be of concern,
a.) Unprotected Oral for about ~2 mins, didn't feel rough.
b.) Protected vaginal for ~2 mins.
Unprotected Oral is the most worrying part for me. After the event I checked with her, she insisted that she is clean.
Symptoms:
Fortunately, its been ~5.5 weeks with no discernible symptoms despite high level of anxiety, stress. No abnormal pain, discharge..
Tests:
11 Days after exposure did a full STD panel ( Chlamydia, Gonorrhea, Hep B, Hep C, HSV I, HSV II, HIV, Syphillis ) all came back negative.
21 Days ( ~3 weeks) for "HIV-1 Antibody & HIV 1/O/2 Abs, Qual" came back negative.
33 Days ( 2 days shy of 5 weeks) for "HIV-1 Antibody & HIV 1/O/2 Abs, Qual" came back negative.
Questions:
1. I try to put this behind, but the odds & 'what ifs' play into my mind immediately. I have come clean with my wife. She insists me to move on & not to worry about it. I really want to put this behind and move on, it is safe to do so ?
2. Now it's ~5.5 weeks, can I disregard any symptoms that may show up to be related to this event ?
3. I have developed a fear of repeat testing may end up resulting in a false positive, can't believe how many tricks mind can play. I am in California could not locate a DUO Test offering, is there any test that I could combine with antibody to make sure I can close this testing once & for all ?
3. Despite the facts presented above how much likely my result will stay negative for this event ?
4. Is it safe to be intimate with wife, any other type of psychical contact other than unprotected sex (mutual genital contact) ?
Appreciate your help & advice..
MEDICAL PROFESSIONAL
Thank you. Take care.
Most certainly did for ASHA.
MEDICAL PROFESSIONAL
Thanks for the thanks. I would recommend ASHA if you would indeed like to make a contribution to STD/HIV prevention specifically and sexual health in general. (Disclosure: I serve on ASHA's Board of Directors.)
Dr Handsfield, just an update & final thank you note. I saw my primary doctor(internist), to my surprise, she tested close to 8 weeks & said it is enough & I am good to go. Out of anxiety, I did my last test @ 11 weeks it came back negative.
Finally I have decided to move on. Just wanted to say a big thanks for you & Dr.Hook for the wonderful service that you guys do here. Without the collective knowledge & wisdom of you guys it would have been an extremely difficult. I wish you guys the very best. During this time I also learned to show respect to the disease & people who struggle with it everyday, I wish & pray a cure would come sooner. Nobody deserves this.
As a thank you, I would like donate to the charity of your choice, from some of other posts I learned, the following would be your choice. American Foundation for AIDS Research (www.amfar.org) or the American Social Health Association (www.ashastd.org). Please let me know.
thanks for the wonderful service.
Finally I have decided to move on. Just wanted to say a big thanks for you & Dr.Hook for the wonderful service that you guys do here. Without the collective knowledge & wisdom of you guys it would have been an extremely difficult. I wish you guys the very best. During this time I also learned to show respect to the disease & people who struggle with it everyday, I wish & pray a cure would come sooner. Nobody deserves this.
As a thank you, I would like donate to the charity of your choice, from some of other posts I learned, the following would be your choice. American Foundation for AIDS Research (www.amfar.org) or the American Social Health Association (www.ashastd.org). Please let me know.
thanks for the wonderful service.
MEDICAL PROFESSIONAL
No, there is no test in men. And even if there were, it would make no difference. If positive, it wouldn't mean anything abnormal; and if negative, it wouldn't mean you aren't carrying Candida.
Further HIV testing indeed is pointless.
Further HIV testing indeed is pointless.
thanks for the feedback Dr, I believe & trust you. But for psychological assurance , is there a procedure, as a male I can get tested & treated for Candidiasis as well, so that we dont reinfect each other even if it is remote chance ?
Also I assume that you have ignored my question on my further HIV testing, since it is pointless to keep testing.
thanks for the help Dr.
Also I assume that you have ignored my question on my further HIV testing, since it is pointless to keep testing.
thanks for the help Dr.
MEDICAL PROFESSIONAL
Candida in women is almost never due to catching the yeast from another person. Women carry it naturally, and symptoms occur when it grows to higher than usual numbers, usually without obvious cause. Her problem is almost certainly is indeed just a coincidence, having nothing to do with your sexual indiscretion. Look at it this way: every day, millions of women start having new symptoms of vaginal candidiasis; and every day, millions of men have sex with people other than their main partners. Naturally, therefore, there are thousdand (may hundreds of thousdands?) of couples in which both events occur within a few weeks of each other.
Dr, sorry for coming back again. At about 36th day I happen to have brief vaginal with my wife ( penetration for only abt ~10 secs), about 4 days after that my wife started to have itching, inflammation in her vagina & about 8 days she had discharge of grayish white (no burning during urination). She went to the doctor(Internal Medicine) told her about my exposure as well, she was tested for all STD's, In the meantime Dr gave her shot of Ceftriaxone, & meds Metronidazole, Doxycycline & Fluconazole. Tests came back -ve for all but expect Candidiasis, Dr has asked to come back for further swabs. After the results wife stopped Doxycycline ( after discussing with Dr.). By now most of my wife's symptoms have subsided.
My question is did my oral exposure resulted in acquiring Candidiasis on my penis & transferring it to her during the brief sex, is this possible (to this day i don't have any abnormalities, may be occasional light itching sensation on penis head). Yeast infections appears to be normal for most women, but the coincidence is so great to conclude otherwise. You feedback will help me a lot..
Most extent I was relaxed, but this event freaked me out, I did my HIV antibody test close to 7 weeks (47 days) came back Negative. Hope I can take this to be definitive.
Appreciate your help & advice.
thx Doctor, I will try to take one day at a time, try to forget about this & move on.
MEDICAL PROFESSIONAL
I think the answer is crystal clear from my replies above. You need no further tests and should move on.
Dr.Handsfield thanks for taking time & answering my questions. With respect to this event, should I continue to test further or should I move on.
thanks
thanks
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
As you seem to understand (intellectually, escorts -- i.e. expensive sex workers by appointment -- often are at low STD risk, especially if they consistengly use condoms for vaginal or anal sex, as your partner apparently does. Further, oral sex is safe sex -- not completely free of STD risk, but much less likely to result in STD than unprotected vaginal or anal sex. The chance of any STD from any particular oral sex exposure, or through an exposure by condom-protected vaginal sex, is probably on the order of one in many thousand.
So based on your low risk exposure, no symptoms, and negative test results, you can be 100% confident you acquired no STD. There can be exceptions to one of these or the other (exposure, symptoms, test results) -- but the odds that all three of them went the wrong way are astronomically small. Had I been in your position, I would have felt no need for testing, would not have stopped having unprotected sex with my wife.
To your specific questions:
1) Your wife is exactly right. While you may have had a psychological/emotional need to tell her about your extramarital exposure, From an STD risk standpoint there was no need and I would have advised you not to say anything.
2) Yes. Any symptoms from here on out won't be due to any infection from that event.
3) There is no need for repeat testing. In any case, fear of HIV or other test results is never a valid reason not to test and I have no patience with it. It isn't the test that gives someone an infection.
4) "Despite" is the wrong word. It is BECAUSE of "the facts presented above" that any and all test results you have in the future will remain negative.
5) As I said, had I been in your position, I would never have stopped having unprotected sex with my wife. You should resume doing so immediately.
Really, it is past time to stop fretting over this event. Deal with whatever implications it has psychologically and in relation to your relationship with your life, but there are no other health consequences from it.
Good luck-- HHH, MD
As you seem to understand (intellectually, escorts -- i.e. expensive sex workers by appointment -- often are at low STD risk, especially if they consistengly use condoms for vaginal or anal sex, as your partner apparently does. Further, oral sex is safe sex -- not completely free of STD risk, but much less likely to result in STD than unprotected vaginal or anal sex. The chance of any STD from any particular oral sex exposure, or through an exposure by condom-protected vaginal sex, is probably on the order of one in many thousand.
So based on your low risk exposure, no symptoms, and negative test results, you can be 100% confident you acquired no STD. There can be exceptions to one of these or the other (exposure, symptoms, test results) -- but the odds that all three of them went the wrong way are astronomically small. Had I been in your position, I would have felt no need for testing, would not have stopped having unprotected sex with my wife.
To your specific questions:
1) Your wife is exactly right. While you may have had a psychological/emotional need to tell her about your extramarital exposure, From an STD risk standpoint there was no need and I would have advised you not to say anything.
2) Yes. Any symptoms from here on out won't be due to any infection from that event.
3) There is no need for repeat testing. In any case, fear of HIV or other test results is never a valid reason not to test and I have no patience with it. It isn't the test that gives someone an infection.
4) "Despite" is the wrong word. It is BECAUSE of "the facts presented above" that any and all test results you have in the future will remain negative.
5) As I said, had I been in your position, I would never have stopped having unprotected sex with my wife. You should resume doing so immediately.
Really, it is past time to stop fretting over this event. Deal with whatever implications it has psychologically and in relation to your relationship with your life, but there are no other health consequences from it.
Good luck-- HHH, MD
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