Unprotected Sex

[segerfan]

I am a 40 year old hetersoxesual male who hasn’t had unprotected sex outside of my marriage of 15 years. Approximately 4 weeks I had unprotected oral and gave unprotected oral and then had a very brief (30 seconds) unprotected vaginal sex with a stripper at a bachelor party in Vegas. Since the event I have been extremely anxious and think about this event every hour I’m awake.

Since then I don’t believe I have had any symptoms except I have canker sores in my mouth (which I hope is stress related) and a jock itch rash on both sides of my inner thighs. I had a full panel of tests done at 1 week for a baseline. All but HSV1 were negative. I then had another full panel done at three weeks, again all negative.

1. What are the odds/ percentages that all STD tests (excluding HSV1) will remain negative?
2. Is the jock itch type symptom a possible symptom of herpes? There is conflicting information from the CDC and other medical sites.
3. How long does it take to accurately test for syphilis, HIV, HSV2, Chlamidia, Gonorhea, and genital warts.

Thanks for your assistance.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  But you're asking me to repeat things I have already said; please re-read my replies above.  Tthe additional information doen't change my opinion or advice.

[segerfan]

Dr. Handfield,

Since my last comments to you I had a 5 week test which was negative for HIV, HSV2, Hep B and Syphilis. I know you recommended I not test until 12 weeks (if at all) but I am extremely nervous about infecting my wife. Over the last two weeks (7 weeks post exposure) I've had intense chronic headaches. Based on other threads I've read and your previous response it appears my risk is extremely low. I understand the probabilities but when you have a perceived symptom that won't go away it makes me anxious. Do I have any risk of infecting my wife with HIV at this point? what about other STDs?

Lastly, this is an oustanding forum. Yours and Dr. Hook's knowledge and quick response has been very helpful

[H. Hunter Handsfield, M.D.]

Those figures are about right.

[segerfan]

I posted a question to HHH and he answered. I'm trying to respond to his thread but unsure how. Here is my follow up question. I believe I read on this site that testing accuracy at 3 weeks for HIV is somewhere near 75-80%. Is this true? I saw that Dr. Hook said at four weeks accuracy is approx 90%.

Thanks for your help

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Oral sex is safe sex, not entirely risk free, but much safer than vaginal or anal sex.  Of course unprotected vaginal sex carries some STD/HIV risk, but probably low because a) most commercial sex workers are not infected and b) the contact was apparently brief.  Further, most STDs of importance would have caused symptoms.  

Chlamydia and gonorrhea tests are valid within a couple days of catching them.  Your negative results at 1 week were valid.  You didn't need the 3 week test and definitely don't need to be tested again.  However, even the 3 week test was too early for syphilis, HIV, and HSV-2.  It is exceedingly unlikely you caught any of these, but to prove it you'll need another round of blood tests at 6 or more weeks for syphilis and HIV and 3 months for HSV-2.  Since the odds you were infected were astronomically low, I suggest you wait until the 3 month mark and get tested for all 3 of these STDs at that time.

There is no valid test for genital warts or HPV.  For warts, you just have to keep an eye out for abnormal growths on your penis or surrounding areas.  Most HPV infections are asymptomatic and there are no tests for them. On the other hand, HPV is not worth worrying about -- use the search link to find lots of discussions about the reasons you shouldn't be concerned.

Those comments answer question 3.  Question 1:  I suspect the chance is a million to one that the remaining tests will remain negative.  Question 2:  Genital itching and jock itch do not suggest any STD.

Finally, I have the impression you have been testing yourself, perhaps through an online testing service -- i.e. without professional advice.  You probably are spending 10 times more than you need to, and that includes the cost of an office visit, not just the lab tests themselves.  I suggest you do it right and seek professional attention.

In any case, mellow out.  If I were in your situation, knowing what I know, I wouldn't have any further testing at all.  There is no realistic chance you were infected with anything.

Regards--  HHH, MD