Affair in Asia

[Kingsing]

I Returned from Hong Kong on January 24th and while there had protected vaginal sex and unprotected oral (giving & receiving) with two sex workers.  I'm worried I could have picked up an std.  

1.  What do you think my chances were?  If one had gonorrhea what are the odds?  Or if one had syphilis?  

2.  I had some medication left over for an infection and travelers diarrhea.  I took 1 gram of azithromycin then 500 mg of cipro twice daily for three days.  Would this cure any std I might have picked up.  

3.  Do you have any idea how prevalent std's are in Hong Kong?

4.  If a person can pick up an std from oral sex, then why is kissing so safe?  Could you please explain the difference?

5.  I have read that the best way to cure syphilis is by injection of pencillin.  Would large doses of ampicillin and/or amoxicillin produce the same results?

Thank you so much for this forum and answering my questions.

[H. Hunter Handsfield, M.D.]

See many other threads on this forum with similar questions.  Search the threads for "STD transmission risk", "HIV transmission risk", "oral sex", and "fellatio".  Because I have responded so many times before, my responses here will be brief:

1) Very low risk for any STD from condom-protected vaginal sex.  Very small risk of gonorrhea or other infections from oral sex--but if you had acquired one of them, you would have developed symptoms by now.

2) With those drugs you would have protected yourself reliably against chlamyda, syphilis, and NGU; and reasonably reliably (but not perfectly) against gonorrhea.

3) I have no particular information about STD prevalence in Hong Kong.

4) STD transmission by fellatio is very uncommon.  STDs that inhabit the genitals usually are not in the mouth; particular bacteria simply survive better in some tissues or anatomic areas than others.

5) Syphilis is not a concern given your exposures.  But if it were, the azithromycin would have prevented it.  Large doses of amp or amox orally would be pretty good at preventing syphilis, but are not reliable in treating active syphilis infections.

Good luck--  HHH, MD

[Imdumb]

If you had protected sex then odds of an STD are near zero.  Some risk of herpes or syphillis where maybe the condom didn't cover..but very small risk.  Syphillis is rare in the U.S. for heterosexuals, I think only a handful of cases thast year. Most cases are now in  the gay communiy and even then there were only a few thousand.  The risk of it low to worry about.  Your chnaces of dying in the plane home are significantly higher.  No real risk of getting an STD giving oral on a woman. Theoretical risk of herpes, but you would be a rare case indeed.  

Very small risk of getting gonnerrea from receiving oral because that bateria can live in a persons throat. But if it has been more than a week or so and you do not have a painful discharge, then the chances you have gonnerrea are very very low.

You had safe sex and I would bet the odds you are STD free are very close to 100%. I would not test.

[Nonstopaxiety]

imdumb,
i notice that you respond to quite a few of these posts.  are you involved with the site in some respect?  what credentials or background do you have?  believe me, i'm not being critical, but just want to make sure the advice and opinion I'm reading is from a credible source.  thanks for your contribution to the site.  if nothing else, some of your responses have been comforting to my own situation.

thanks

[Imdumb]

No problem - I hope I can help sometimes.  I was a "worried well" on a few occassions.  I searched the internet and just go more worried as I read what I found.  I found this forum and thebody.com as two forums where you could get 100% honest info with no agenda.  Just great facts and Dr's who actually take the time to read the questions and know there are real people behind those questions who need information.  Many people have make a one time mistake and are really worried.  Most of the worry comes from main steam sources that do not give specific, but general information and some even have a poliical agenda.  

That said, I took it upon myslef to get educated on HIV and other STD's.  I have read many medical journals and the respones by Dr. HHH here.  He is one of the world's foremost experts and I would never pretend to be affiliated with him.  He has my utmost respect and admiation.  I just hope that if I happen to be on this site and can calm someones fears, when appropriate, that it will help someone  get through a hard day.  I would never say anything in a judgemental way or in a way I hope the Dr. would not agree with.  If a post is out of my league, I will not respond.  If I can add value, I will give it a shot.

I hope I have helped.  I do feel for people who get in a bad situation.  We are all just good folks looking for answers.  Some of us have made mistakes we regret, but we are still good folks.  As an added bonus, Dr. HHH works with the Univeristy of Washington in Seattle.  My Alma Mater and home town.  GO DAWGS!!

[H. Hunter Handsfield, M.D.]

OK, that's all for this thread.  You do yourself no good to try to get clues about your wife's problem by this or any other online source.  Whatever your wife has, it CANNOT have anything to do with your sexual events in Hong Kong.  It is a waste everybody's time, including yours, to continue this discussion.

HHH, MD

[HHH,MD]

Furthermore, I only now clicked onto the realization that this whole disucssion has been a thread jump; you aren't the original poster.  Apologies to that person for permitting the discussion to continue.  I have deleted most of the discussion that occurred over the past couple of days.

HHH, MD