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STDs (Expert Forum)
Conflicting Information
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Conflicting Information
by frustrated411, Nov 17, 2006 12:00AM
Dr. H:
Thank you so much for continuing to support this forum, it has really helped me.
I am a 32 year old male. I recently recieved oral sex (5-10 minutes) from a female CSW. The CSW had no obvious signs of active sores. It has been 9 days and I have no symptoms. My long-term partner is pregnant. Having reviewed previous posts and other information on this site, I concluded that I was at minor risk for herpes and long-shot risk for a couple bacterial infections. I feel confident (but not certain) that I didn't contract an STD. However, given my partner's status, I felt that I should get a herpeselect test to confirm that I was already positive for HSV1 and possible take antibiotics provolacticly to ensure that the baby was not put at risk.
Yesterday I visited my GP. He refused me the HSV1 test for the following two reasons: 1. He is certain I would register positive (he told me 95% of the population has been exposed and 30-40% have had HSV1 symptoms, plus I described to him blisters that I got regularly in my 20s on the inside of my lower lip near the gum which he said was definitely (his words) herpes. 2) he said having herpes orally does not protect you from acquiring it genitally so knowing I was positive already wouldn't add any information about the risk of pssing it on to my partner.
He also refused me the atiboitics saying that the risk of advese reaction to the drugs is greater than the risk of acquiring the bacterial infections through oral sex. However he did have me tested for HIV, HepB, Gon, Clamid, and Syph. Saying that this would give us a baseline status and that I should wait 6 months to retest, because (his words) that is how long it takes for an HIV infection to register positive. Perhaps he assumed I had been engaged in more sexual activities than I was willing to admit?
I am not seeking to put you into debate with some GP you've never met. Rather, I have a few specific questions about my situation:
1. Could the blisters I described in side my lower lip be herpes - my impression was that herpes sores were always external to the mouth. The blisters started when I was about 18 and were occuring about 3 times per year for a many years, but are no longer occuring with any frequecy, maybe once per year. My partner started getting identical sores after we became involved 7 years ago. The first time I had them a nurse practitioner told me they were essentially the flu expressing as blisters.
2. If I could find a willing doctor is taking antibiotics, without symptoms or likely infection a ridiculous idea in my situation?
3. Perhaps for others on the forum, any body have any suggestions as to where or how I get the HSV1 test. My local std clinic does not test for herpes.
4. Finally, assuming I continue to have no symptoms, I would like to go to my local clinic in Dec. to get retested for the bacterial infections. Is 30-45 days long enough to wait?
Thank you
Thank you so much for continuing to support this forum, it has really helped me.
I am a 32 year old male. I recently recieved oral sex (5-10 minutes) from a female CSW. The CSW had no obvious signs of active sores. It has been 9 days and I have no symptoms. My long-term partner is pregnant. Having reviewed previous posts and other information on this site, I concluded that I was at minor risk for herpes and long-shot risk for a couple bacterial infections. I feel confident (but not certain) that I didn't contract an STD. However, given my partner's status, I felt that I should get a herpeselect test to confirm that I was already positive for HSV1 and possible take antibiotics provolacticly to ensure that the baby was not put at risk.
Yesterday I visited my GP. He refused me the HSV1 test for the following two reasons: 1. He is certain I would register positive (he told me 95% of the population has been exposed and 30-40% have had HSV1 symptoms, plus I described to him blisters that I got regularly in my 20s on the inside of my lower lip near the gum which he said was definitely (his words) herpes. 2) he said having herpes orally does not protect you from acquiring it genitally so knowing I was positive already wouldn't add any information about the risk of pssing it on to my partner.
He also refused me the atiboitics saying that the risk of advese reaction to the drugs is greater than the risk of acquiring the bacterial infections through oral sex. However he did have me tested for HIV, HepB, Gon, Clamid, and Syph. Saying that this would give us a baseline status and that I should wait 6 months to retest, because (his words) that is how long it takes for an HIV infection to register positive. Perhaps he assumed I had been engaged in more sexual activities than I was willing to admit?
I am not seeking to put you into debate with some GP you've never met. Rather, I have a few specific questions about my situation:
1. Could the blisters I described in side my lower lip be herpes - my impression was that herpes sores were always external to the mouth. The blisters started when I was about 18 and were occuring about 3 times per year for a many years, but are no longer occuring with any frequecy, maybe once per year. My partner started getting identical sores after we became involved 7 years ago. The first time I had them a nurse practitioner told me they were essentially the flu expressing as blisters.
2. If I could find a willing doctor is taking antibiotics, without symptoms or likely infection a ridiculous idea in my situation?
3. Perhaps for others on the forum, any body have any suggestions as to where or how I get the HSV1 test. My local std clinic does not test for herpes.
4. Finally, assuming I continue to have no symptoms, I would like to go to my local clinic in Dec. to get retested for the bacterial infections. Is 30-45 days long enough to wait?
Thank you
Doctor's Answer
by H. Hunter Handsfield, M.D., Nov 17, 2006 12:00AM
, Nov 17, 2006 12:00AM
The proportion of the population with HSV-1 is closer to 50-60%, not 95%--probably 40-50% among people your age. So I disagree with your GP about the HSV-1 antibody test. And the information indeed would be useful in determining whether your lip "blisters" are due to herpes. If you are HSV-1 positive, or suspect you are, you should avoid performing oral sex on your wife as she approaches her due date--to reduce the risk (even though that risk is extremely small) of late-pregnancy infection that could lead to neonatal herpes.
1) Not all herpes lesions are outside the lips. Recurring blisters sounds like herpes, and other febrile illness--like influenza--often trigger outbreaks. (Hence the name "fever blisters".) (Flu itself does not cause blisters.)
2) I agree with your doc on this one. You do not need antibiotics. That sort of use increases the risk of later resistant infections, both for you and for society as a whole. (Antibiotic overuse is a huge public health problem.)
3) Just call around to other providers, or consider a store-front clinic. Or planned parenthood. Or look for online sources.
4) You don't need bacterial STD testing. The only bacterial STDs that are ever transmitted by oral sex are gonorrhea, which almost never causes asymptomatic infection; and syphilis, which is extremely rare in heterosexuals in the US. Chlamydia is never acquired from oral sex. And although nonchlamydial NGU can result, there is no test for it--you just have to look for symptoms. So if you want blood test for syphilis, do it about 6 weeks after the event. Otherwise, if you have no symptoms within 2 weeks, you're home free.
Good luck-- HHH, MD
1) Not all herpes lesions are outside the lips. Recurring blisters sounds like herpes, and other febrile illness--like influenza--often trigger outbreaks. (Hence the name "fever blisters".) (Flu itself does not cause blisters.)
2) I agree with your doc on this one. You do not need antibiotics. That sort of use increases the risk of later resistant infections, both for you and for society as a whole. (Antibiotic overuse is a huge public health problem.)
3) Just call around to other providers, or consider a store-front clinic. Or planned parenthood. Or look for online sources.
4) You don't need bacterial STD testing. The only bacterial STDs that are ever transmitted by oral sex are gonorrhea, which almost never causes asymptomatic infection; and syphilis, which is extremely rare in heterosexuals in the US. Chlamydia is never acquired from oral sex. And although nonchlamydial NGU can result, there is no test for it--you just have to look for symptoms. So if you want blood test for syphilis, do it about 6 weeks after the event. Otherwise, if you have no symptoms within 2 weeks, you're home free.
Good luck-- HHH, MD
Because my greatest concern is, on the low chance I contracted HSV1 genitally, I might then pass it on to my partner through vaginal intercourse and create issues with the pregnancy, I am going to seek confirmation that I already have HSV1. I will probably also get re-tested for Syph at 30 days.
I found an online service that can help find and organize std testing nationally. I have no idea if they are a good service, but if anybody alse reading here has a similar problem the service can be found at http://www.advancedtestingcenter.com They located and set me up for testing at a semi-local Quest Diagnostics lab.
Thank you again.