Feel I'll never get a clean slate...So scared

[That Dude]

Dr. HHH

About 3 and 1/2 months ago I had vaginal sex with a sex worker at a massage parlor. I wore a condom the whole time. At the 3 month point I went to an STD clinic and got tested for H.I.V and all the other STDs’. Everything was negative. What I'm worried about is getting genital warts from this incident. I understand I might be at high risk for HPV infection from this incident but what about actually getting warts.

I've been to dermatologists that have checked my genital area and said they saw no warts. I've just been so confused reading the incubation time for genital warts and that condom use doesn't completely protect because of uncovered areas. It's just with everything else I've been able to get a clean slate but not this.

It sounds like almost everyone will get HPV at some point and I probably have had it before and cleared it since I've had over 4 previous partners and with a couple I even had unprotected but this time even with the condom, I'm freaked out beyond belief. I never worried about anything like this before and it's tearing me up inside.

Anyway, if you can't really find good questions in that rant here's some questions I have that I hope you can help me with.

What are my chances of getting genital warts from this incident. Maybe even percentage wise if possible?

What do you think honestly from the incident I described, will I get genital warts?

how at risk am I?

If I was going to get genital warts, would I have probably got them by now from this?

Is there going to be a point that it's going to be safe to say, I'm not going to get genital warts from this incident or at least that it's highly unlikely. 3 mo. 6 mo. 1 yr. 2 yr. 5 yr?

What do you recommend I do. Get examined every 6 months, don't get checked unless I see something?

Will I ever be able to get a clean slate from this incident on the wart issue?

What percentage of people who get HPV get genital warts.

Thanks in advance

[H. Hunter Handsfield, M.D.]

There is nothing in your situation that even hints at herpes.  Move on.  Any further comments and I will delete the entire thread.  And don't start a new one; I will delete it without response.

[That Dude]

thanks for the response.  I feel I really might be fine but just wana be sure.....I kinda wana here from the doc whether he thinks I should get Herp test though. I noticed this got bumped to second page. If I don't get responce from him by later today, I'll probably pay and post as new question. I know, I'm a psyco but I can't help it. again thanks for comment

[slacker101]

Dude, you are fine!!!! You DON'T have anything other than a possible Ulcer. Relaxxxxxx

[That Dude]

sorry and did I miss any tests NGU? I don't need that right......any thing I'm missing? other than my sanity. Thanks

[That Dude]

I know you closed this down but I have one more question. Same incident. Please let me know and I will post new thread and pay if thats more appropiate.

My question is regarding herpes. I didn't really think of getting tested for before because I haven't noticed any symtoms and when I told provider I wanted to be tested for all STDs' she didn't mention Herpes test.

So, you don't have to re-read original post. Recap: Vaginal sex with sex worker and she prefomed oral sex on me . Condom used whole time. H.I.V, Climidia, Goneria, Syflis, Hep B,C (all negative) (3 months point) it will have been 4 months next week.

1) Do you think I should get a herpes test? (I haven't noticed any symtoms) and I'm nervous about.

If so,which one is the best.  HerpesSelect, CAPTIA, other? make suge IgG right?

Maybe I should pay and post new thread on this. Let me know, no problem at all.

This service has been a godsend. Thanks again Dr.

[That Dude]

Thanks for the follow up comments.

[H. Hunter Handsfield, M.D.]

You are way overthinking this.  Stop calculating.  Accept that since you have no visible warts 3 months later, you probably weren't infected.

Also, get a perspective on genital warts.  With rare exception they are a slightly unpleasant inconvenience, nothing more; not a signficant health issue.  It is ridiculous for anyone to go around worrying about it, or making fear of warts a significant element in their sexual decision-making.  Worry about (and take precautions against) HIV, chlamydia, and herpes, which are the three STDs that frequent enough (in heterosexual populations in the US) and/or dangerous enough to be important considerations in sexual safety.  Disregard HPV.

I won't have any further comments.

[That Dude]

Thanks for all the info. I really appreciate it. It has made me feel better. I do feel I'm obsessing over this more than is necessary.  

The thing is I know it wasn't meant to be calculated from the estimated condom protection and the guess of around how many HPV infections result in visable warts but I calculated it using these numbers and came to around 1-3% chance of catching warts from a single incident and thats if the woman does in fact have an HPV infection which I have no idea of and I guess in many case the male partners wouldn't know. So, from all the info I feel my chances of getting warts from a single incident are statsitically less than 1% and even microscopic at that. Which is/would be great news but I do have a tendancy to over analyze stuff. Hopefully thats what I'm doing here but it's just my fear is with this woman's extremely high volume of sexual partners in her profession, I'm just thinking she is much more likely than your average partner to not only have an active HPV infection but have an active wart causing HPV infection.

This might be way off but also I'm thinking most sexually active woman would have regular pap smears or even HPV tests and know their status. Where as in this case, I'm not sure if this woman even has regular check up's, never mind pap smear tests.

Thanks again Dr.

[H. Hunter Handsfield, M.D.]

There are no available data on the risk of acquiring warts from any single sexual encounter.  Recent research indicates that about 10% of sexually active have a diagnosis of genital warts before age 40.  (The data are from Scandinavia, but most likely there wouldn't be a major difference compared with North America or elsewhere in Europe.)  If you factor in the number of sexual encounters that occur year in and year out, the risk for any single episode must be microscopically low; and your case lower still, because of condom use. (Condoms aren't perfectly protective, but they reduce the risk by an estimated 70-80%.)

To your direct questions:

1-3) The chance you caught warts is too low to measure.  Therefore, most likely it won't happen.  

4) Most warts probably show up before 3 months.

5) It is safe to assume now you didn't catch genital warts from this event.

6) A health care provider is no more able than you are to see warts of the penis.  Even when someone has sex with someone known to have warts, CDC recommends against routine examination, just that the partner get examined if s/he notices possible warts.  Therefore, I recommend you not have further examinations at all.

7) For practical purposes, you have a "clean slate" now.  But if you live to 90, nobody can ever give you 100% assurance you weren't infected.

8) As a guess, somewhere around 5-10% of all genital HPV infections result in visible warts.

Bottom line:  You are obsessing over this much more than is necessary or wise.  Let it go.

Good luck--  HHH, MD