STD fears!! Very worried.

[reallyworried2012]

I am very worried about what occurred over the past weekend. I was with a group of friends on a trip to Seattle when we all went out to a club. After the club everything is very hazy. I basically was having partial blackouts where I remember bits and pieces of what happened after we left the club. I know that we met two girls outside of a club and they came back to our hotel. I left with one of the girls and we started walking around seattle and from what I remember we went to a restaurant briefly and then left. The next day my friend told me they were both hookers. He told the one girl to leave the room after she asked for money. I remember standing in a parking lot and the girl I was with asked that question too. I was so drunk that I didn't know they were hookers; but at the same time I have no recollection at all of ever engaging in any sexual activity. But the thing that scares me is what if I did?! I have gentile herpes which I have had for about 4-5 years. I went some STD's screening today.

So much questions are:

1. What is the risk of contracting HIV from a one time exposure? (I'm have no memory of anything sexual occurring but again I was so drunk I don't remember a lot). I also have HSV-2 with outbreaks that occur on my lower penile shaft area but at the time there was no outbreak occurring.
2. Is it possible to get infected a second time with genital herpes? Could I have HSV-2 a second time? I've read on the internet that there are several strains of HSV-2 and you can get infected with more then one strain. My family doctor told me that it's not possible that once you have HSV-2 your body builds up antibodies that prevent a second infections; especially in someone who has had it for 4-5 years.
3. Finally, I don't have any outbreaks at the moment, but I was wondering if I did have sex with this girl is there a high risk that I infected her if she didn't already have it?
4. Any risk for Hep A B or C?


Thanks for any feed back.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'll try to help.

Perhaps most important, it seems very unlikely you had sex with the woman you met.  Despite how fuzzy your recollections are of that evening, I cannot imagine you had intercourse or other sexual contact (e.g. oral sex) without remembering it.  Assuming that's the case, then obviously you aren't at risk and should not be at all worried.

And even if we assume you did have unprotected sex, you shouldn't be worried.  Heterosexually transmitted HIV is rare in Seattle, and rare in commercial sex workers there -- well under 1% have HIV, probably closer to 1 in 1,000.  Continuing with the assumption that sex occurred, here are my responses to your specific quesitons:

1) IF she had HIV, and IF you had sex, and IF it was unprotected, then the average transmission risk is once for ever 2,000 exposures.  Having HSV-2 roughly doubles the risk, so that makes the odds somewhere around 1 in 1,000.  (The increased risk of HIV from herpes occurs without regard to having an outbreak.  Just having a positive HSV-2 blood test does it.)

2) Second infections with the same HSV type are very rare if they occur at all.  The immune system prevents it.  No worries here.

3) The average HSV-2 transmission risk, in the absence of an obvious outbreak, is similar to that of HIV -- probably somewhere around once for every 1,000 unprotected vaginal sex exposure.

4) For sure no risk for hepatitis C, which is NOT sexually transmitted, despite what you will see on some websites.  And miniscule (1 chance in many million) for hep A or B.

My advice is that you go forward with the assumption that no sex took place; and even if it did, that transmission of any of these STDs was unlikely.  I don't recommend any testing. But if you remain uncertain or nervous, you could visit a doctor or your local health department STD clinic for testing for chlamydia, gonorrhea, syphilis, and HIV.  For sure you don't need herpes or hepatitis testing.

Regards--  HHH, MD

[reallyworried2012]

Thank you very much Dr. Handsfield for your very prompt response. You have eased a lot of my fears. My family doctor sent me for STI tests because he said that I won't stop worrying unless I have them. But he was like you'll get normal results back at the end of the week so he's not concerned. He does want me to follow up in 4 months for the HIV and Syphillis as he said that would give me 100% assurance that I'm ok; but again he stated my risk is not zero but pretty close. I got genital herpes from a one time exposure but it is very likely the person was having an active outbreak at the time. She was in denial and told me she had a staph infection but I know that's was not the case. So this is where part of my fears come from but as stated before she probably had a active outbreak; for all I know she could have just acquired it so it was really bad and infectious at the time.

Psychologically I'm very upset in that this is completely out of character for me; I have fears that I may have broken the law but have no way of knowing if I did or not; I'm afraid I put myself a risk (but you have eased those concerns); and I'm also afraid of exposing another individual to HSV-2 (even one who has sex for money).

Thank you so much for you response once again; my gut tells me I did nothing wrong and that I was just drunk who encountered two girls who may have been prostitutes but nothing actually happened; if something did I probably am ok.