STDs Expert Forum
How confident can I be?
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The STD Forum 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.

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How confident can I be?

Same as posted in community...just want an MD opinion as well.  Thank you.

Same story...same anxiety...as many on here.

5 weeks ago, I received unprotected oral from a CSW (no other sex).  No signs of illness on her, she told me twice she was clean - no issues to worry about.  Since then, I've had no symptoms (no burning, itching or discharge).  A little stinging in the tip (very recent) though my amateur guess is, that has to do with anxiety, over examination and getting overzealous with the soap a week or so ago.  But other than that, no symptoms.

Still, I'm worried. Despite my idiocy, I'm happily married.  Some "luck" has kept me from having sex with my wife since this encounter (travel schedules mostly) but we're about to take a vacation together.  

I know the odds of her (CSW) having an std are low, oral std even lower, and transmission if she did are also quite low.  On top of that, if I had something, not showing any symptoms are also pretty low.  So mathmatically, I should feel how confident?

I know this may be a silly question, but some reassurance would be nice.  Also, if I were to be tested, I'd like to do it anonymously.  Do you feel confident in the std labs that are advertised online?

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239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

You have correctly predicted my reply.  Your own statement covers it well:  "I know the odds of her (CSW) having an std are low, oral std even lower, and transmission if she did are also quite low.  On top of that, if I had something, not showing any symptoms are also pretty low."

With no symptoms at 5 weeks, you can be very confident you weren't infected.  If I were in your circumstance, I would never have stopped having unprotected sex with my wife, with no worry of infecting her.

If you still feel you need to be tested for additional reassurance, you shold be tested only for gonorrhea, syphilis, and HIV.  Chlamydia is rarely if ever transmitted by oral to genital contact, but gonorrhea testing usually includes chlamydia at no additional cost, so you may as well do that as well.  But after an oral only exposure, it is pointless to waste money on a "comprehensive STD panel" that includes hepatitis, herpes, etc.

All "online" labs simply arrange testing at a local laboratory, and mostly they have contracts with one of the major national lab systems, like Quest or LabCorp.  They all use only reliable, FDA-approved test methods.

I hope this has helped.  Best wishes--  HHH, MD
7 Comments
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Avatar_m_tn
Thank you Dr. You do a great service here.  I hope we never have to correspond again...but keep up the great work.
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239123_tn?1267651214
Glad to have helped.  Thanks for the thanks.
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Avatar_m_tn
So Dr., this is my only follow up.  Reread your note.  Still feel better but will probably get the 100% relief of a test done. I was under impression that chances of HIV were extremely small via oral transmission.  So your rec to get the test for that threw me just a bit.  

Also, i feel as if I've read that both NGU and Gonnorhea (Gonorrhea) would clear up on their own in time. On the very small chance I acquired either, I'd still medicate  them but just wanted to get your view on that.

And that will be it from me.  Again, thank you for your time.
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239123_tn?1267651214
I mentioned HIV testing because it is automatic whenever any STD testing is done; and because the tone of your question indicates you will need a negative HIV result for its reassurance value.  You were at zero risk for HIV from the exposure described.

Of course you should be medicated for any treatable STDs that turn up.  But none will.
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Avatar_m_tn
Once again, thank you Dr. You've put a large amount of anxiety to rest.  Have a great one.
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Avatar_m_tn
Just wanted you and anyone else reading to know.  Of course, you were right.  Test results came back, all negative. Huge weight lifted - even with your expert advice, test did give great peace of mind. But thank you for talking me through it. (Incidentally, it was less expensive to buy full panel than 3 individual tests...so the bonus is, i'm clear all across the board)

One final thought (you don't have to answer).  If my odds were 1 in 1000 (by my 10% of 10% of 10% loose math - that would mean 1 person out of 1000 in similar situation would contract something.  You've probably consulted tens of thousands of people?  So a few positives when thought testing wasn't too important? So isn't testing more important than seems to be indicated here.

Definitely not questioning or being argumentative.  You were a rock for me and I am so grateful.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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