Possible STD after sex with csw

[supermike]

Hi

Im back wit a new question.

This time I had sex with a CSW in Singapore, 10 days ago.
Had brief unprotected oral sex in the bathtub, and then condom protected vaginal sex.

The oral sex lasted only less then a minute, but risk anyhow.
Due to my previous post in here I have read noumerous answers from you dr.s regarding the different risks.

Im planing to go for a full std testing when Im back home, on Monday.
My issue is that I have been hoping to get home symptom free, and with very little to worry about.
This changed last evening as I noticed a clear white discharge from my penis. This was present also this morning, and continues to be present if I "milk" my penis.

Do you think I might have caught gonorrhea or chlamydia? There is no discomfort or strange sensation when urinating.

[supermike]

Thank you for your very reassuring comments and advice.

Gonhorrea and chlamydia tests came back today with nothing to worry about.
And with the symptoms of NGU retracting and gone last 24 hours I will finish the last two days of doxy and move on.

You and Dr. HHH are really making a difference in STD  counceling and education online.

[Edward W Hook, MD]

There was no meaningful risk for HIV from the exposures you describe.  The is no evidence that HIV has ever been acquired from receipt of oral sex and your vaginal sex was condom protected and therefore no risk.  I would not worry about HIV from you encounters and see no need for further testing for HIV.  EWH

[supermike]

Thanks, one more time.

One last question, based on the risk only, would you recomend the 2. HIV test if the first one is negative.

The test used is only latest HIV Duo test.

[Edward W Hook, MD]

A person who gets one STD (like NGU) is at higher risk for HIV than someone who has not gotten an STD.  Even so, the risk for HIV is very low and, in your case, essentially zero.  On one has ever gotten HIV form receipt of oral sex and your vaginal exposure was safe becasue it was condom protected.  EWH

[supermike]

Thanks for your comments and information.

Went to a sti clinic snd was diagnosed with NGU, and got 7days cure of doxycycline. Took samples for Gonhorrea and chlamydia.

What made me slightly worried was that I was tested for HIV and Hepatitis and was told that there is a risk for HIV. Was also told to test again at 8 weeks for HIV and Syphilis, afger this high risk encounter.

I didnt argue and will do the testing, but I believe that you dissagree that the incident was high risk for HIV?

[Edward W Hook, MD]

The discharge you experienced may or may not be normal withthe intiat discharge being the result of your earlier masturbation.  Your continued self examination may have irritated your urethra as well and increased the amount of normal secretions present.  Typically the discharge of NGU does not diminish over the day or so after its onset.

NGU may be caused by bacteria other than chlamydia.  NGU is best diagnosed with a swab specimen taken from the penis at least an hour after last urination. On occasion microscopic evaluation of urine collected just as a person begins to urinate can serve the same purpose but the swab is the preferred  approach.  With either method, one is not looking for bacteria but for white blood cells which are a sign of inflammation.  It is the signs of inflammation, manifest as increased numbers of white blood cells, which are the basis for the diagnosis of NGU.   No matter what the casue, NGU is treated the same way, typically with a single 1.0 gram dose of azithromycin or doycycline 100 mg twice daily for 7 days.  EWH

[supermike]

There is still some milky discharge from penis, but not much after now 2 days.

[supermike]

If it is ok with a couple of follow up questions,

The discharge started 1-2 hours after masturbation. And keept beeing present when "milking" the penis next 12 hours. This morning it was still some discharge, but all clear without any colour. Could this suggest that the discarge is because irritation due to to my continous miliking to look for any discarge?

If it is NGU, will you believe it is fom chlamydia? If not, how will the tests be done to look for infection? Standard STI testing at my GP office only test for gonorrhea and chlamydia, and if they come out clean I will not be given any antibiotics.
Should I possible go to a more specialized STI clinic and ask for some other testing?

[Edward W Hook, MD]

Welcome to the Forum. I will try to help  While the encounter you describe was low risk- most women do not have STIs and most unprotected encounters with infected partners do not lead to infection, your discharge is a bit worrisome and warrants testing.  The timing is about right for NGU arising from receipt of oral sex (if your condom was worn throughout the vaginal encounter, it was safe sex) and unless you masturbated sometime shortly before you noted the discharge, I would be concerned about NGU as the culprit If this is an STI, it may worsen somewhat but is probably not a major health hazard and it is probably OK to wait for testing until you get home on Monday or Tuesday.

I would not be worried about other STIs. there is no risk of HIV from receipt of oral sex and condom protected sex is safe sex. Nothing in your history is suggestive of herpes or syphilis.

I hope this comment is helpful.  EWH

[supermike]

If my question was unclear, what should I test for, and should I be concerned about other sti's as well?