STDs Expert Forum
Possible STD?
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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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Possible STD?

Hi Doc -

Two Sundays ago, I had protected sex (oral and vaginal) with a CSW.  The condom did not break, but I fear that when the CSW removed it (with a paper towel), the exterior of the condom may have touched my uretha and transmitted something - she spent an unusual amount of time wiping me off and I wasn't paying attention to the condom itself at that point.

Several days later, I developed pain in my uretha, had the urge to pee more frequently, and generally thought something was amiss in that realm.  It did not, and does not, hurt to pee and I haven't noticed any 'discharge', although I can leak a bit after urinating.  I was in a part of the world where I could treat myself with a zpac (took 500mg one day, 1g the next) and did so.

The sensations continued and prompted me to visit a doc - she prescribed 500mg cipro 2x/day for 10 days and indicated it may be a UTI although a pee-cup check did not indicate an infection (would it have caught a bacterial STD?).  I didn't share my CSW history, which I certainly regret now.  Two days in to this treatment, I feel 95% better.

I have a feeling you'll say my symptoms are a result of anxiety and that the likelihood I caught something is low.  My question is this - if I did catch a bacterial STD, would the antibiotics I've taken treat it?  I've been told I shouldn't test for STDs till the antibiotic treatment is complete.  Do you think I should be tested and should I have unprotected sex with my partner?

Appreciate the advice.  Thank you very much.
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Welcome to the forum.  Thanks for your question -- and thanks for apparently reading other, similar threads before starting this one.  Also congratulations for a responsible, effective approach to STD prevention with commercial sex partners -- i.e. condoms for vaginal or anal sex, and even for oral sex.

You have correctly predicted my response.  I'll add that the details of how condoms are removed -- i.e. the potential that small amounts of a partner's genital secretions could have fleeting contact with the penis if not removed carefully -- is not likely to ever be a significant STD risk.  STDs are not simply genital infections.  STD bacteria and viruses evolved in a way that they are difficult to transmit; fleeting contact with small amounts of them, or small amounts of infected secretions, generally are insufficient to be considered a risk.

As you predicted I would say, your symptoms indeed are most consistent with genitally focused anxiety.  You also are correct in your understanding that it would have been best to give your doctor the full story.  While I don't think you needed antibiotic treatment at all, the precautionary prescriptions you were given probably would have been different.  Your azithromycin self-treatment would have been effectively treated or prevented gonorrhea, chlamydia, or syphilis.  But ciprofloxacin is not reliable against any of them; that treatment was strictly for possible UTI (which is rare in healthy males, and in any case you didn't have, based on the urine test).

At this point I don't recommend any STD testing at all; given your treatments, a negative result is guaranteed.  It would only mean you weren't infected at the time of the test -- without telling whether or not you were infected before you took the antibiotics.  So don't waste your money on it.

If I somehow found myself in your situation, I would continue unprotected sex with my wife with absolutely no fear of infecting her with anything.

Best regards--  HHH, MD
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