STD Risk from CSW?

[bayridge]

Hi Drs --
Just over 3 weeks ago, I received unprotected oral sex for approximately 1-2 minutes and had protected vaginal and anal sex (condom stayed on and intact) with a CSW.  I am married and greatly regret this one-time lapse.  Although I've been anxious about STD risk since then, I've had no visible sores or discharge.  A few times over the past 3 weeks, I've felt a burning sensation around my genitals which comes and goes.  I also came down with symptoms of a cold (nasal and sinus congestions, etc. for a few days about 4-5 days after the encounter, which lasted roughly 5-7 days.
My question is whether I should be tested, especially for HSV, or whether I can resume unprotected sex with my wife without putting her at risk since I've had no visible lesions.  Thanks in advance for your help.

[Edward W Hook, MD]

Medical advice should integrate all available information.  In your case, when you put all the "pieces" together you can be confident that you did not get HSV from the encounter you describe. I would not worry and would urge you to move forward.  EWH

[bayridge]

Thanks Doctor - the burning sensations are all external and come and go. One quick follow-up question.  I've read that HSV infections can be asymptomatic.  If I've had no sores or lesions in more than three weeks since this encounter, can I be confident that I didn't catch HSV?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help. Your condom protected vaginal exposures should be no risk for you in terms of acquiring any STD.  That leaves receipt of oral sex.  Fortunately, oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.   It is not clear to me where the burning genital sensations you are experiencing are.  If they are external, on the surface of your penis or scrotum and there are no lesions then this is unlikely to be an STD, including HSV.  if they are internal to your penis, then I would suggest evaluation, particularly for NGU.

Your sinus congestion is unlikely to be related to your exposure and rather is probably coincidence.  EWH