STDs - HIV/Hep B/Herpes/Syphillis

[lasvegasfear]

I recently had sexual intercourse with an Asian female who works in a massage parlor in Las Vegas.  She did not sound like she was born here, which concerns me as I've read that a lot of Asian countries have a high rate of Hep B.  I used a condom and sex was only about 3-4 minutes.  There was no rip in the condom.  When I took the condom off, I don't think it touched the penis.  My questions are as follows:

1) What are my odds of contracting Hepatitis B/HIV/Herpes?
2) Can Hepatitis B/HIV/Herpes live outside the body and the condom accidentally touched the penis to give me the disease?
3) I know Aids/HIV takes 2-3 months in 99% of cases to be tested for (based off of the CDC website), but for Hepatitis B, when can I test with accuracy?  What about Herpes?  Syphillis?  Can I go in and test for each individually if their dormant states are different?
4) What is the odds of an Asian massage parlor employee having these diseases, especially since she kept telling me not to tell anyone, as she does not do this?
5) Most important, can I receive the Hepatitis B inoculation 8 days after my sexual intercourse and not acquire the disease?  I know that Hep B vaccination is 3 shots, but over how long (a lot of conflicting info on this)?
6) I went to the hospital two days after and received a shot and 4 pills (antibiotics staring with a K and an M, but can't remember their exact names).  Does that cover Gonorrhea, Chlamydia and Trichomoniasis (NGU)?  Does it cover Syphillis?  Are the antibiotics 100% effective, or is there still a chance they could return?
7) Have noticed an ongoing tingling/very slight burning in my penis since day 2 and it is now day 8, but no other symptoms, so am I to guess that these are normal sensations heightened by my own obsessive behavior?

Thank you for any guidance you can provide, as I'm concerned and have never done anything like this before.

[Edward W Hook, MD]

Welcome to our Forum.  In preparing to address your questions I see that you have already asked the same questions at the STD Community site and then gone on to wear out your welcome there.  The information you receive from them however was correct.  I will repeat much of what has been said and perhaps expand slightly on some in the hopes that hearing the same information from me will help you to get over your concerns.

You had protected sex with a commercial sex worker.  Even if she was infected, which is unlikely, most infections are not transmitted following a single act of intercourse. In your case, you used a condom and it was intact when you finished. Condoms are highly effective for prevention of STDs, including HIV and hepatitis B. Thus your exposure was safe sex.  Your risk of infection of any sort is virtually zero.  On to your questions:

1.  Virtually zero
2.  No, transmission does not occur in this way. STDs are not transmitted through intact skin in the manner you describe an the bacteria and viruses which cause STDs do not survive well outside of the body.
3.  Hepatitis B and syphilis can also take as long as 3 months to give a positive blood test although, just as for HIV, the vast majority of infections are detectable long before that (at 8 weeks). Testing for herpes is a waste of time. If you do not develop lesions within 14 days of exposure, you did not get HSV.
4.  Low although I cannot provide a precise number.
5.  You can start hepatitis B vaccination at this time. It may offer partial protection but it will not be complete in the way if would have been if you had been fully vaccinated before your exposure.
6.  Although the letters you mention are not the same, it sounds like you got ceftriaxone (Rocephin) and Azithromycin. It that was the case, this would have cured gonorrhea, chlamydia, NGU and prevented syphilis.
7.  2 days is too early for STD symptoms to begin and if it persist since your treatment it is more likely that this is yet another manifestation of your anxiety than a manifestation of an STD of any sort.

This completes my answer.  You are clearly quite anxious about this exposure.   humored your long list of "what if" questions which have no relevance to your no risk, condom protected exposure.  Please no further what if questions, you are not at risk.  EWH

[lasvegasfear]

A related discussion, Tested Negative for everything was started.

[Edward W Hook, MD]

No, your results are definitive. Three month testing is overly conservative.   No need for further testing.   EWH

[lasvegasfear]

After 59 days and now that I'm in my 9th week.  I went to the Planned Parenthood Clinic today and they tested for HIV, Hep B and Herpes.  (I probably don't have Herpes, but it gives me peace of mind).  I had the nurse the fungul infection and it looks like this is going away, as I had no redness or unusual bumps.

My HIV test came back negative.  They utilized the Rapid Test from Uni-Gold and stated that this is just as accurate as any other test.  Is this correct?  Also, do I really need to follow-up in 3 months if everything else comes back negative?  

[Edward W Hook, MD]

These symptoms are non-specific.  Your exposure was condom protected and therefore very low risk. I anticipate you tests will be negative.  EWH

[lasvegasfear]

I'm going for testing tomorrow afternoon, 59 days since the incident.  I'm nervous, as the Clinic will be able to provide HIV results back first thing tomorrow.  I've been experiencing some mild lower abdomen pain, just above my pelvis and below my ribs.  Then I have a mild fever of 99.7 degrees.  No other symptoms, but could HIV or Hep manifest themselves in this way?  Are symptoms usually worse than this?

[Edward W Hook, MD]

Glad to hear that you are working through this.  This could still be a fungal infection. Some such infections are due to fungi which are resistant to clotimazole.  Another possibility is that this may be an allergic reaction of some sort.   I'd suggest you see a clinician and ask them about next steps.  

There are not differences in opinion about herpes, there are misunderstandings.  In some instances person do not detect their inital or subsequent herpes infections and, as a result, are unaware of their infections. These are not asymptomatic, they are missed.  You have been repeatedly examined and clinicians for nothing to suggest herpes.  You should believe them.   In your own case, there is NOTHING you ahve reported to suggest you have herpes.  EWH

[lasvegasfear]

So it has been 40 days since this encounter and I haven't shown any lessions, but a mild jock itch.  I've had time to educate myself on all STDs and am a lot less worried about any disease.  I do have a question about Herpes.

During the 2nd week after my encounter I started experiencing some itch and dryness on the penis and I went to a Panned Parenthood Clinic for a nurse to check me out.  She stated that it was not Herpes (no blistering) but a dryness of the skin and I should use a 1 % Hydrocortisone Cream.  I did for 6 days, but it didn't really stop.  

I then went back to a different PP Clinic (first one was booked).  She told me that it was not Herpes, but a possible fungal infection/Jock Itch and I should use a Anti-Fungal Cream to help.  I purchased Lotrimin AF (Clotrimazole 1%) and after 7 days it was much better and I stopped utilizing the cream.  A week later it started again and I've gone back to the creme.  I've been using for 6 days, but it hasn't changed, again the symptoms are exactly the same as what I experienced the second week and there is no blistering consistent w/ Herpes.

My questions are:
1) What else could cause this?  Did I just discontinue the cream too soon and the fungus has come back?
2) During both my visits to the PP Clinics Nurses, on the 12th day and 18th day, they both assured me it was not Herpes, but just because I don't have symptoms it does not mean I have Herpes.  Also, a lot documentation states that 50% of all cases are asymptomatic.  On my July 5th post you responded that if I don't have symptoms in 14 days I don't have it.  I'm wondering about the differences in medical opinion.

Please note that in no way do I doubt your medical opinion, but with your experience I'm wondering if you have just seen more cases that refute what a clinical textbook might say.

As always, thank you for your help, as my anxiety has been greatly reduced.

[lasvegasfear]

Thank you for your answers as it helps a lot and makes me feel a lot better.  

My apologies for the posts as I was trying to figure out how to have a doctor respond and had never been to this site, so I was a little confused on how to utilize correctly.  Sorry to wear out my welcome.