Very worried.

[timmy25]

Hello,

About 10 days ago I was in the Amsterdam Red Light District.  I was drunk and alone and one of the girls called me in and I agreed.

I went downstairs and took off my clothes.  She put on a condom (although I did not see the quality of if she put it on proper).  I did not get fully erected however the condom appeared to be snug.  After a couple of minutes of this she complained it wasnt working and for me to pay an additional sum for the full service.  I agreed.

Firstly (without changing condoms) we were in doggy position; however very breifly.  And then me on top, again very breifly.  At this point she was yelling that I couldnt get erect and I sobered up enough to realize what I was doing and instantly stopped.

The original condom was still on and still looked snug.  I took it over touching the outside base of the condom, not sure if there was vaginal fluid on the outside or not.  I went back to my hotel and with 15 minutes had a shower before going to bed.

A few days after this I noticed some irritation at the tip of my penis.  It continued until today when I went to a doctor (not my family doctor) and described my situation.  No test was performed but he assumed it was Chlamydia and wrote me a prescrption for a pill I'm to take once a day for 3 days.

I'm very nervous about the possibilites of getting HIV.  I deeply regret what I did -- I suppose you get that a lot.

I guess my questions are as follows:

1.  Did I likely contract Chlamydia or could it be anxiety that is causing the burning?  I took the first pill apx. 3 hours ago and note I still have burning.

2.  If the CSW had Chlamydia the forums state she has a higher chance of having HIV.  Given that I got Chlamydia but was wearing a condom, does that mean it likely failed and my chances of getting HIV are high?

3.  Should I be tested at 28 days?

Thank you in advance.

[Edward W Hook, MD]

Welcome to our Forum.  Unfortunately, you have posted on the wrong site.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your questions with this reply but, if you have additional questions or follow-up they must be on the HIV Prevention site.  Sorry.

Before I answer your specific questions, let me reassure you that you are not at risk for HIV form the exposure that you describe above.  CSWs in Amsterdam are licensed and as part of that are tested regularly for HIV and other STDs, thus it is unlikely that she had HIV or any other STD.  In addition, even if she somehow was infected, use of a condom makes a single sexual exposure virtually zero risk as long as the condom stays intact.  your condom stayed intact, thus no risk.   In fact the symptoms you describe are really not suggestive of chlamydia either and unless you were tested for chlamydia, my guess is that you did not have chlamydial infection or any other STD.  Let's now address your questions:

1.  See above.  I doubt that you had chlamydia.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turns leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation - it is not uncommon for us to hear such complaints and find to objective evidence of chlamydia or other STD.
2.  Studies show that condoms are more effective for preventing HIV than for chlamydia.  This may just be a fluke of the way studies are designed.  As i said, it is doubtful that you got chlamydia from the exposure you describe.  Even if you had chlamydia, your risk of HIV is miniscule and at this point, unless a test was done before you started antibiotics, I suspect you will never know if you had chlamydia.
3.  I see no need for testing.

I hope these answers help.  As i said above, if there are further questions about chlamydia I will be happy to briefly address them but there will be no further answers about HIV.  Take care.  EWH

[timmy25]

Thank you for your prompt response.  I wasn't sure what forum to post as I was going to mention HIV and Chlamydia, I will try to keep my return limited to Chlamydia.

Thanks for the info, it sure does reassure me.  Further to my original post and your response:

1.  Is it possible then that the burning sensation was due to anxiety?  If yes, how likely?  (I note where I have felt pains before, it was very noticable until recently, after 24 hours on the medication I do feel better, my mind playing tricks on me?).

2.  Is it common to get Chlamydia and not HIV when using a condom?  Previously I thought a condom was near sure assurance that you would catch neither if used properly and consistantly.

3.  Finally, you said my symptons did not describe Chlamydia, is that because although I had the burning I did not have penile discharge OR rash OR any visable effects to my genital area?

Thanks so much doctor for your help!  I dont think Ill have any additional questions after the above.

[Edward W Hook, MD]

1.  Yes, anxiety often leads persons to detect urethral sensations they would otherwise ignore.  Obviously, I cannot tell you if your mind is playing traicks on you or not but it would be most unusual to gt an STD when a condom was used.
2.  Of course it is.  Chlamydia is far more contagious than HIV.  Your assumption about condoms and their protective effect is correct
3.  "Irritation at the tip of the penis is not a common symptoms of chalmydia.

EWH