Worried Sick

[frederick772]

Doctor

I have posted on other forums but I wanted your expert opinion.

Here are the cold facts. I had brief protected vaginal sex with two chinese CSW's in the Middle East four weeks ago. There was no kissing, no oral, no anal. Condoms were used at all times and they changed the condoms with each partner. They masturbated me but kept the condoms on. They each gave me oral but used condoms and changed with each partner. They washed between acts and I showered immediately afterwards. No condoms split. They seemed to be very aware and careful of what they were doing.

Now four weeks later, I have no symptoms. No lesions, no burning when I urinate, no rashes, nothing out of the ordinary. Apart from the lack of sleep through guilt, shame and anxiety, my health is normal.

I am meeting up with my wife next week and petrified to resume normal relationships in case i have caught something - eg HIV, STD's etc. I would get tested but its difficult in the Middle east although on my next visit to te UK I intend to get tested. If I do not resume normal relations with my wife she will know there is something wrong. I am determined not to destroy my marriage but equally frantic that I pass something onto my wife.

This was my first time doing something like this and never again....

Please can you advise??

Thank you

[H. Hunter Handsfield, M.D.]

The definition of an emotional or psychological problem, i.e. not normal for that person, is one that is significantly affecting one's life satisfaction and happiness.  Yours seems to meet that definition, and most people wouldn't be so affected by this situation.  But it certainly isn't rare.

All this forum can do is address the medical issues.  From that perspective, there is no problem here.

[frederick772]

Thank you, Doctor.

I appreciate your reassurance. I am trying to put this reckless event behind me and a trying to move on but I can't help thinking constantly  'what if?'

I'm even waking up in the middle of the night with what I can only describe as panic attacks. In your experience is it 'nomal' to have this level of anxiety?

Thank you again for your opinion and I know you can only give your best advice based on the information provided.

[H. Hunter Handsfield, M.D.]

You were given accurate responses on the STD community forum.  You describe nearly zero risk exposures for all STDs, even if either of the CSWs was infected.  STDs are not transmissted through intact condoms, and oral sex is low risk with no protection and absolutely zero risk with an intact condom.  

On the community forum, you describe confusion about symptoms, when to test, and so on.  Testing for STDs is recommended only when there is a plausible risk of infection and when testing can detect an infection you can do something about.  It is true that many STDs can be asymptomatic -- but it's still true that absence of symptoms is reassuring.  When you factor in the virtually zero risk in these events, plus lack of symptoms, it is not a realistic possibility you caught anything.

Although I do not recommend testing for STDs, if it will make you feel better, the next time you travel to the UK feel free to visit one of the many fine genitourinary medicine (GUM) clinics, or see a private STD provider.  If your history is accurate, and if your wife hasn't had other sex partners, you can be sure of negative results.  Although I never guarantee someone isn't infected, if I were in your situation, I would not get tested and I would not hesitate to continue unprotected sex with my wife.

Really, let this go.  STDs and HIV are not a realistic concern in this setting.

Best wishes--  HHH, MD