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Worried about HIV, Chlamydia...
Dear Doctor,
I am a 24 year old, healthy male living in a rural area in Japan. I have almost always practiced safe sex, but 4 nights ago, I had a brief unprotected encounter with a 20 year old Japanese female I met at a bar. It was the first time something like this has happened. I had intercourse without a condom during the first ~5 minutes, but put one on for the remainder of the session. I am concerned about the potential that I could have been infected with a STD, because although the AIDS/HIV infection rate in Japan is comparatively low to other countries, this female happened to be on her period at the time, and she also mentioned being fond of foreign men. In particular, she mentioned that her ex-boyfriend was a man from Brazil, and she also happened to have a couple tattoos. This leads me to believe she could be a little promiscuous.
Of course, in the span of 4 days, I haven't developed any noticable symptoms of an infection, although my right testicle has been aching off-and-on in an unusual manner (anxiety over the situation, perhaps?). Although this is a vague question, I would like to ask how "concerning" this situation is, in your professional opinion, and whether you think the chance that I could have contracted something from this single encounter is high. I intend to have an anonymous HIV/Chlamydia test done in about 3 weeks, but being in a foreign country, I am unsure if they are able to treat the latter (or other STDs in general) with the same proficiency that a US doctor could provide. I will be returning to the US in a couple months, however, but will not have insurance immediately upon arrival.
Again, I know this is a vague question, but I would sincerely appreciate any advice you could possibly give me as I have been extremely worried for the past 4 days. Thank you very much.
I am a 24 year old, healthy male living in a rural area in Japan. I have almost always practiced safe sex, but 4 nights ago, I had a brief unprotected encounter with a 20 year old Japanese female I met at a bar. It was the first time something like this has happened. I had intercourse without a condom during the first ~5 minutes, but put one on for the remainder of the session. I am concerned about the potential that I could have been infected with a STD, because although the AIDS/HIV infection rate in Japan is comparatively low to other countries, this female happened to be on her period at the time, and she also mentioned being fond of foreign men. In particular, she mentioned that her ex-boyfriend was a man from Brazil, and she also happened to have a couple tattoos. This leads me to believe she could be a little promiscuous.
Of course, in the span of 4 days, I haven't developed any noticable symptoms of an infection, although my right testicle has been aching off-and-on in an unusual manner (anxiety over the situation, perhaps?). Although this is a vague question, I would like to ask how "concerning" this situation is, in your professional opinion, and whether you think the chance that I could have contracted something from this single encounter is high. I intend to have an anonymous HIV/Chlamydia test done in about 3 weeks, but being in a foreign country, I am unsure if they are able to treat the latter (or other STDs in general) with the same proficiency that a US doctor could provide. I will be returning to the US in a couple months, however, but will not have insurance immediately upon arrival.
Again, I know this is a vague question, but I would sincerely appreciate any advice you could possibly give me as I have been extremely worried for the past 4 days. Thank you very much.
I was under the impression that the infection chance from unprotected intercourse was substantially higher than 1/1000 and am relieved to hear that it is lower. Needless to say, though, I'm going to be much more careful in the future and will test soon (several times) for the psychological confidence.
Thank you for the fast response, doctor. Your advice has been very helpful and reassuring to me. :)
Thank you for the fast response, doctor. Your advice has been very helpful and reassuring to me. :)
MEDICAL PROFESSIONAL
Yes, wrong forum, but your question concers STDs as well as HIV, so I'll let it stand.
I see little HIV risk here. Sex during menstruation raises the risk only a little. Much more important is the fact that statistically, it is unlikely your partner has HIV; and even if she had it, the chance you would have been infected is somewhere around one chance in 1,000. I see no need for HIV testing, except that from a psychological perspective you probably will need to know a negative test result; most people in your situation require more than my reassurance. So feel free to get tested if you wish.
As you rightly understand, the risk for chlamydia and gonorrhea is much higher than for HIV. Three weeks is the wrong time to test, however. Gonorrhea and chlamydia testing is accurate within a few days of exposure, and can be done now; but there's not much point in HIV testing until 6 weeks have passed. (A negative test at 3 weeks will be reassuring, but only 70-80% would have positive tests by that time, so you'll probably just have to do it again.) Have a syphilis blood test while you're at it.
You don't need health insurance for low-cost (or cost-free) STD/HIV testing, if you go to your local health department -- which in most towns is the best place for the most confidential and professionally expert evaluation anyway. Anonymous testing makes no sense these days, by the way, at least not in the US, and probably not in Japan.
Best wishes-- HHH, MD
I see little HIV risk here. Sex during menstruation raises the risk only a little. Much more important is the fact that statistically, it is unlikely your partner has HIV; and even if she had it, the chance you would have been infected is somewhere around one chance in 1,000. I see no need for HIV testing, except that from a psychological perspective you probably will need to know a negative test result; most people in your situation require more than my reassurance. So feel free to get tested if you wish.
As you rightly understand, the risk for chlamydia and gonorrhea is much higher than for HIV. Three weeks is the wrong time to test, however. Gonorrhea and chlamydia testing is accurate within a few days of exposure, and can be done now; but there's not much point in HIV testing until 6 weeks have passed. (A negative test at 3 weeks will be reassuring, but only 70-80% would have positive tests by that time, so you'll probably just have to do it again.) Have a syphilis blood test while you're at it.
You don't need health insurance for low-cost (or cost-free) STD/HIV testing, if you go to your local health department -- which in most towns is the best place for the most confidential and professionally expert evaluation anyway. Anonymous testing makes no sense these days, by the way, at least not in the US, and probably not in Japan.
Best wishes-- HHH, MD
It just occurred to me that I probably should have posted this in the "HIV Prevention" forum, as I'm looking for a "risk assessment," I suppose. I apologize if my question was posted in the wrong area.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
