Worried about Std

[adamny]

I am a 30 year old man. I made a terrible mistake last night. I always use a condom normally butI got hammered drunk and had unprotected vaginal and anal sex with a 25 year old woman for hours and did not ejaculate. I am worried about Std's. few questions:

1. When can I get tested?
2. What are the odds of getting the various Stds from this exposure (herpes, HIV, warts, chlamydia, etc)

Thanks for your help. I know I screwed up, and I have an insane amount of anxiety and guilt right now.

[Edward W Hook, MD]

I'll take you at your word and will make this my last answer.  Herpetic whitlows do not come  from autoinoculation.  Persons who already have HSV do not get it again and another site through autoinoculation.

Herpetic whitlow is most often a problem for health care workers.  Their hands are typically chaffed from repeated hand washing and then, in the course of their work health care workers often come in contact cold sores in their patients.  Herpetic whitlows are now quite uncommon.  EWH

[adamny]

How do people normally get these? By autoinoculation durig a primary genital outbreak? Like by touching leaking sores? (Seriously last question) thx

[adamny]

How do people normally get these? By autoinoculation durig a primary genital outbreak? Like by touching leaking sores? (Seriously last question) thx

[Edward W Hook, MD]

No, in over 30 years of STD focused practice, I have never seen someone who got a herpetic whitlow from masturbation.  

Yes herpetic whitlows are typically painful.

EWH

[adamny]

Ok thanks. Have you ever seen this acquired this way before? Is that why you say "theoretical"? Are herpetic whitlows painful?

This is my last comment thanks again.

[adamny]

Ok thanks. Have you ever seen this acquired this way before? Is that why you say "theoretical"? Are herpetic whitlows painful?

This is my last comment thanks again.

[Edward W Hook, MD]

It is theoretically possible that, IF she had HSV and you already had a cut n your finger you could ge a herpetic whitlow but the risk is quite low.  the only way to be sure wouild be to get a PCR or culture test perfromed on the blisted (there is NO value in a blood test).   EWH

[adamny]

I have hsv-1 already,  but not hsv-2

[adamny]

Thanks again. I also fingered her vigorously. Does this pose a risk for herpetic whitlow? I have blister on my finger where I believe I had a paper cut last week I noticed today and am unsure if it is a bug bite or possible HSV. Apologies if this question seems silly, but I'm having anxiety about the exposure.

[Edward W Hook, MD]

Estimates are that, if your partner had herpes (and apparently you do not know whether she does or not),  and if there are no lesions, the risk of acquiring HSV from an unprotected exposure is less than 1 in 10,000.  Herpes is not easily transmitted to others.  EWH

[adamny]

Thanks doc. I asked her and she said she had a physical a couple of months ago and was good, so this gives me a little more comfort.

I just have one more follow up. With herpes, is there any statistical framework to understand how easily it spreads? I have heard mixed things, some say its difficult to get, and some say its very easily spread. I suppose it's all relative, but are there any numbers to put around this? Thanks again.

[Edward W Hook, MD]

Welcome back to our Forum.  The answer to your question really comes down to just how likely it is that your partner has an STI of some sort.  On one hand, most people do not have STIs and most STIs are not spread by a single exposure.  In aggregate, your risk for infection is low.  The most direct way to address your concerns is too ask her about her status and when she was last checked.  If she had not been checked (or even if she has) you might suggest that you both go get checked together.

The world however is not an ideal world so, if you choose not to do what I've suggested above:
1. When can I get tested?
You can test for the most common STIs, chlamydia, gonorrhea and NGU at any time more than 2-3 days after your exposure and expect accurate results.  For other STIs such as syphilis and HIV, blood tests at 6 and 8 weeks will provide definitive answers.  There are no tests for HPV and we do not recommend blood tests for herpes.  For herpes, if you do not develop an outbreak within two weeks of your exposure, you can be confident you did not get HSV.

2. What are the odds of getting the various Stds from this exposure (herpes, HIV, warts, chlamydia, etc.)
Overall, your risk is low.

I hope these comments are helpful. EWH