risk assessment

[Rab19978]

hello doc,

I had the following encounter today -
a. insertive vaginal with a condom;
b. received covered oral sex
c. provided Unprotected cunnilingus(for about 5 minutes). My mouth is healthy and I was intermittently drinking a low alcohol wine.
d. Masturbated her with my finger for a few minutes

The girl had a sore right under her bottom lip; i asked her about herpes and she said it was not but was from someones bite(kiss?!); it was crusty and didn't ooze any liquid as far as I can tell. I avoided kissing her on the lips.
Her vaginal area was clean (no noticeable warts or lesions)  and didn't emit any odors.
One more thing - she had a full std test 6 month ago and was all clean. But since then she had a couple of partners and always insisted on protected vaginal sex. However, she does occasionally perform unprotected oral(without ejaculation). About an hour after this encounter I got  a sore throat.
Here are my questions:
1. what are my risks for the following:
    a. HIV
    b. Syphilis
    c. Herpes
    d. Chlamydia
    e. Gonorrhea
    f.  HPV
2. Can my sore throat be an indicator of any of the above?
3. Do I need testing in your opinion?
4. If needed how soon can I test for the above STD?
5. In general - what I did would you call it "safe sex"

Thanks a lot Doc

[Edward W Hook, MD]

This could go on for ever. this will be the final answer:

1.  Syphilis blood test -6-8 weeks.
2. Herpes blood test - Testing not recommended in the absence of lesions.  If you must, a 3-4 month test with a type specific antibody test would be conclusive in your situation.

2 and 4.  Chlamydia and gonorrhea. Testing at any time more than 2-3 days after exposure

5.  There are no recommened tests. We strongly recommend against testing

End of thread.  Please no, but what if type questions. You ar emore likey to be struck by lightening that to have any of these STDs at this time.  EWH

[Rab19978]

Hello Doctor,

What are the accepted time frames for testing:
a. HIV
    b. Syphilis
    c. Herpes
    d. Chlamydia
    e. Gonorrhea
    f.  HPV

Thanks

[Rab19978]

I appreciate your time and response.

Thanks You!

[Edward W Hook, MD]

You said you did not contact the lesion below her lip, either through kissing or sex (since your sex was condom protected). If this is the case, you need not worry.  

HPV, were it to occur would be asymptomatic.

Herpes typically appears 4-14 days after exposure.  Taking valacyclovir to prevent herpes has never been shown to help and would proably just confuse things.  EWH

[Rab19978]

Dear Doctor,

Please answer my last question and that would be the end of the discussion

Thanks a lot!

[Rab19978]

Thanks a lot Doctor,

In #1 you mention "in the absence of lesions"  are you referring to genital area?
she did have a lesion under her lip as I mentioned. What about that one? how much is my risk increased?
if I did get herpes or hpv when do symptoms usually appear?
will taking "valtrex" today help for herpes?

[Edward W Hook, MD]

Welcome back to our Forum.  This question is very similar to your interchange with Dr. Handsfield in September so I won't repeat what he has already said other than to congratulate you for the precautions you are taking.  Your only exposure of significance in terms of STD risk is your performance of unprotected oral sex on your partner and that risk is quite low.  The protected vaginal sex, receipt of protected oral sex and masturbation is virtually no risk.  With that as background:

1.  Your global risk of infection is very low for all STDs.  No risk for HIV, or chlamydia.  Minis clue risk for gonorrhea.  In the absence of lesions, no meaningful risk for syphilis or herpes.  Oral HPV infections are similarly rare and when they occur are typically of no consequence.  I would not worry.

2.  No, your sore throat came on far too soon after contact to reflect anything you might have caught from the partner you had earlier in the day. Symptoms of infection typically take several days to occur.  

3.  No, I really see o need for testing of any sort.

4.  See no. 3

5.  Yes, I would call this safe sex--good job.

EWH

[Rab19978]

Just about her sore - it was in size about a quarter of an inch