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Avatar universal

Single Exposure, Brief Unprotected Vaginal and Oral, Risk?

Hello Doctor, need some advice (sorry for my english).

6 nights ago I was very drunk and went to a strip club in Mexico, I met a girl there (24 year old). After some talking  I practiced her unprotected oral sex that last like 2-5 minutes. Later she took my pants off and with lubricant she rubbered many times her vagina with my penis, later I felt that I was penetrating her a little bit I don´t remember very well. She said that I never penetrate her, but I have a weird sensation that I did, about 5-10 seconds of unprotected exopsure. We stop the intercourse.  Later I noticed like a red rash (like circle shaped isolated and localized only in her left leg about a size of a tennis ball). She said that it was nothing to worry about it and she cover herself. I asked if she use drugs and she told that she usally smoke meth, not other drugs. Four days after I went to strip club and they told me that all girls do STD and HIV test every 2 months and they have a health care card. I talked to ther girl and she told me again that I never penetrate her (thing that I doubt) and that she was clean, I asked for her health card and she was mad and left (I´m afraid she's hiding something). I´m super anxious.

2 days after exposure: flu (no fever, just green-yellow mucus, sore thorat, no runnig nose)
3 days after: Diarrhea and sore throat.
5 days after: Red rash all over my chest that last like 2 hours. Sore throat and Diarrhea.

1. Are these are ARS symptoms. Do they come gradually like in me, or is it only anxiety?
2. Risk of getting STD (oral and in my penis), which exams of STD should I take and with what window period?
2. Risk of getting HIV form this intercourse (in case she´s infected)?
3. ELISA test will be reliable after 30 days of exposure?
4. The red rash in her leg (with the characteristics I described) could be some ARS symptom?
5. I´ve herad about the new Procleix "early test" that can detect HIV infection after a week of exposure. Is reliable?,    how about PCR?

10 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum and thanks for your question.  I'll try to help.

The replies you have had in past threads on the HIV community forum were accurate. Here is the main thing you need to know about avoiding HIV from sexual exposures:  outside of a mutually monogamous relationship, choose your partners carefully, and use condoms for vaginal or anal sex.  That's all. No other sexual exposures should be of concern. Follow these rules and you'll go your entire life without catching HIV.

In other words, the exposure described here carried no risk, even if your partner had HIV -- and you give no reason to suppose that she does.  Her rash doesn't sound worrisome; and your symptoms are not those of HIV. And anyway, new HIV symptoms cannot start sooner than 7-8 days after exposure.  You caught some sort of minor viral infection, not HIV.

Also, it is statistically unlikely your partner has HIV.  You challenged her honesty, essentially accused her of lying.  I would be just as upset as she was.  It doesn't mean she has HIV.

To your specific questions:

1) Your symptoms don't sound like ARS and they started too soon.

2) This exposure was not high enough risk for HIV or any other STD testing.  But if you remain concerned, visit a doctor or STD clinic and have urine tests for gonorrhea and chlamydia and, after a few weeks, blood tests for syphilis and HIV.  If this is your only potential risk, you can expect negative results.

3) A stand-alone antibody test, such as ELISA, would be about 90-95% reliable at 30 days.

4) Such a rash does not suggest HIV or any STD.

5) I'm not familiar with that particular test. But in the US, any test approved by the US Food and Drug Adminstration can safely be assumed to be reliable and to perform as advertised.  I would not recommend PCR testing in a situation like yours, but if negative, it would confirm you don't have HIV.

Regards--  HHH, MD
Avatar universal
Doctor, thank you very much for your comments. I really appreciate your work here at the forum.

Tomorrow (7 days after exposure) I´m going to do chlamydia and gonorrhea  tests at a local clinic.  Also I think I´m going to take the ELISA test at 30 days afetr exposure for a first aproximation. I´ll keep you updated.

The thing that bothers me right know is the chest rash I had 5 days after exposure. I never had a rash before in my life (not that I remember), that´s why I´m scared (in my mind I have the worst case scenario, for example that she was infected and that I did penetrate her for 10 sec). So to clear my mind I want to know if ARS rash can come for 2 hours and then go. Sore throat is still here but i think it could be just anxiety. What do you think?

Regards
239123 tn?1267651214
MEDICAL PROFESSIONAL
It doesn't matter that you had no such rash before.  Every symptom has to start sometime.  Rash is never the only symptom of ARS and cannot start so soon. Your rash has nothing to do with the sexual exposure; and rash.  Believe it.  Discuss it with the clinic if you still have it when you visit for testing of if you remain concerned.

I recomment that you not request any particular HIV test at any particular time.  Tell the clinic your story then follow their advice.  They might recommend an ELISA at 30 days, or they might have other advice.
Avatar universal
Hello Doctor, thank you again for your comments.

Just got today my STD results:

For gonorrhea (7 days after exposure) I took the swab test from my throat and my urethra, both came negative, just got Estafilococos epidermidis in the urethra and Neisseria catarrhalis in the throat which is normal right?

For  chlamydia I took the AC. ANTI-CHLAMYDIA TRACHOMATIS IgM blood test (7 days of exposure), it also came back negative.

1.- Is the chlamydia blood test reliable?,
2.- should I take one from urethra swab sample?

The thing that bothers me right now (12 days after exposure) is that I have litlle itchy and  burning sensation when passing urine, no discharge...

3.- could this be chlamydia symptoms or could this be stress related?...I have felt this before when being very anxious.

4.- If chlamydia symptoms are present they always produce discharge?

Regards,  
239123 tn?1267651214
MEDICAL PROFESSIONAL
The gonorrhea tests are reliable; the bacteria identified are entirely normal in the urethra and throat, respectively.

Chlamydia blood tests are useless and your negative result doesn't mean anything.  The ONLY way to diagnose sexually transmitted chlamydia is to test a swab from the urethra (or the cervix or vagina in women) or a urine sample.  However, chlamydia is almost never transmitted by oral sex; if that was your only exposure, no chlamydia testing is necessary (and you wasted your money on the useless blood test).

Your itchy urethral sensation probably is indeed just anxiety.  Chlamydia does not always produce discharge, but as already discussed, you were not at risk of chlamydia from the exposure you described above.
Avatar universal
Thanks Doc,
I have an appointment to do the chlamydia swab test on tuesday. They said they need special conditions to do the test. I´ll keep you updated. Just wondering, rubbing penis with vagina fluids (as i described before) isn´t enough to get chlamydia?  

Regards
Avatar universal
Sorry to bother you with so many questions
239123 tn?1267651214
MEDICAL PROFESSIONAL
Hand-genital contact rarely spreads any, even with genital fluids as lubrication -- and certainly cannot transmit chlamydia.  I repeat that based on the exposure you are so anxious about, you are not at risk for chlamydia.  On the other hand, occasional chlamydia testing makes sense for non-monogamous persons, especially under age 30.  So feel free to be tested.  But be sure you understand:  if the result is positive, it will be from some event other than the one described above.

That will end this thread; I won't have any more comments or advice.
Avatar universal
Hello Doctor, just want to thank you again for your comments and support.

I just received my chlamydia urine antigenic test (done at 13 days after exposure) and is negative.  I also consulted a urologist and he told me that test are very reliable , even though, he wanted prevention and he prescribed azythromicin 2 tables 500 mg today and one tablet of 500 mg in two days more and a single dose intra-muscular of ceftriaxon.

I´m still waiting the 6 week for my first elisa test. If you don´t mind I want to keep you updated with my results at this thread.
239123 tn?1267651214
MEDICAL PROFESSIONAL
If your urologist really considered it necessary to treat you, I won't challenge his or her judgment.  If it was done at your request because you remained anxious despite such overwhelming evidence you weren't infected, in my opinion he should not have complied; we would not have agreed to that request in my clinic.

I have nothing more to say.  Feel free to post your future results if you wish, but I won't have any comment about them if they are negative -- as I fully expect them to be.
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