Do I need to worry?

[notverysmart1]

Thank you for your time. I recently went to Manila in the Phillipeans for a work trip.  While I was there I had sexual relations with a sex worker. I met her in one of the establishments set up for that kind of thing. Supposedly the girls that work in these clubs have to go through weekly STD tests, but who knows if that is true. This is one of the biggest well known clubs in town.The first night I had protected sex with her. The one part that worries me is she took my penis into her mouth for not more than 30 seconds without a condom on, and there was no ejaculation on my part. Protected vaginal sex followed right after, and I am positive the condom did not break. I did kiss her deeply throughout the encounter. The next morning, the same thing. No oral sex. Just protected vaginal sex with deep kissing. Once again condom was intact. The next night I had the same girl. Protected sex, deep kissing, condom intact. She was grinding into me fairly hard pelvic area to pelvic area. Enough to where I was very sore in that area for a few days. My questions and observations are as follows. 1. What are the chances of contracting an STD from this? HIV being the biggest worry. Also I should of washed myself right after each encounter but I did not. Once I may have accidentally brushed the outside of my penis with the removal of the condom with the outside portion of the condom. 2. I have had diarrhea starting about 3 days after I returned from the trip. It has lessened but has been ongoing (5 days now) since I returned. Could this be a sign of an  STD infection? I have been feeling not quite right but I am not sure if I am imagining things. My testicles seem to be a little sore as well and I have had different kinds of sensations inside my sexual organ area/testicles all week. Nothing visible. 3. How soon can I get a STD workup for anything that could of happened and what STDs should I be worried about? It's only been a week since the occurrence. Thanks..

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our STD forum.  I am going to answer each of your questions here below:

1. What are the chances of contracting an STD from this? HIV being the biggest worry. Also I should of washed myself right after each encounter but I did not. Once I may have accidentally brushed the outside of my penis with the removal of the condom with the outside portion of the condom.

NO RISK OF HIV INFECTION AT ALL.  THERE IS A RISK OF STDs THROUGH THE ORAL SEX INCLUDING CHLAMYDIA, GONORRHOEA, NSU, HERPES AND SYPHILIS.

2. I have had diarrhea starting about 3 days after I returned from the trip. It has lessened but has been ongoing (5 days now) since I returned. Could this be a sign of an  STD infection? I have been feeling not quite right but I am not sure if I am imagining things. My testicles seem to be a little sore as well and I have had different kinds of sensations inside my sexual organ area/testicles all week. Nothing visible.

I DO NOT BELIEVE THAT THE DIARRHOEA HAS ANYTHING TO DO WITH THAT SEXUAL ENCOUNTER OR WITH ANY SEXUALLY TRANSMITTED INFECTION.  THE SORENESS ON THE TESTICLES MIGHT BE RELATED TO ONE OF THE STDs MENTIONED ABOVE.

3. How soon can I get a STD workup for anything that could of happened and what STDs should I be worried about? It's only been a week since the occurrence.

FOR CHLAMYDIA, GONORRHOEA OR NSU, YOU CAN BE TESTED NOW.  FOR SYPHILIS YOU WOULD NEED TO WAIT AT LEAST 4 WEEKS FROM THE ENCOUNTER.

Best wishes,
Dr José

[notverysmart1]

Doc,

Hopefully this is replying back to my original post, I am not totally up on how to use this forum correctly. There has been an update to my situation. My doctor had a liver test done when I went to see him on 11/22/10 due to my trip to the Philippeans and my bad diarrhea, see above post. My readings were-

ALT 44
AST 27

Which were normal but the incident that I was concerned with happened on 11/12/10 so it was fairly early. On the 17th of November I had to have a blood draw from my employer for a biannual physical and I received a call from them because they were concerned with my liver readings which were-


ALT-163
AST- 470

Now I was freaking out. I went back to doctor and he did a full liver and hepatitis panel. The blood draw was on the 12/20/10 which was 39 days after the incident. Roughly 5.5 weeks after the incident. The results were-

ALT 131
AST 80

He also did a Hepatitis panel and the results were-

Hep A IgM, EIA Non-Reactive Non-Reactive-    
Hep B surface AG, EIA Non-Reactive Non-Reactive-    
HEPATITIS C VIRUS AB, EIA QL Non-Reactive Non-Reactive-    
Hep B core IgM, EIA Non-Reactive Non-Reactive-    


So he has ordered another test to be completed after the New Year. My questions are as follows.

1. If my Liver enzyme what they are (possibly indicative of Hepatitis C), but there was a non-reactive reading at almost 6 weeks, what are the chances of the test not picking up the antibodies?

2. Based on my readings is it most likely that I do have Hepatitis C (I have been inoculated against A and B) ?

My doctor seems to not be concerned and says that based on his opinion that I caught a virus that had hepatic implications but was getting better due to the blood readings. From what I read about Hep C it seems that it could be just too early to tell. I am just extremely worried. I have been having strange sensations in my abdomen. I wouldn't call it pain but a dull ache, but it seems more in my lower abdomen then my upper. Strange urination urges as well and it almost seems like my kidneys ache a little as well. So far I have not had any fever or vomiting. I have had a few bouts of mild nausea, but my appetite is fine.  What do you think? I need someone to talk with about this.

Thanks for your time!