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Potential STI Exposure with a CSW in Thailand
Hello I'm a 30 year old heterosexual circumcised male and recently had brief unprotected vaginal intercourse with a CSW in Thailand, no oral sex occurred, I was under the influence of alcohol.
The CSW was early 20s and told me there was nothing to worry but her status is unknown. Neither of us demonstrated any visible STI or wounds at the time of exposure.
Within 36 hours i went to a commercial walk in clinic and was given a 1g intramuscular injection of ceftriaxone and a 28 perscription of PEP 1 pill (tenofovir, emtricitabine, dolutegravier). After reading more and more it seems like the PEP might be overkill in my situation, and the clinic seemed eager to keep adding things to my bill, more shots, more prescriptions, so i'm looking for an alternative. I did a baseline test and was completely clean, good liver and kidney function, but no hep B vaccine.
In this scenario is PEP advisable? Aside from a persistent headache, i haven't had my other sides but i'm concerned about the medication and don't know enough about any potential long term effects regarding that combination. I'm on no other medication.
Finally midway through the PEP (if i complete the treatment) i'll be traveling to a time zone 12 hours behind Thailand, is it advisable to adjust the medication schedule so it stays consistent (e.g. if I've been taking it at noon , switch to midnight?)
Thanks for any insights and help here. Obviously i'll get tested at the appropriate times.
The CSW was early 20s and told me there was nothing to worry but her status is unknown. Neither of us demonstrated any visible STI or wounds at the time of exposure.
Within 36 hours i went to a commercial walk in clinic and was given a 1g intramuscular injection of ceftriaxone and a 28 perscription of PEP 1 pill (tenofovir, emtricitabine, dolutegravier). After reading more and more it seems like the PEP might be overkill in my situation, and the clinic seemed eager to keep adding things to my bill, more shots, more prescriptions, so i'm looking for an alternative. I did a baseline test and was completely clean, good liver and kidney function, but no hep B vaccine.
In this scenario is PEP advisable? Aside from a persistent headache, i haven't had my other sides but i'm concerned about the medication and don't know enough about any potential long term effects regarding that combination. I'm on no other medication.
Finally midway through the PEP (if i complete the treatment) i'll be traveling to a time zone 12 hours behind Thailand, is it advisable to adjust the medication schedule so it stays consistent (e.g. if I've been taking it at noon , switch to midnight?)
Thanks for any insights and help here. Obviously i'll get tested at the appropriate times.
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Did they give you any doxycycline or azithromycin? The names might be different where you are. One you take for 7 days, and the other is usually a one time dose.
Just keep taking the PEP, if you continue it, 24 hours apart. So adjust that accordingly. It needs to be 24 hours for your body.
When you say "brief unprotected vaginal intercourse" - how brief was it? Are we talking about 2 minutes? 10? 20?
Taking it for a month shouldn't result in any long term issues, but I can't tell you to stop taking it. That's your call.
You should get the hep B vaccine at some point, though.
Just keep taking the PEP, if you continue it, 24 hours apart. So adjust that accordingly. It needs to be 24 hours for your body.
When you say "brief unprotected vaginal intercourse" - how brief was it? Are we talking about 2 minutes? 10? 20?
Taking it for a month shouldn't result in any long term issues, but I can't tell you to stop taking it. That's your call.
You should get the hep B vaccine at some point, though.
2 Comments
Thanks for the reply. Would taking a single dose of azithromycin be advisable a week after exposure? I only had the 1g intramuscular shot as noted approx 36 hours after exposure. I've had a mild sore throat but i dont think its related to anything.
In terms of briefness it was 2-3 minutes no ejaculation occurred.
In terms of briefness it was 2-3 minutes no ejaculation occurred.
It's not any more or less advisable than taking the ceftriaxone. That treats gonorrhea, and the azithromycin treats chlamydia.
Generally speaking, chlamydia is more common than gonorrhea, and it's certainly more common than HIV, both of which they presumptively treated you for.
I think this is a lot of treatment for just a few minutes, but the only treatment you're missing is for chlamydia.
Generally speaking, chlamydia is more common than gonorrhea, and it's certainly more common than HIV, both of which they presumptively treated you for.
I think this is a lot of treatment for just a few minutes, but the only treatment you're missing is for chlamydia.
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