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Avatar universal

1 Encounter, Really worried

I recently had an unprotected encounter with a woman who I know has multiple partners.  I received brief (2-3 minutes) oral and there was brief (1-2 minutes) intercourse.  She has told me that she normall uses protection and that she doesn't have anything but that doesn't make me feel any better.  It has been 4 days and there are no symptoms but I plan to take a urine test on day 6 to test for gonorrhea and chlamydia.  First of all, is this long enough for accurate results?  I am married and I'm very concerned about passing something on so I was wondering how high you think my risk is.  I know that my HIV risk is very low but I'm more concerned about other STDs.  Should I be extremely concerned and should I go for further testing after the chlamydia and gonorrhea test?  What STDs should be of most concern to me?  Thanks in advance for your help
10 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll try to help.

In general, STDs are not transmitted with very high efficiency.  Even when one partner is infected, with a single brief exposure transmission usually doesn't occur.  You don't mention your partner's age, but if she is under 25 the chance she has chlamydia probably is around 5%, up to 10% in some settings.  Gonorrhea is around one tenth as common.  From female to male by vaginal sex, these probably are transmitted with around 25% efficiency (higher for male to female transmission). Thus with one exposure the odds you caught chlamydia might be around 1-2%; for gonorrhea 1-2 in 1,000.

The risks of syphilis and herpes are much lower.  The chance your partner had syphilis is extremely low, well under 1 in 1,000.  Same for HIV.  And although 20-40% of such women might have HSV-2, most of the time herpes is not active and not transmissible.  HPV is an unknown, with up to 50% chance infection is present, but no data available on efficiency of transmission.  But everybody gets genital HPV anyway and undoubtedly you have already been infected, perhaps several times -- so for practical purposes it's not an issue.

Six days is fine for accurate gonorrhea and chlamydia testing; 2-3 days probably is sufficient.  For the next 2-3 weeks, keep an eye out for genital blisters or sores; if none, herpes and syphilis are very unlikely.  If you want further assurance, have a syphilis blood test at 6 weeks.  I don't recommend HSV testing after single exposures of such low risk.

HIV is too low risk to really need testing in this situation.  But it's a good idea for all people sexually active outside mutual monogamy to have HIV testing from time to time.  So perhaps you'll want to do that while it's on your mind.  If so, have a single test at 6 weeks.

As for sex with your wife, no distant online expert can guarantee someone isn't infected.  But if I were in you situation, knowing what I know, once I had the negative results for gonorrhea and chlamydia, I would resume unprotected sex with my wife without fear for her health.

Best wishes--  HHH, MD
Avatar universal
Thank you very much for your help.  I have had trouble eating or sleeping the past several days and I know it is for my own stupididity.  Following up the age of the woman was 26, if that makes any difference.  Also, does duration of contact have an affect on the likelihood of transmission?  It is good to hear that my chances aren't great but I still won't feel better until I get the first results.  Thanks again.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Age does make a difference; that's why I mentioned it. Chlamydia is dominantly a disease of youth, with by far the highest rates in teens and declining (but still high) rates age 21-25.  After age 25, chlamydia is so uncommon that CDC recommends against routine testing.  This isn't hard and fast, but it puts your partner in the low end of probabilities, probably under 1-2% chance she had it.  Gonorrhea is also youth-related, but not as sharply as chlamydia; my estimate for likelihood your partner had gonorrhea is unchanged.

Duration of contact does make a difference, but hard to know how much.  I suppose the transmission rate in your case is under 25%, but it isn't possible to say more.
239123 tn?1267647614
MEDICAL PROFESSIONAL
I meant to add that if you had caught gonorrhea, almost certainly you would have had symptoms by now, i.e. pus dripping from your penis.  Chlamydia can be asymptomatic, but because of your partner's age the chance is 10 times lower than my original estimate.  So you can be quite mellow about your upoming tests.  You can expect negative results.
Avatar universal
Thanks again doctor.  The symptoms of gonorrhea really show up that fast?  I've had problems in the past with frequent urination so I shouldn't be worried about that should I?  Also, why is it that the chlamydia rate drops so much?  And last question.  I've seen other places that Trichomoniasis is the most commond STD but I don't see it mentioned much here.  Should that be a concern?  Again, thank you for your help.  I'm starting to feel a little better.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Gonorrhea symptoms usually start in 2-4 days, rarely more than 5 days.  Frequent urination is not a symptom of gonorrhea or chlamydia.

The reasons for the strong age associations of chlamydia are not fully understood.  It is believed to be a combination of immunty due to prior exposure, anatomic issues of the cervix that probably increase susceptibility in the teen years, and behavioral issues (who people have sex with).

Trichomonas indeed is fairly common, probably with risk comparable to gonorrhea.  It usually causes no symptoms in men and there are no commercially available accurate tests.  And although some experts believe trich deserves more attention than it gets, it usually causes no serious outcomes in women.

Should have said it above, and you're probably thinking this yourself:  but next time you find yourself in a potentially sexual situation outside your marriage, have a condom handy and use it!

Feel free to report your test results.  Otherwise that will be all for this thread.  
239123 tn?1267647614
MEDICAL PROFESSIONAL
It is inappropriate to start a new thread with follow-up questions when the original thread has been terminated, especially when the new questions is purely anxiety driven with no educational value.  And especially when the new question was already answered (initial reply, paragraph 4).  I deleted the new thread.  Only a limited number of new questions can be accommodated and superfluous ones block others with their own questions.  
Avatar universal
Doctor, I just received my results for gonorrhea and chlamydia and both were negative 5 days after exposure.  I am continuing to monitor for other signs or symptoms but I believe that my anxiety gets the best of me.  I often see discoloration or think that there is some sort of odor when there probably isn't.  I apologize for starting a new thread and if you do not care to answer, I understand, but what exactly should I be looking for in relation to HSV and syphillis even though they are unlikely.  Discoloration, raised bumps, itching, etc.  Thank you again for your help.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Congratulations on the negative results for chlamydia and gonorrhea.

The symptoms of new herpes or syphilis are genital sores.  For herpes, lesions usually start after 2-5 days (rarely up to 3 weeks); typically there are multiple lesions that start as blister-like, then progress to ulcers that scab over within a couple of weeks.  Syphilis usually causes a single painless sore that starts 2-4 weeks after exposure.  For both diseases, the lesions would occur only at the exposed site, usually the penis.  Disccoloration, bumps, itching or pain without sores, etc are not sypmtoms of STD.

That will be all for this thread.
Avatar universal
A related discussion, HPV after on encounter? was started.
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