Please Help...

[concerned848690]

Dr.'s thank you again for all your hard work helping many people including myself through their anxieties and gerneral concerns about their sexual health.

I'll get right to it...

Situation: Last week during travel I bumped into a woman that I had met on other occasions but never had had sex and we had a week long fling. We regretably had unprotected oral, vaginal, and anal sex four times. To make matters even worse during one of the events I realized that she was on her period and had bled on me during intercourse. As I stated before all sex was unprotected but she assured me that she had been to the Dr. recently and was free of all STD's. Also, during the anal portion of the sex I realized that post sex I believe there was some fecal matter on my genital area including penis. I hope that I can trust her with her telling me of her sexual history and also of her results regarding STD's however my anxiety has peaked and has caused me some detrimental anxiety regarding this situation. In addition, I don't know if it matters but she is from the Texas, Louisiana area.

My history: I have been tested for STD's regarding Gonnorhea, Chlamydia and HIV, Hepatitus A, B, and C and received my results 3 weeks ago all with negative results. I was not tested for Herpes this time as I had been tested a year ago and it was negative and was told if I did not see or notice symptoms after an exporsure 10-14 days post occurence that I should be fine. In my tests for Hepatitus though I was negative but had a non-reactive test for Hepatitus which I was told made me unprotected from other circumstances if exposed to the virus.

My questions:

If she unknowlingly had an STD what are my chances of acquiring any STD including Herpes, HIV, and Hepatitus from these events?

What testing if any would your reccomend me getting after these possible exposures?

In a situation like this what are the odd's of someone contracting an STD?

[Edward W Hook, MD]

There goes your anxiety again.

The data on the frequency of STD transmission is sparse.  Gonorrhea is best studied.   IF your partner had gonorrhea (unlikely) your chance of infection would be about 20% per act of intercourse.  Rectal infection would probably be a bit lower and transmission from oral sex is probably less likely still.  The transmissibility of chlamydial infection is thought to be in the same range but has not been well studied.  There is still less data for other STDs.

No need for a hepatitis booster. Very unlikely that your partner had it or that you would get it is she did.  

I repeat, try to relax.  EWH

[concerned848690]

Thank you Dr. Hook for your quick response to my question.

Just a couple follow up questions.

Can you give me some statistics or figures regarding unprotected encounters like this one and someone actually acquiring an STD if the person did actually have one?

Also, do you reccomend getting the Hepatitus booster since my results were non-reactive or is the possibility of acquiring Hepatitus from a sexual encounter to low to warrant it?

Thanks again!

[Edward W Hook, MD]

Welcome back to the Forum.  I'll try to help.  I note from your prior interactions on the Forum that you have a tendency to become anxious following exposures that you, in retrospect have concerns about.  Certainly there is some modest risk for acquisition of STD if your partner had one but the fact that she stated that she had recently been evaluated and was negative makes her a low risk partner.  That does not change the possibility, even the low one, that your partner might have had an infection that she was unaware of.

To that end, the longer you are without symptoms, the less likely that you acquired a STD.  Most STDs do cause symptoms.  Gonorrhea would become evident in 3-5 days, chlamydia or NGU perhaps slightly longer and if you acquired herpes you would likely develop a noticeable outbreak within 10-14 days of your exposure.  

While your risk is low, my suspicion is that you would like to be tested for the assurance that it might provide.  If so, the important tests for you are for the most common STDs, chlamydia and gonorrhea.  Tests may actually become positive even before symptoms so you can get tested at any time more than 3 days after your exposure  and have confidence in the results.   Other STDs are so much more unlikely that I would not worry.  

I hope this is helpful.  EWH