risk assessment - on steroids therapy

[Rab19978]

Thanks a lot for taking  time to answer my question.

I am currently on Prednisone (10MG 3 tabs a day) . there is a warning on the label  to avoid contact with people who have contagious diseases.

I've had an encounter with an escort who was an iv drug user a year before. She claims to be clean and free of STD - based on her claim she had a full panel done 3 month ago.

Everything was covered besides a very brief oral(both ways) around 15 seconds. I didn't notice any rash or sores.

Are my risks for different STDs much higher than usual? should i get tested asap? any advice?

thanks

[Rab19978]

She said she hasn't done it for a year and has a full clean test results within the last 3 month. However, you can still see the blueish color on her arm

[H. Hunter Handsfield, M.D.]

Depends on what "prior" means.  If current or recent, within a few weeks, in general injection drug users have pretty high STD rates.  The frequency in people who have been clean for a long time probably isn't different than in the broader population.

[Rab19978]

Thanks a lot doctor,

in general how more prevalent HIV and other STDs in persons with prior history of IV drug use?

[H. Hunter Handsfield, M.D.]

Greetings.  Welcome to the forum.

In general, immunosuppressive drugs (like prednisone, other corticosteroids, and numerous others) do not increase the chance of catching an infection if exposed.  It's important to avoid contact with certain kinds of infection because, once acquired, they can be more severe or more difficult to treat.  The main effect is on viral infections or on chronic bacterial infections like tuberculosis.  If you catch a cold or influenza, you might expect worse or more prolonged symptoms; or more severe TB.  

For those reasons, you needn't be worried about your recent sexual contact.  You are no more likely to catch anything than anyone else, and in any case it sounds like you had completely safe sex.  If somehow you were to acquire herpes or syphilis (which in many respects is similar to TB), it might be more aggressive than otherwise -- but since you had completely protected sex, you are not at risk.  I recommend against testing, and if you have a regular partner, you can continue unprotected sex without worry of transmission.

I hope this has helped. Best wishes--  HHH, MD