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STD Help
Four days ago, I received a 5 minute protected ** from a high risk prostitute in India. The condom was a cheap local brand, so not sure about its quality.
I was given 2g Azithromycin and 600mg Cefixime as prophylaxis later that night. However, the very next day, I started getting pain (like an ache) in the left inguinal node area that lasted a few minutes at a time and recurred throughout the day, but it did not hurt when I touched the area. This lasted 2 days and on the third day, although the inguinal pain went away, I awoke to a mildly discomforting sensation at the urethral opening (which is ongoing for 2 days now, though it is also intermittent). No pain while urinating or discharge that I can notice though. I also got what seems to feel like hemorrhoids the day the inguinal pain started – i.e. it basically feels swollen there, but no blood, etc. and this is still ongoing though marginally better.
1. I thought this was no risk!? What could this be? Is there any chance this is an STD? Am really worried about the inguinal node pain!
2. I will be in the US the first week of December. Can I do a test of cure for STD’s then or will the medication I took affect the results?
3. What STD’s would be cured by the prophylaxis I already took? What STD’s wouldn’t be cured?
4. What prophylaxis is recommended for LGV and Granuloma Inguinale (prevalent in India)? Should I take 1g azithromycin weekly for two more weeks (as per CDC treatment guidelines)?
5. Given that I may have gotten an STD even with protection, am I at risk for HIV and do I need to test?
6. Can I have unprotected sex with my wife immediately or is it better to wait and get tested?
7. In India, they offer HSV 1 and 2 IgG and IgM at a local lab. I think I got herpes a long time ago – which test would confirm this, or is Herpes Select in the US the only test that can detect this?
8. How can I check if I ever was infected with HPV (i.e. blood tests)?
I was given 2g Azithromycin and 600mg Cefixime as prophylaxis later that night. However, the very next day, I started getting pain (like an ache) in the left inguinal node area that lasted a few minutes at a time and recurred throughout the day, but it did not hurt when I touched the area. This lasted 2 days and on the third day, although the inguinal pain went away, I awoke to a mildly discomforting sensation at the urethral opening (which is ongoing for 2 days now, though it is also intermittent). No pain while urinating or discharge that I can notice though. I also got what seems to feel like hemorrhoids the day the inguinal pain started – i.e. it basically feels swollen there, but no blood, etc. and this is still ongoing though marginally better.
1. I thought this was no risk!? What could this be? Is there any chance this is an STD? Am really worried about the inguinal node pain!
2. I will be in the US the first week of December. Can I do a test of cure for STD’s then or will the medication I took affect the results?
3. What STD’s would be cured by the prophylaxis I already took? What STD’s wouldn’t be cured?
4. What prophylaxis is recommended for LGV and Granuloma Inguinale (prevalent in India)? Should I take 1g azithromycin weekly for two more weeks (as per CDC treatment guidelines)?
5. Given that I may have gotten an STD even with protection, am I at risk for HIV and do I need to test?
6. Can I have unprotected sex with my wife immediately or is it better to wait and get tested?
7. In India, they offer HSV 1 and 2 IgG and IgM at a local lab. I think I got herpes a long time ago – which test would confirm this, or is Herpes Select in the US the only test that can detect this?
8. How can I check if I ever was infected with HPV (i.e. blood tests)?
MEDICAL PROFESSIONAL
LGV is an exceedingly rare STD in all countries and has never been known to be transmitted by oral sex. But yes: presumably the standard chlamydia drugs like azithromycin would successfully prevent LGV in exposed persons.
Stop worrying about this exposure -- and stay safe (i.e. use condoms) if and when you have other extramarital exposures.
That will be all for this thread.
Stop worrying about this exposure -- and stay safe (i.e. use condoms) if and when you have other extramarital exposures.
That will be all for this thread.
Hi Doc,
Thanks for the response. That's what I thought as well - i.e. not logical to get an std in this manner.
It was really the pain in the groin nodes that got me worried (the hemmorrhoids were just something that happened at the same time and the urethral discomfort was probably magnified by my worrying). Thats why I got to thinking of maybe the condom wasn't intact, she touched her vagina before touching my penis while putting on the condom, etc.
Out of curiousity, since LGV is a chlamydial infection, wouldn't the azithromycin I took theoretically also be effective against that (even though no prophylaxis in indicated for it)?
Thanks for the response. That's what I thought as well - i.e. not logical to get an std in this manner.
It was really the pain in the groin nodes that got me worried (the hemmorrhoids were just something that happened at the same time and the urethral discomfort was probably magnified by my worrying). Thats why I got to thinking of maybe the condom wasn't intact, she touched her vagina before touching my penis while putting on the condom, etc.
Out of curiousity, since LGV is a chlamydial infection, wouldn't the azithromycin I took theoretically also be effective against that (even though no prophylaxis in indicated for it)?
MEDICAL PROFESSIONAL
Welcome to the STD forum. Responding only to the opening line of your question, before I read anything else: It is absolutely, totally impossible to acquire any STD from condom-protected oral sex. If that is your only potential exposure, then there is no risk and you do not need testing -- regardless of the details that follow when I go on to read your question.
And now I have done that. Guess what? You didn't need the STD medications, and your symptoms cannot possibly be due to an STD from the exposure described. In addition to the impossibility of transmission through an intact condom, no infection (STD or otherwise) can start to cause symtoms less than 24 hours after exposure. To your questions:
1) This sounds mostly like an emotional reaction, magnifying what may be normal body sensations. No STD causes such symptoms.
2) There is no point in being tested for STDs.
3) If you had been exposed (because of the condom, you were not), the antibiotics you received would have prevented gonorrhea, chlamydia, nongonococcal urethritis (NGU), and syphilis.
4) No prophylaxis is indicated for those STDs.
5) You were not at risk for HIV and do not need testing for it.
6) No distant online expert can guarantee someone isn't infected. But if this is your only potential STD exposure, you can safely have unprotected sex with your wife.
7) There is no need for HSV testing on account of this exposure. But if you feel you might have HSV from a prior exposure, the local IgG test probably is just fine. Ask whether it is a truly type-specific test; if so, it will be fine; you don't necessarily need the HerpeSelect test. However, please do NOT have an IgM test. The HSV IgM tests are highly unreliable and often misleading.
8) There is no test for HPV.
Please put this event into perspective. There simply is no STD risk. Let's not have any ongoing "yes but" or "what if" questions. There is nothing you can add that would change my opinion or advice.
Regards-- HHH, MD
And now I have done that. Guess what? You didn't need the STD medications, and your symptoms cannot possibly be due to an STD from the exposure described. In addition to the impossibility of transmission through an intact condom, no infection (STD or otherwise) can start to cause symtoms less than 24 hours after exposure. To your questions:
1) This sounds mostly like an emotional reaction, magnifying what may be normal body sensations. No STD causes such symptoms.
2) There is no point in being tested for STDs.
3) If you had been exposed (because of the condom, you were not), the antibiotics you received would have prevented gonorrhea, chlamydia, nongonococcal urethritis (NGU), and syphilis.
4) No prophylaxis is indicated for those STDs.
5) You were not at risk for HIV and do not need testing for it.
6) No distant online expert can guarantee someone isn't infected. But if this is your only potential STD exposure, you can safely have unprotected sex with your wife.
7) There is no need for HSV testing on account of this exposure. But if you feel you might have HSV from a prior exposure, the local IgG test probably is just fine. Ask whether it is a truly type-specific test; if so, it will be fine; you don't necessarily need the HerpeSelect test. However, please do NOT have an IgM test. The HSV IgM tests are highly unreliable and often misleading.
8) There is no test for HPV.
Please put this event into perspective. There simply is no STD risk. Let's not have any ongoing "yes but" or "what if" questions. There is nothing you can add that would change my opinion or advice.
Regards-- HHH, MD
The ** refers to oral sex....
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
