Thank you ahead of time

[northman1981]

Doctors,

I am a 30 year old heterosexual married man with no drug use history and no health problems besides being very overweight.

I made a stupid mistake and stepped outside of my marriage and had an experience with a call girl.  She gave me UNPROTECTED oral sex for 3-4 minutes and then we had PROTECTED vaginal sex for about 3-4 minutes before I ejaculated internally inside of the condom.  To my knowledge there was no tears or holes in the condom.  I immediately washed myself and left.

This was on Monday December 13th.  I then had unprotected sex with my wife a few days later, with internal ejaculation.

A friend recently called me (who was aware of my activity and with whom...) and said he saw the same girl recently and said she may have a history of IV drug use.  I immediatly contacted the call girl and vigorously asked her if she was totally clean, and she said she was and she would never endanger anybody.  She also claims she gets tested every 3 months or so.  The frightening part is there are some pictures of this girl in what looks like a very "under the influence" state, which may be alcohol effects or perhaps drug use.  

Words like HIV, Hepatitis, Chlamydia, Ghonnorea, Herpes, and HPV have started coming to mind now.  At about 4 weeks post exposure I got sick and had the following symptoms...dry, soreish throat that didn't hurt persay but was very uncomfortable, headache, extreme stuffed up nose, clogged ears.  I never had a fever of any kind.

So I have a few questions.  There is a company close by that offers a series of all STD tests but it's VERY expensive at $245, but I wanted a Dr's opinion before I made any decisions.  I'm not a paranoid and anxious person, I just want to make sure, most importantly, that I didn't put my wife in danger from this stupid mistake.

1.  Considering my risk, was I at risk for ANY of the STD's?  HIV, Hepatitas, etc?
2.  Do I need testing?  If so, which tests would you say I need?
3.  my symptoms?

[Edward W Hook, MD]

HIV infection is not a common cause of irregular periods in women. It is far, far more likely that your wife's irregular periods are related to having been on the pill for 8-9 years.  

Time for this thread to end.  No further questions please.  EWH

[northman1981]

I might add before stopping birth control last April, she used it for 8-9 years straight, and about 7 or 8 years ago she was very anorexic as well, and didn't get her period then either

[northman1981]

Doctor, I'm at almost 8 weeks so I plan to test soon, but something has come up that I needed an answer for before I post my test results.

About. 1 year ago my wife stopped taking birth control pills and now we are trying to have a baby.  Since she stopped she hasn't had a normal period.  When she does have one it's extremely light as if spotting.  Her dr. Called today after a blood test she took and she is not ovulating either...

Can HIV cause this in a woman?  I'm terrified.

[Edward W Hook, MD]

As we have said on this Forum, looking for ARS is a waste of time and effort. many peole who get HIV do not have ARS and of persons who have "ARS symptoms" 99% have some other process such as a commuity acquired viral infection.  

The ARS symptoms are those of the flu and include fever, muscle aches, and rash., among other things.  You really are not at risk, as I have told you before.  EWH

[northman1981]

at the 4 week mark past my exposure I told you I got sick.  I never had a fever, but I felt generally not too well.  Family says I had a bad head cold.  My final question (and thanks for your answers) is this...

If someone were to have the ARS, it's more of a really bad flu or is it like a really bad cold?  I had no diahrrea, no fever, no rashes.  I did have these small red dots/pimples appear and go away the next day, but I DID have a slightly sore throat.  bad headache and the kind of stuffy nose that makes you think theres cement stuck up there.

I guess I'm just confused as to what signs to look for, plus, the timing at 4 weeks has me a little nervous.  Because on this site people say it can come between 2-4 weeks and last 1-2, and I was smack in the middle of that.  Plus, I shouldn't be overreacting because condoms are safe right?  you cant get any STD thru intact latex.

I'll take your last comments and decide if I should test based on them.

[Edward W Hook, MD]

None of these symptoms suggest any STD.  Their occurrence is coincidental, not a result of your exposure.  EWH

[northman1981]

as well as a bloody nose on Thursday that seemed to come from nowhere...

[northman1981]

6 weeks past the only "symptom" I have at this particular moment is a slight pain when I push on my front left rib that slightly protrudes.  I feel nothing at all when I breath or move...but when I push on it it feels tender and somewhat sore.  Notices this on saturday night.

Does this sound like a symptom of any kind of STD you have ever heard of, HIV included?

[northman1981]

Thank you so much

[Edward W Hook, MD]

Hepatitis C is not spread through hetrosexual sex and hepatitis B is not spread by oral sex (only ano-genital sex).  Similarly, despite the tales all too common on the internet, there are no believable cases in which HIV has been spread by oral sex.

If you were my patient I would tell you precisely what I am saying now- I see no medical reason for testing.  EWH

[northman1981]

Thank you for your prompt response...

When I heard the girl may have been an IV Drug user I started thinking Hep B or C, and remembered the oral sex as well.  

So despite having unprotected oral sex and whether she may or may not be an Iv Drug addict with or without Hep B or C or even HIV, considering my exposure you say I'm good?  No worries?  I can continue unprotected sex with my wife without worry?

You're also saying if I came into your office with this same problem you would say "no test necessary" right?

[Edward W Hook, MD]

Welcome to the Forum. The fact is that most commercial sex workers do not have STDs(including HIV) and even if they do, the biological fact is that most exposures to infected partners do not lead to infection.  In your own case, condom protected sex is safe sex and if your condom appeared intact, it was-when condoms fail they break wide open.  Few STDs are transmitted through receipt of oral sex and when they are, symptoms are typically present long before 4 weeks have passed.   The symptoms you describe are non-specific and do not suggest any STD (or HIV) and are more suggestive of a cold or other common, community acquired respiratory tract infection.

In answer to your specific questions:
1.  Your risk is close to zero.
2.  Testing at this time would primarily be for your peace of mind.  General STD screening can likely be obtained for far less than $245 at your local health department.
3.  See above.  EWH