Should I get tested?

[ZappBrannigan]

Hi all,
as many others posting in this forum I am wondering about the risks of a recent potential exposure. I had protected intercourse with a GO-GO Bar prostitute in Thailand a couple of days ago after a gents night with loads of booze. The intercourse itself was just a couple of minutes, but after I took off the condom she sat on top of me and started to rub her vagina against my penis (not for long though). She also rubbed my penis with her hands after rubbing her vagina with it. I don't know if she was menstruating, but she took quite some time to wash herself before we started. However, I read that this is the usual procedure here and I didn't see any blood afterwards. Also, I didn't really penetrate her after taking of the condom which appeared fully intact.  What are the odds of an STD transmission through this kind of contact? Should I get tested for any STD and if so could/should I do it here while still in Thailand? I am extremely worried of getting home and bringing something along and It wont be easy to get tested at home.

Thanks,
Zapp

[Dr Mervyn Tyrer, MB BCh; Dip HIV Medicine, Freedomhealth London]

Hello Zapp. I don't think you need worry about HIV as HIV is a difficult virus to transmit and your exposure does not sound terribly risky at all. I would though seriously consider taking some STD / STI tests such as syphilis (at 28 days post exposure) chlamydia and gonorrhoea - after about 5 to 7 days post exposure. These are distinct possibilities with sex workers when there has been genital to genital contact even though there was no penetration. Certainly there are very good STD testing and treatment facilities in Thailand so I would seriously consider taking advice there in Thailand. I suspect after all this all will be well but as you suggest it is best to be safe than sorry, best wishes, Dr Mervyn

[ZappBrannigan]

Hi Mervyn,
thanks for your advice. As for the genital to genital contact, it was really brief (just a couple of seconds because I asked her to get off as soon as she started pressing her vagina against my unerected penis) and there was no vaginal fluid on my penis as far as I can say). I actually thought that frottage is considered safer sex. It has been four days now and I don't have any discharge or any burning sensation while urinating. However, I had some tingling feeling on the tip of my penis right after the contact which subsided during the last days and is almost gone now (maybe a reaction to the condom/spermicide, I never use them since I didn't have intercourse with anybody but my wife for the last 12 years). It could be though that the region around the urethrae is slightly red, but it's not really obvious, will have a look at it the upcoming days. I will stay for only or 4 more days here in Thailand, most likely not long enough to complete the tests. Is there a medication I could easily get here at the pharmacy? Maybe a combination of broad spectrum antibiotics? I will have a hard time to explain my wife why I don't want to sleep with her for the next month. I am glad that you consider the risk of HIV low enough to not be worried about it since this was my major concern ( nevertheless I will likely do a duo as soon as I can).

Thanks,
Zapp

[Dr Sean Cummings]

Hello Zapp

Sean here this time. The danger with random broad spectrum treatment is that it may well miss something obvious and thus you might unwittingly put your wife at risk.

I would agree with Mervyn that you should see a doctor and get his or her advice. I don't see that you need to avoid sex with your wife for a month - you just need to get yourself together and get down to one of the clinics there which as Mervun has said are excellent.

best wishes, Sean