Chances of contracting STI/D

[seekingmedhelp]

I'm a 24 yo male and I stupidly had two sexual encounters with two different guys within five days. I had intercourse with each, one time was with a condom, one was not. (3 minutes w/condom) (2m w/o). Both times I engaged in oral sex (reciprocal) each for under one minute. Each guy claimed they were completely STI free and had no visible signs/sores (although in low-light). I'm worried in terms of what I could have contracted. What are the chances I contracted a STI? How long should I wait before I get tested? I am planning on getting a STI battery w/ HIV DNA by PCR but I wonder how long I should wait before results can put me in the clear?
    

[Edward W Hook, MD]

The HIV test results will be reliable before those for herpes.  In your situation, your HIV test will be reliable any time after 6 weeks.  As for the herpes, at 6 weeks over 75% of test that are going to be positive will be while at 12 weeks that figure will be over 90%.  Given your history (very low risk), I would think that testing for both at six weeks would be reliable.  EWH

[Edward W Hook, MD]

From a statistical point of view your chances are very low.  Very few STDs are transmitted by oral sex and the odds of getting HIV are less than 1 in 10,000 by this route.  The STDs that can be acquired through oral sex are primarily gonorrhea, nongonococcal urethritis and herpes.  If your partners did not have cold sores, your chances of herpes are miniscule.  If you have not symptoms, your chances of the other STDs are likewise low.  

As for your other exposure, was it rectal genital or both?  Either way, again the odds of acquiring infection are low.

All this said, we recommend periodic screening for gonorrhea, chlamydia, syphilis and HIV for most persons who have new or multiple partners in the past year.  While symptoms are a good indicator of infection, all of these can also occur without symptoms and, therefore it is worth getting tested once a year at all sites of exposure.

Finally, regarding an HIV test, given your very low risk, a negative test anytime after 6 weeks would guarantee that you did not have HIV, even if it is just a b serological test.  How much and whether a PCR test really adds much other than expense is hard to say but, overall is probably not warranted.

Hope this helps.  EWH

[seekingmedhelp]

Thanks. One last question: if i did have it now, could I give it to someone else, even if asymptomatic?  

[Edward W Hook, MD]

To clarify, the time lines for appearance of lesions and for a blood test becoming positive are different.  The 2-20 days issue is for the appearance of lesions following exposure and herpes acquisition.

The times I quoted above are for how long it would take for blood tests to become positive.  EWH

[seekingmedhelp]

Wow. That's longer than I expected for herpes to show up. I've read 2 to 20 days. Given this I need to ask: if i did have it, could I give it to someone else, even if asymptomatic?  

[seekingmedhelp]

I don't remember ever having a cold sore or anything in or around my penis. However, given your general suggestions, I decided to order both an HIV test and a HSV 1 and 2 IgG test and can report to the lab at anytime to have the blood drawn. When do you recommend I get tested in order to be relatively in the clear as far as the numerical averages of HSV/HIV showing up positive go?

[Edward W Hook, MD]

Receptive rectal sex seems to be a higher risk exposure for acquisition of infection than insertive but both in turn are higher than penile-vaginal sex in heterosexuals.  

Regarding herpes, odds are low that you acquired infection at the events you describe.  On the other hand, if you have other episodes such as those described above, there is a chance that you've already acquired a herpes infection of some sort (HSV-1 or 2, at some site).  While an HSV antibody (blood) test won't tell you the site or when you got infected, it could tell you if you are already infected.  EWH

[seekingmedhelp]

Thank you Dr. Hook. To follow-up, it was rectal intercourse with both guys. In both instances I was the inserter (vice receiving partner). Does that make a difference in terms of HIV infection? Also, I am worried about herpes. I have a phobia of it. What are my odds in the case that I came into contact via kissing with a cold sore/contagious period I failed to see/notice? Thank you very much for your helpful and thorough answer.