Screwed up - what are my chances?

[MrJ123]

Hello doctor,  so I screwed up last night.  I had drunken unprotected sex with a girl I met at a bar.  I'll give you some background...I am 28 y/o white male, decent shape, I've never had an std.  She is a 25 y/o white female.  I did inquire about her std status the next morning, she stated that she had been tested recently and was clear.  She is not an IV drug user and did not have any visible symptoms.  The exposure consisted of  unprotected oral and vaginal intercourse.  There was no ejaculation because the sex would go then stop for awhile.  Please could you tell me 1)what level of exposure is this? 2) should I be freaking out right now about giving someone else something?  Thank you for your consideration

[Edward W Hook, MD]

The official recommendation is that you should abstain from sex until you complete your doxycycline but it is likely that after three or four doses you will no longer be infectious for sex partners, if you were even infected.  EWH

[MrJ123]

Thank you again doctor...a little update.  I went to my doctor yesterday and have a urine sample as you suggested.  He told me that given the time of my possible exposure though, the test at that time would not be conclusive.  Just in case he prescribed me 100 mg doxycycline to be taken twice daily for 10 days.  In your opinion, do you think it would be safe for me to resume sex with my regular partner?  I have taken 3 doses of the doxy so far and am wondering if that has killed the bacteria beyond transmission yet (assuming there is some).  This will be my last question on this post.  Thank you

[Edward W Hook, MD]

While the odds are very much in your favor, if you want to be completely confident, testing for the common STIs (gonorrhea, chlamydia) might be best.  Infections are rare but they do occur.  EWH

[MrJ123]

Thank you for your response.  This was a one time thing and was a mistake.  So given this information, you would be comfortable resuming intercourse with your regular partner?  Testing would be optional?

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to comment.  Overall the risk of any single exposure is unlikely to lead to acquisition of any STI and based on the information you provided, your risk is, if anything, somewhat lower than average.  While STIs are relatively common, the fact is that most people do not have STIs and even when they do, most exposures do not lead to infection.  Risk for infection is typically higher for genital exposures than for receipt of oral sex. The facts that your partner has recently been checked for STIs and found to not be infected, as well that she is white and not clearly a drug user makes her somewhat lower risk, on average than persons who had not been checked or of other race/ethnicity.  

In answer to your specific questions:
1)what level of exposure is this?
See above, this was a relatively low risk exposure.  The odds are in your favor.

2) should I be freaking out right now about giving someone else something?
You, you need not freak out.  If you had acquired an STI, the most common ones cause symptoms in most people within a week or so of exposure.  A smaller proportion of infections will be asymptomatic.  Testing is not mandatory if you do not develop symptoms but it is also not a bad idea for anyone with new or multiple partners to get tested for STIs from time to time- we call this screening.  Testing for the most common problems (chlamydia, gonorrhea, NGU) can be often performed on a urine test.  

My other advice is to be prepared in the future.  Condoms are widely available, easily transported and help to reduce heartburn following new or casual exposures.  

I hope these comments are helpful.  EWH