Stress Over Potential STD infection

[Jadelance]

Dear Dr

I am currently feeling a fair amount of panic over the potential consequences of a regretful act I undertook 1 week ago and find myself continually looking online at confusing information. I have posted a question in the HIV international forum and have received a response but I am also concerned with other STD possibilities. I am a 33 year old overweight and uncircumcised family man who up until this has never strayed from his partner.

A summary of what occurred following a night of drinking with a college in Guangzhou China. My colleague sent a massage girl to my hotel who proceeded to give short protected oral sex using a "rubber condom" she provided during which I attempted to play with her vagina and she pushed my hand away. Following this she then proceeded to sit on top of me for vaginal sex with the same condom still in place, I had a short turn on top with condom still in place but as I was now very uncomfortable we stopped and she started to provide protected masturbation which after a short time she removed the condom and continued using the hotel body lotion as lubricant until I came. She then wiped the area and left which then feeling very disgusted I used the hotel bath to wash myself in a long bath.

The following day I had some pain in my lower abdomen and the need to repeatedly go to the toilet. a local chemist with very limited english gave me a box of amoxillin tablets and said to take these for a UTI. I have been and the pain has gone and the repeated urination is becoming less. this week I have also had a cough, slight running nose, sweat during sleep, dry mouth pain in lower back, slight tingle in my penis when urinating, upset stomach and dioreah. But all appear to be going away today.

Everything online points me to think I have an std. What is the risk should I get tested and when or just put this behind me and return to my normal life including unprotected sex with my wife.

[Edward W Hook, MD]

Welcome t the Forum. I tend to agree with the information you have already received on the International Forum. Not only is there no risk for HIV from the events/activities that you describe but there is no risk for other STIs as well. Statistically it is unlikely that your partner had an STI and even if she did, most exposures to infected partners do not lead to infection.  Even if your partner was infected, condom protected sex is safe sex and as long as the condom is in place for the entire sex act there is no risk for infection.

The symptoms you experienced occurred too early to be due to an STI. There are no STIs that cause symptoms until at least two days after infection and typically more like 3-5 days.  On the other hand, the discomfort you describe is highly suggestive of the sorts of symptoms we se in persons with genitally focused anxiety.

I see no reason for concern related to the exposure you describe, no medical need for testing, and no reason for you to abstain from unprotected sex with your wife.

I hope these comments are helpful to you. EWH

[Edward W Hook, MD]

This will be my final reply.  You need to be examined to have the origin of you discomfort sorted out.  It is not an STI however.  Whether it is some other process or simply a perceptual issue because of your focus on looking for genital signs or symptoms can only be determined through direct examination.

It is now time for this thread to end.  EWH

[Jadelance]

Dear Dr Hook

Thank you for your quick response I do feel as if regretful situation is coming to an end but I have one last question if I may.

Originally following my exposure I had what we believe was a UTI causing pressure and discomfort in my groin as well as frequent urination. This following the amoxicillin has eased considerably and did not show up in any tests thus far. I have noticed over the last day or two some irritation around the get real pubic area which is not severe but noticeable with the remaining discomfort I currently feel from before. Should I have concern regarding this as being signs of a un detected STI or is this likely something fungal. I don't have a fever but do gave a head cold and mild sore tonsils at the same time. I do have a current fungal problem on my feet and I wonder if I may have transferred this to my pubic area with the constant checking of late.  

Would it be wise to try some anti fungal cream and see what happens.

Regards

Jade

[Edward W Hook, MD]

Thanks for the follow-up.  The combination of an examination and tests at 10 days should be sufficient for evaluation of consequences of your low risk exposure.  I see no need or additonal testing related to the exposure you have described.  EWH

[Jadelance]

As an update to my previous question following my return to Australia last week I decided regards less of my low risk that I would go to my local sexual health clinic and see what they thought. The Dr their gave my down stairs a through examination and took blood and urine for testing for possible STDs. These came back all clear with no trace if anything as of day nine since my low risk activity. My anxiety has subsided but I sill have some discomfort with slight pain in my foreskin when I need to urinate. The dr at the clinic suggested I may have some minor bacterial infection in the area due to the UTI I likly suffered in china that the amoxicillin had dealt with thus far. She suggested the best solution would be to keepy fluids up and flush the remainder out. I guess this feel right.

Given the test were at 9 days do you feel I should get retested any further to confirm or just try to flush this lady issue out and move on

Regards jade

[Jadelance]

Thank you for your response it has eased my thoughts considerably.

Regards

Jade

[Edward W Hook, MD]

There is no reason to think that your cough is related to the encounter you describe.

As for the tingling you are experiencing, this is almost certainly a manifestation of increased focus on your genitals rather than an STI symptom.

I urge you to stay off the Internet, it is all too often misleading.  EWH

[Jadelance]

Thank you for your prompt response.

I appreciate your feedback since the event I have been hyper sensitive to all the information available online. One last question if I may as the coughing etc came 2 or so days after the event should I be concerned, also I still notice some tingling in my foreskin as well some pressure in my groin where it joins with my thigh. I am thinking this may be anxiety driven but given the one act if unprotected masturbation I do wonder if the increased the risk. Also Is there any impact due to the amoxicillin I should be aware of the dose is .5 g every 6 hours or so.

Regards jade