Risks and Testing for STIs After Intimate Encounters

Q: Risks and Testing for STIs After Intimate Encounters

Hello： Sexually transmitted infections (STIs) can be transmitted through contact with bodily fluids. <br>The following principles can help determine the level of risk： <br>- Low risk： Masturbation, mutual masturbation, light kissing, and sexual activities with condom use.<br>- Mo

Herpes Simplex Virus Type 1 and Type 2 Issues

Hello, doctor! Last Saturday, July 27, I had intimate contact with a stranger.
I am gay and would like to consult with you.
I only lightly touched his lips for about a second, not a deep kiss, and I licked the area where his penis meets his scrotum for about three seconds.
There was no contact with the prostate area, and he licked my nipples and performed oral sex on me without a condom.
During the process, there was a moment when he vigorously licked my urethral opening, which caused a brief moment of pain.
That was the extent of our interaction.

The day after or the day after that, I started feeling something unusual on a small part of my upper lip, specifically the right upper corner, as shown in the red circle in the image (the lip seems to have become very dry and cracked due to stress and worry about getting sick, although it seemed fine that day).
Initially, it felt swollen, as if there was something stuck in my nose, but pressing on it doesn’t hurt.
Sometimes it feels a bit numb, and the color is slightly different from my lip color.
When I pull the sides apart, it feels like normal skin, but there seems to be a dark spot in the middle.
However, when I don’t pay much attention to it, I don’t feel anything unusual there.

I would like to ask if this could be herpes, or if it’s due to anxiety, an allergy, inflammation, or possibly a mosquito bite.
If I only lightly touched lips, what is the likelihood of transmission? When should I get tested to get accurate results? Is there a chance that I could have contracted something during oral sex, either on my penis or nipples? I have previously been tested and have never had infections with HSV-1 or HSV-2.
I know I shouldn’t have engaged in these activities, and I feel very sad about being driven by my desires.
I haven’t been able to sleep well for the past few days and have been feeling very depressed, constantly thinking about this situation, and I feel like I might be developing depression.

I want to get tested for all STIs.
Is my plan correct? I plan to get an HIV RNA PCR test in 10 days; will that be accurate? With current medical technology, is this possible? I plan to get tested for 15 different STIs on August 8, ten days after the intimate contact, and then again three months later for some tests.
I will check for early HIV RNA detection, FTA-Abs for early syphilis, HSV I/II IgM, Hepatitis A, B, C, and then a month later do an HIV Combo ELISA rapid test, and three months later return for a full STI panel including HIV, syphilis, HPV, and viral hepatitis A, B, and C.

Lastly, I would like to ask about the risks of contracting HIV, syphilis, and other STIs from unprotected oral sex.
How high is the risk?

Bai Bai, 20~29 year old female. Ask Date: 2019/08/01

Dr. Du Shixi reply Urology

Hello: Sexually transmitted infections (STIs) can be transmitted through contact with bodily fluids.
The following principles can help determine the level of risk:
- Low risk: Masturbation, mutual masturbation, light kissing, and sexual activities with condom use.
- Moderate risk: Deep kissing, oral sex, and withdrawal method (coitus interruptus).
- High risk: Engaging in sexual activities without any protection, causing wounds or bleeding.
If there are no symptoms, due to the possibility of a window period, it is recommended to have a blood test after three months.
If symptoms are present, a medical consultation is necessary for oral symptoms.
As for the frequency of blood tests, it depends on your personal choice.
If you are paying for tests at a lab, you can decide how many to take; if you are using health insurance at a hospital, you will need to follow the regulations of the insurance.
Wishing you good health.

Reply Date: 2019/08/01

More Info

When it comes to understanding the risks associated with intimate encounters, especially in the context of sexually transmitted infections (STIs), it is crucial to approach the situation with both knowledge and caution. Based on the details you've provided about your recent encounter, let's break down the potential risks and the appropriate steps to take regarding testing for STIs.

Understanding the Risks
1. Nature of the Encounter: You mentioned engaging in light kissing and oral sex, which can carry varying levels of risk for STIs. The risk of transmission largely depends on the specific activities involved and the presence of any infections in either partner.

2. Oral Sex and STIs: Oral sex can transmit infections such as HIV, gonorrhea, chlamydia, syphilis, and herpes. While the risk of HIV transmission through oral sex is generally lower compared to anal or vaginal sex, it is not zero, especially if there are cuts or sores in the mouth or if the partner has a high viral load.

3. Symptoms You Noticed: The symptoms you described on your lip could be due to several factors, including anxiety, irritation, or even an allergic reaction. However, they could also indicate a herpes outbreak, especially if there are blisters or sores. It’s important to monitor these symptoms and consult a healthcare provider for an accurate diagnosis.

Testing for STIs
1. Timing for Testing: For HIV, the window period for accurate testing can vary depending on the type of test used. An HIV RNA test (also known as a PCR test) can detect the virus as early as 10 days after exposure, but it is more reliable after 2-4 weeks. For most other STIs, including syphilis and gonorrhea, testing is typically recommended about 1-2 weeks after exposure.

2. Comprehensive Testing: Your plan to get tested for multiple STIs, including HIV, syphilis, and hepatitis, is prudent. Testing for HIV using an RNA test at 10 days post-exposure is a good start, but follow-up testing at 3 months is essential for conclusive results. Additionally, testing for other STIs should be done as per the recommended timelines.

3. Mental Health Considerations: It’s understandable to feel anxious and overwhelmed after such encounters, especially with the potential health implications. If you find that your anxiety is affecting your daily life, consider seeking support from a mental health professional. They can help you manage your feelings of distress and provide coping strategies.

Conclusion
In summary, while your encounter carries some risk for STIs, the level of risk varies based on the specific activities and any existing infections. It’s essential to get tested at the appropriate times and to consult a healthcare provider about any symptoms you experience. Additionally, addressing your mental health is just as important as your physical health, so don’t hesitate to seek help if you’re feeling overwhelmed. Remember, being proactive about your sexual health is a positive step, and there are resources available to support you through this process.

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