Concerns About STDs: Evaluating Risks and Symptoms After Recent Encounters

Suspected sexually transmitted infection (STI)?

Hello Dr.
Lai: I currently have a stable sexual relationship (with a fixed partner, using condoms during ovulation and not using them during menstruation).
However, I had sexual encounters with two different women about three weeks ago (at different times).
To prevent sexually transmitted infections, I used condoms throughout the entire process with both women, and the encounters were similar (the partners put the condom on, ensuring it reached the base of the penis).
The activities that occurred were as follows: 1.
Oral sex (with a condom), 2.
No vaginal penetration, 3.
I touched the women's genital areas with my hands (no cuts), 4.
No kissing, 5.
I did kiss their nipples, 6.
After finishing, I rinsed in the bathroom before removing the condom.
Currently, I have no symptoms, and my genital area appears normal.
However, I have two small red spots on the back of my hand (the hand that did not touch the genital areas), resembling insect bites, about 2mm in size.
They have not enlarged or proliferated, and there is no sensation (no hardness or similar).
They are just slightly red in color.
On my left thigh, I initially developed a red spot resembling an acne lesion, which crusted over in 2-3 days.
Then, a similar spot appeared on my right thigh, which also did not proliferate, measuring about 1.5mm.
When I squeezed it hard, it bled and crusted over in 2-3 days, but visually and upon touch (when pressed), it does not resemble the early signs of syphilis.
Doctor, is there a possibility that I contracted a sexually transmitted infection? Should I undergo blood tests to check for syphilis or HIV?

Xiao Q, 20~29 year old female. Ask Date: 2010/04/28

Dr. Lai Ronghao reply Urology

If you suspect you have a sexually transmitted infection (STI), it is best to visit a clinic for an examination and to avoid multiple sexual partners.

Reply Date: 2010/04/28

More Info

When it comes to concerns about sexually transmitted diseases (STDs), particularly HIV/AIDS, it's essential to understand the risks associated with different types of sexual encounters and the symptoms that may arise after such activities. Based on your description, you have engaged in sexual activities with two women approximately three weeks ago, using condoms throughout the process. This is a crucial factor in assessing your risk for STDs, including HIV.

Firstly, the use of condoms significantly reduces the risk of transmitting HIV and other STDs during sexual activities. Since you mentioned that you used condoms during oral sex and that there was no penetration, the risk of contracting HIV from these encounters is relatively low. However, it is important to note that while condoms are highly effective, they are not 100% foolproof. The risk of transmission can increase if the condom breaks or if there are any visible sores or cuts on either partner that could facilitate the exchange of bodily fluids.

Regarding your specific activities:
1. Oral sex with a condom: This is considered a low-risk activity for HIV transmission, especially when a condom is used.

2. No penetration: Since there was no vaginal or anal penetration, the risk of HIV transmission is further reduced.

3. Hand contact with the genital area: If your hands were uninjured and clean, the risk of transmission through this method is minimal.

4. Kissing and touching: These activities, especially without any open wounds, carry a very low risk for HIV transmission.

5. The small red spots on your hand and thigh: These do not appear to be indicative of an STD, especially since they are not expanding or causing discomfort. However, any unusual skin changes should be evaluated by a healthcare professional to rule out other conditions.

In terms of symptoms, you mentioned that you currently have no significant symptoms related to STDs. It's important to remember that many STDs, including HIV, can remain asymptomatic for a period of time. The acute phase of HIV infection can present with flu-like symptoms, but this typically occurs within 2 to 4 weeks after exposure. Since your encounter was three weeks ago, if you were to develop symptoms, they would likely appear soon if they were related to an HIV infection.

Given your concerns, it is advisable to get tested for STDs, including HIV. Testing is crucial not only for your peace of mind but also for the health of your partner(s). The recommended timeline for HIV testing is generally at least 2 to 4 weeks after potential exposure for an initial test, with a follow-up test at three months for conclusive results. This is due to the "window period," which is the time after infection during which the virus may not be detectable.

In summary, while your risk of contracting HIV from the described encounters appears to be low due to the consistent use of condoms and the nature of the activities, it is still prudent to get tested. Additionally, if you experience any new symptoms or if the red spots change in appearance or become bothersome, seek medical advice. Regular testing and open communication with your partners about sexual health are key components of maintaining sexual health and preventing the spread of STDs.

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