Managing STD Testing Anxiety and Mental Health Support

Sexually Transmitted Infection (STI) Testing and Psychological Disorders

Hello Dr.
Hsu, on February 17, I impulsively engaged in sexual intercourse with a sex worker.
Afterward, I felt deep regret and guilt, and I've been under significant psychological stress these past few days, constantly searching for information online.
During the encounter, I used a condom throughout (including during oral and vaginal sex) and made sure to hold the base of the condom tightly while withdrawing after ejaculation.
There was no exchange of other bodily fluids, and I have no visible fresh wounds on my body.
After extensively researching over the past few days, my anxiety regarding the risk of infection has decreased somewhat, but to ease my mind, I plan to follow the recommended testing timeline.
Currently, my main concern is the psychological pressure.
I would like to ask:
1.
Are there suitable specialties or units that can handle psychological counseling for this type of situation, considering confidentiality and targeted support for similar cases?
2.
It is recommended to test for HIV three months later; during this period, should I refrain from any sexual activity (even with safe practices)?
3.
If I do not exhibit any obvious clinical symptoms on my genitals or body within a month, can I temporarily rule out syphilis and gonorrhea infections and wait until the three-month blood test?
4.
In last year’s physical examination, my Hepatitis B surface antigen was negative.
When I asked my family physician whether I should receive the Hepatitis B vaccine again, the doctor suggested monitoring, as it might just be a decrease in quantity and not necessarily indicate a lack of antibodies or immunity, so I did not receive the vaccine.
Should Hepatitis B be included in the testing items three months later? Would you recommend getting vaccinated again? Thank you, Dr.
Hsu.

Xiao Sheng, 20~29 year old female. Ask Date: 2016/02/20

Dr. Xu Weikai reply Urology

Hello, the Ministry of Health and Welfare provides anonymous sexually transmitted infection (STI) screening services.
You can visit the Centers for Disease Control website for more information.
If you have any further questions, feel free to ask, and we can discuss and research together.
Please note that online responses should only be used as a reference; if necessary, you should seek medical attention at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.
This response is provided by Dr.
Hsu Wei-Kai, Director of the Urology Department.

Reply Date: 2016/02/20

More Info

It's understandable to feel anxious after a sexual encounter, especially when it involves a sex worker, and it's commendable that you're seeking information and support. Let's address your concerns one by one.

1. Psychological Support: For managing anxiety and guilt related to sexual health, consider seeking help from a mental health professional, such as a psychologist or counselor who specializes in sexual health or anxiety disorders. Many clinics and therapists offer confidential services, and some may even provide online consultations. Look for local mental health services or organizations that focus on sexual health. You can also consider contacting a sexual health clinic, as they often have resources for mental health support related to sexual health concerns.

2. HIV Testing and Sexual Activity: The recommendation for HIV testing is indeed three months after potential exposure, as this is the window period during which the virus may not be detectable. During this time, it's advisable to avoid any sexual activity, even with protection, to minimize any potential risk of transmission. While using condoms significantly reduces the risk of HIV and other sexually transmitted infections (STIs), no method is 100% effective. Therefore, abstaining from sexual activity until you receive your test results is the safest approach.

3. Symptoms and Testing for Other STIs: If you do not experience any noticeable symptoms within a month, it is reasonable to feel somewhat reassured, but it does not entirely rule out the possibility of infections like syphilis or gonorrhea. Many STIs can be asymptomatic, especially in the early stages. Therefore, it is still recommended to get tested for these infections at the three-month mark, regardless of symptoms. Early detection is crucial for effective treatment.

4. Hepatitis B Testing and Vaccination: Since your Hepatitis B surface antigen was negative during your last check-up, it suggests that you are not currently infected with Hepatitis B. However, it does not necessarily indicate your immunity status. The presence of antibodies can decrease over time, so it’s wise to check your Hepatitis B antibody levels (anti-HBs) during your follow-up testing. If your antibody levels are low or undetectable, your healthcare provider may recommend a booster shot of the Hepatitis B vaccine to ensure continued protection.

In conclusion, it’s important to prioritize both your physical and mental health following this experience. Regular testing and open communication with healthcare providers can help alleviate anxiety and ensure that you receive the necessary care. Remember, seeking help is a sign of strength, and taking proactive steps towards your health is commendable. Don't hesitate to reach out for support, whether it's through mental health services or sexual health clinics. They can provide you with the guidance and reassurance you need during this time.

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