Can STD Be Contracted Through Protected Sex?

Posted on Mon, 12 Oct 2015

Question: I will try to keep this as short as possible. I am and have been freaking out for the last four months. A little background about the situation. Four months ago I cheated on my wife one time with an escort. It was protected sex, that was it. Oral on me and her too. Since then I have been freaking out and looking at every possible thing as a symptom of an STD. I feel guilty and am worried I might have caught something. Problem is, I have not had any major symtoms at all of an STD, especially herpes. I just think I do but they turn out to be nothing. No itching, no pain, no ulcers, nothing. I have found a tiny red spot on the tip of my penis this morning. Looks a little raised, but not sure. I have found a little red spot on the head before and it goes away. So why am I so worried. I used to be able to wear briefs underwear and stuff, but now they cause a little dryness and chaffing, so now all I can wear is boxers. My hands have started peeling skin for the last two weeks, but with extensive hand lotion that fixed the problem. Also, my penis head, only when it is hard, will have very small amounts of dry skin below the rim of the head. Also, my wife has come down with what we think is a case of vaginitis. No burning or itching, just a white smelly discharge during sex. Something she has had before, but has again. Antibiotics fixed it before, but now I am worried that I might have given her something else. I am so paranoid and dont know why. Again, no symptoms, just me reading into small things like they are. Is this red spot something to be concerned about. Are any of these things something I should worry about. Plese help, much concern Thank you

Answered by Dr. Dr. Kakkar (54 minutes later)

Brief Answer:
Candida seems to be the likely etiology; I suggest screening for herpes

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have noted down your concern. I have also reviewed the Images
As far the sexual act is concerned a protected sex though is protective against HIV, Gonorrhea and Chlamydia, it does not protect completely against Herpes, Hpv and syphilis. This is because a condom covers only a portion of shaft of penis and leaves a lot of adjacent skin i.e base of shaft of penis, pubic skin and base of scrotum exposed for skin to skin contact and contact with vaginal secretions during sexual intercourse.
Oral sex too is a risk factor for transmission of oro-labial herpes (usually Hsv type 1) to genital mucosa.
The image does not seem to suggest that it is genital herpes. I cannot appreciate well enough but the lesion in these images is a red spot with intact skin rather than an erosion of herpes. This seems like a fungal infection, yeast or candida. Dryness below rim of head too is most likely candidal in origin and white vaginal discharge in your wife along with foul smell also suggests candidal infection Or probably a case bacterial vaginosis. Candida can transmit during sexual intercourse.
I suggest an Oral antifungal e.g single dose of tablet fluconazole in both i.e you and your wife. Topically you may use an otc antifungal e.g clotrimazole 1% cream, twice daily. A clotrimazole vaginal tablet once daily at night for 6 days is what I would suggest for your wife in addition to single dose of fluconazole.
Nevertheless you should get tested for genital herpes. An ELISA for Hsv type 1 & 2 IgG would be conclusive at this stage since its already been 4 months since contact.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (10 minutes later)

Since the last question an hour ago, the red spot has seemed to go away. The dryness is just a tiny bit and it was happening before my wife had her condition. I have never shown any symptoms of herpes and wife hasnt either. If i had contracted herpes wouldnt it have shown in the first month or so after contact.

Answered by Dr. Dr. Kakkar (21 minutes later)

Brief Answer:
I would definitely suggest a screening test for herpes

Detailed Answer:
Hi.

Herpes can remain clinically silent for weeks or months and absence of signs of symptoms after a possible infection does not reliably rule out herpes. On the other hand a screening test at appropriate interval after a risky sexual encounter is a reliable way to either confirm or rule out an std.
Candida can affect female genitalia without much symptoms and transmission to sexual partners is quite common. It is likely that she gave it to you when she was not having XXXXXXX discharge. The fact that she presently has vaginal discharge and has had before as well requires her to be treated appropriately. Dryness of glans and faint red superficial spots, off and on are part of candidal balanitis.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (1 hour later)

What are the odds of catching herpes after a one time encounter using a condom, 10%, 20%, idk.

Answered by Dr. Dr. Kakkar (8 hours later)

Brief Answer:
Chances of acquiring herpes are 4% from a single sexual encounter

Detailed Answer:

It is 4% from a single sexual encounter.
Chances of acquiring herpes are more during an active episode of genital sores in sexual partner (when there is lot of viral shedding) and less during clinically asymptomatic phases.
The risk is reduced by a condom.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (18 minutes later)

I will be honest, I never saw anything that resembled sores so I doubt she had anything. I do appreciate the response back.

Answered by Dr. Dr. Kakkar (13 minutes later)

Brief Answer:
Thank you for writing to us

Detailed Answer:
Hi.

Risk is less with clinically silent herpes and with a condom but that needs to be totally ruled out with a IgG screening test for Hsv 1& 2.

regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar