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Worried Sick
Dec 12, 2007

Dear Dr. Bob,

I had protected (condom) sex with a women who I now believe is prostitute. It did not last long, maybe 10-15 min, after I ejaculated I pulled out went into the bathroom, took off the condom (durex) and threw it away. I then showered and found that she was already dressed and ready to go home. I met her thru a manager at the office of my client in Athens, Greece. She explained to me that my client had given her money and that she needed to leave--all this time I thought we had just hit it off. I gave her some taxi money, she gave me her number and I waved bye to this Russian beauty. I then went into the bathroom and downed 1.5g of Zithromax. I am due to return to the states in 2 weeks so I am here in Greece alone and need to hear your wonderful voice of reason and compassion. 1. Even though I had protected sex I am worried and will be taking an HIV test back in the states in 8 wks and then in 12 wks. Is there any statistical significance for a test performed at 8 weeks?

2. I am so paranoid, eventhough I didn't see any open sores I take the Zithromax in the event that I was exposed to Syphillis. Will Zithromax kill incubating T. Pallidum?

I hope you can answer my questions and I thank you ahead of time. You are life-saver.

Response from Dr. Frascino

Hi,

Why all the worry? You adhered to safer sexual guidelines and your Durex latex condom remained intact. Neither HIV nor T. pallidum can permeate intact latex. No way. No how. In my opinion your Zithromax post-coitus chaser was not warranted.

To answer your specific questions:

1. If you remain worried, get a 12-week HIV test. HIV-antibody tests taken prior to the three-month mark are not considered to be conclusive or definitive.

2. The recommended treatment for primary, secondary and early latent syphilis is Benzathine penicillin G (2.4 million unites, intramuscularly administered). Alternative treatments used to include Zithromax (azithromycin) at a dose of two grams by mouth, however this is no longer recommended due to recent emergence of azithromycin-resistant Treponema pallidum.

So what if the hot Russian beauty you shagged turned out to be a prepaid naughty lady from Shady Lane. Your STD risk really doesn't change as it is based on how you did what you did, not whom you did it with. Your excessive worries are unwarranted.

Relax, stud. I'm quite sure all will turn out well (including you).

Dr. Bob



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