[Question #10543] Possible syphilis and oral gonorrhea exposure
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22 months ago
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Hello,I am a bi top male and My usual partner (not dating) is on PREP and after connecting for months and his tests were all clean (he showed me), I got a bit apprehensive and had unprotected topping sex on 9/29. We both exchanged oral, he rimmed me and I topped him and finished in him. With that, on 10/9 he mentioned he had popped positive for oral gonorrhea on an at home HeyMistr kit that he takes for his PREP and the rest was negative. He then admitted to me of having a risk scenario 3 some the night after on 9/30. I got full 10 panel test on 10/11 and everything came back clean, I did a follow on urine gonorrhea test on 10/17 and also came back non reactive. Then on 10/19 he said his follow on blood tests showed low positive on Syphilis. Indicating a fresh infection is what the docs told him. So on 10/20 I got another blood test for syphilis RPR and it showed non reactive once again. I got prescribed doxycycline 100 mg twice per day as a preventive measure and they said to take it for 28 days as the penicillin shot would be a risk for me of allergic reactions I’ve had in the past with this. With that I have some questions please because the internet is confusing and amps up my health anxiety. I have zero symptoms, no lesions (been checking all the time now) and I have never tested postive for any STi’s now or previously, so ho1) Would the continual negative tests even though it’s been a short period and his previous negative test prior to us connecting clear me of being infectious of syphilis? I ask this because I connected with the mother of my son a week ago. I just want to be sure she was protected as I had no lesion and blood test RPR was clean.2) Do I really take the doxycycline for 28 days? Everywhere I read it is for 7 or 14 days. 3) Should I check with oral and anal swab for gonorrhea with no symptoms and the activity I had and still no positive?
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Edward W. Hook M.D.
22 months ago
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Welcome to the Forum and thanks for your confidence in our service. You're right to be wary of statements made on the internet. While the internet is a great place to communicate and carry out some elements of business, it is a terrible place to seek information about STIs, including HIV. There is no filter on what is said there and much or shat is said is out of date, taken out of context, or just plain wrong. You may have been exposed to a partner who had syphilis. You partner, unlike all too many persons who are embarrassed by their infections, did the right thing to inform you. Following a possible exposure to infectious syphilis, the recommended approach is to test to determine if you are currently infected and then, if your test is negative, to take preventative antibiotics. Thus, in response to your specific questions:
1) Would the continual negative tests even though it’s been a short period and his previous negative test prior to us connecting clear me of being infectious of syphilis? I ask this because I connected with the mother of my son a week ago. I just want to be sure she was protected as I had no lesion and blood test RPR was clean
As long as your tests have been negative, you can be confident that the mother of your son was not exposed. She does not need testing or treatment.
.2) Do I really take the doxycycline for 28 days? Everywhere I read it is for 7 or 14 days. 3) Should I check with oral and anal swab for gonorrhea with no symptoms and the activity I had and still no positive?
28 days of doxycycline is overkill. 14 days is sufficient therapy for proven syphilis infection (which you do not have- your tests are negative) and in persons such as you with negative tests following an exposure, 7 days is sufficient to prevent development of infection. Given the details of your exposure and the fact that your partner also had gonorrhea, out of an abundance of caution and because doxycycline is not reliable treatment for gonorrhea, I think it would be wise to have a throat swab and urine test for gonorrhea (FYI, the same specimen will likely also be tested for chlamydia that is really not a concern in this situation. )
I hope this information is helpful. If any part of this response is unclear, please use your up to two follow-ups for clarification. EWH
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22 months ago
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Thank you for the assurance of my mothers son, that was my biggest concern.
Just to clarify, I have had 2 urine tests for gonorrhea and chlamydia (both negative) over the 3 weeks since the possible exposure (one at 11 days after and another at 18 days after).
As a follow up just a few more questions:
1) You suggest the 7 day course as long as I do not have any symptoms or run for 14 days?
2) Only a throat swab would be needed for gonorrhea even if the partner only had oral gonorrhea? I thought that would be least of my worries because only way that would transmit is kissing? I have already had two negative urine tests so don’t believe it was transmitted there.
3) Is anal rimming risky for me to have anal gonorrhea and should get that anal swab? Or is that low risk?
4) Are people infectious if they do not have a sore yet? I ask because partner didn’t have a sore yet when we connected.
Thanks.
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Edward W. Hook M.D.
22 months ago
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1. Correct
2. Correct, only a throat swab would be needed. The likelihood that it will be positive is vanishingly low.
3. Receipt of rimming is very, very low risk for acquisition of gonorrhea or other STI‘s.
4. Syphilis is transmitted only through contact with an infectious lesion. No lesions, no risk of syphilis.
I hope this information is helpful. Please don’t worry. EWH.
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