[Question #10970] Hiv test 25 days

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18 months ago
I had sex with sex worker and my condom broke i immediately pulled out now i am having severe anxiety and i asked her to test after 5 days and she was hiv negative and syphilis positive. I tested fourth genration hiv on 25th day and the result was negative 
Now 5 weeks is over i dont have any symptom also no syphilis sores. I am circumsized
When should i test for syphilis
Suppose i am infected with syphilis will my hiv test result be false negative
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H. Hunter Handsfield, MD
18 months ago
Welcome to the forum. Thanks for your confidence in our services.

HIV first: your partner's negative Hiv test means she probably was not infected at the time of the exposure. However, if she had been exposed and infected within a few days before your contact with her, she might have had a new infection that didn't show up on testing. However, that is statistically very unlikeoy, and your negative HIV AgAb (4th generation) test at 25 days is highly reassuring. You'll want one more test 6 weeks after the sexual event, but you can expect that result to also be negative.

Syphilis is the greater danger here. Your partner should have sought medical care immediately about her positive syphilis blood test. Did she do that? Do you know the outcome? Was she evaluated by public health? Where are you and she located? Do you know anything more about either her syphilis stage or the strength (titer) of her syphilis blood test? And whether the initial test was confirmed with a follow-up test? If she was found to have infectious syphilis (primary, secondary, or early latent stage), you should have been treated immediately with long acting penicillin (benzathine penicillin) by injection; or with two weeks of doxycycline orally. 

Lack of syphilis symptoms -- most likely a sore (chancre) of your penis -- is reassuring and means you probably were not infected. However, this isn't certain and the wisest approach -- assuming you do not know and cannot learn about your partner's syphilis status and treatment -- would be for you to be treated with a benzathine penicillin injection or doxycycline. You should find a doctor or clinic experienced in syphilis and discuss these options. If for some reason this isn't possible, then at least you must have a syphilis blood test now; and if negative, a repeat test in a couple of weeks (at least 6 weeks after the exposure). If these results are negative, you can be sure you didn't catch syphilis.

The answer to your last questios is no:  neither syphilis nor HIV interferes with testing for the other. (For HIV, there are NO medical conditions or drugs that have any affect at all on any of the currently used HIV blood tests.)

All things considered, it is unlikely you acquired either syphilis or HIV. But you should see an experienced doctor or clinic for personal evaluation and possible follow-up testing to be certain. And no sex with anyone else in the meantime.

I hope these comments are helpful. Let me know if anything isn't clear, or if you have answers to the questions above about your partner's subsequent evaluation for syphilis or HIV.

HHH, MD
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18 months ago
Thank you for your reply doctor
Tpha test was also done and syphilis was confirmed in her case, she said 4 months before she was negative, she is currently going to get her treatment started.
Doctor this monday will be my 6 weeks and i will test for syphilis on tuesday, if this is negative is it conclusive also i dont have any symptoms till now.
Also doctor with condom break i took out within 5-10 seconds maximum, will this help me from both hiv and syphilis
Also doctor for my hiv test after 6 weeks i will get negative result right doctor i am very anxious please help
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H. Hunter Handsfield, MD
18 months ago
Negative syphilis testing at 6 weeks is considered conclusive by most experts, but after a known exposure many (or most?) would advise testing again at 3 months.

Probably your risk was very low, given the brevity of the exposure after the condom broke. On the other hand, even if the condom had not broken, standard recommendations and that of most if not all experts would still be penicillin treatment for anyone with a known exposure with a partner with early syphilis (under a year in duration). This is something to discuss in person a clinic or doctor experienced in syphilis. This forum will not take the responsibility of advising you not to be treated.

HIV testing with the AgAb (4th generation) blood test always is conclusive by 6 weeks. Your risk of HIV was much lower than for syphilis.
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18 months ago
Ok doctor i will test today itself tomorrow it is 6 weeks.
Doctor one more doubt is syphilis 100% curable will i be safe? Will there be any treatment failure, i wont have sex again until everything is clear. Should i be worried of this disease even if i take treatment
Doctor regarding hiv i will be safe right? 
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H. Hunter Handsfield, MD
18 months ago
The standard treatments for syphilis -- a single dose of long-acting penicillin or 2 weeks of doxycycline by mouth -- are 100% effective in curing it. Or preventing syphilis from taking hold if exposed.

I see no need to repeat what I've already said about syphilis. Re-read my opening reply above.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the disucssion has been helpful and that you'll follow through as advised about syphilis. Best wishes.
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