[Question #11149] Follow up

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16 months ago
Hello Doctors. So I went to planned parenthood and they did a rapid hiv test and a urine test for stds. HIV came back negative and I will be waiting on the results for the std/sti test. I asked for a throat swab but the nurse advised me that if I wanted a throat swab it was have be done with an exam and that would cost extra. I decided against it for now because I’m not in the best situation financially. 
My questions are: 
1. Should I go ahead and get the throat swab test done? 
2. What std could I have gotten from my experience. And can you explain the changes. 
3. If oral Gonorrhea was present, would it be asymptomatic? And does it self cure? 

Just to clarify I still dont have symptoms whatsoever. How often does genital Gonorrhea go asymptomatic? 
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H. Hunter Handsfield, MD
16 months ago
Welcome back but I'm sorry you found it necessary. I read over your just-completed discussion with Dr. Hook and agree with all he said.

1,3. Oral gonorrhea is exceedingly rare from cunnilingus. (As it happens, Dr. Hook was the senior researcher on one of the main studies showing how rare it is.) And when present, it almost always causes no symptoms and it goes away by itself within a few weeks and is rarely transmissible to partners. I would not have recommended a throat swab for gonorrhea. Don't worry about it.

2. The main risk was from oral sex on you. The three main STDs from such exposures are gonorrhea, nongonococcal urethritis (NGU), and herpes due to HSV type 1. There's also a very small risk of syphilis either from receiving oral sex or cunnilingus. Absence of symptoms (discharge, painful urination, penile sores) is strong evidence against all these. You can definitely expect your (urine?) gonorrhea test to be negative. Although syphilis is exceedingly unlikely, it's a dangerous infection and it would be reasonable to have a blood test after 6 weeks -- but any test before that is too soon.

Your HIV test apparently was done only a couple weeks after the exposure event, which is too soon; a negative result will be meaningless. OTOH, you were at zero risk for HIV anyway; as Dr. Hook advised, there are no known cases transmitted by cunnilingus or from mouth to penis.

HHH, MD
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16 months ago
Hello Doctor Hunter Handsfield I appreciate your comments and would like just a little bit of clarification. 
1. In other words a throat swab is unnecessary as my results regardless with most likely be negative.
2. They are testing me for Gonorrhea, chlamydia, and trichomoniasis and they did a rapid finger prick blood draw for hiv. Should I be worried about any of these. 
3. As you prob read I was feeling pain after urinating for a couple days and then it went away. From your experience do you also agree that my vigorous examinations on myself caused irritation on my urethra?
4. How quickly do symptoms usually start with the stds that I was at risk of? 
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16 months ago
Also just wanted to know what you meant by “urine?” Was I not suppose to take a urine sample? 
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H. Hunter Handsfield, MD
16 months ago
1. Correct.
2. All these are very unlikely, nearly impossible based on the exposure you have described.
3. Yes, vigorous penile squeezing and "milking" in search for discharge certainly can cause this sort of discomfort. And there's no point in continuing to look:  if there's not enough discharge to be obvious without squeezing, then there isn't any there.
4. All the STDs mentioned would almost always cause symptoms within 2 weeks of exposure. With no symptoms now, you're probably home free and can expect negative test results.

"Urine?" was just meant to imply my guess that's the sample they took. The same tests often are done on a urethral swab, but that's painful to collect and urine is just as good. In other words, I was just clarifying the sample I assumed they collected.
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H. Hunter Handsfield, MD
16 months ago
Just don't overreact and do your best to stop worrying. You had a no risk sexual event for all practical purposes. Don't confuse your anxieties over a sexual decision you might regret with STD risk from it. They aren't the same. Deal with the former as you need to but you definitely can expect all tests to be negative. When they are, drop the whole thing.---
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16 months ago
Hey Doctor Hunter Handsfield I wanted to say thank you for ur kind words. And hope you will accept my request to keep this thread opened until I get my results. I have been waiting and was told I would get news by tomorrow if not by Monday. 
Going back to the last time we spoke: 

1.With my encounter that I had I’m not sure if you might have misread but it was protected oral on me and unprotected on her. Even if I was protected do you still think I could be at risk for any of the possible stds we discussed? 
2. It has been 18 days post possible exposure. I have no symptoms whatsoever is this most Likely a good sign or is it possible for symptoms to be asymptomatic right now?
Again I ask if it’s possible to keep the thread open so I can give u my results when I receive them. Thank you. 
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H. Hunter Handsfield, MD
16 months ago
The point of my last comment was that there were to be no more comments or discussion until your test results are available. Normally threads are closed after two follow-up exchanges and we're there. I'll address these questions if still needed after you have received your negative test results -- and that's what they will be, negative. No more comments until then.---
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16 months ago
Hello Doctor Handsfield, I got my results today and they came back negative. Thank you for ur help and ur confidence in knowing I was negative. Truly remarkable. 
Just so I can be more informed about all this can you plz answer my questions please and thank you. 
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H. Hunter Handsfield, MD
16 months ago
Glad to hear of your negative result but of course not surprised. 

1. Nobody can say the risk is zero even with excellent condom protection etc. But for practical purposes you can consider such events to be no risk for HIV or most STDs. The main exceptions are STDs transmitted by skin-skin contact, because not all skin contact is prevented by condoms.

2. Yes absent symptoms after 18 days is strong evidence you were not infected.

Best wishes and stay safe. Please not the forum policy against repeated questions on the same topics. No more about these events and related issues please. Thanks for your understanding.
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