[Question #11554] Confused

13 months ago

Hello doctors I recently had an exposure and I’m confused about testing windows. 22 days ago I engaged in same sex hand jobs with a guy I met on an app. I did not know his sexual history. Through out our hookup we touched each others penises (he may have used the same hand to touch mine that he used to touch his). The room was dark so I could not see his penis clear (don’t know if there were any lesions).

Yesterday I noticed a small spot on my penis( kind of looks like a canker) but really small, and tends to look different from certain angles. It is also red in the middle with a white/dry looking border. So today I went to the clinic and got tested (rapid hiv and rapid syphilis came back negative).

The nurse practitioner at the clinic looked and said that she is almost certain that it’s not herpes or syphilis but tested me just to ease my mind.

Here lies my question:

1. Is it too early to reliably test for HIV?

2. Is it too early to reliable test for syphilis? The test used was the syphils health check rapid test which the clinic performed twice to provide me with reassurance.

3. Should I find another doctor to get a second opinion and look at the chancre?

4. The clinic also ran an RPR test to give me added reassurance. Is this test more reliable? Should I wait a few days and test again?

5. Should I be concerned about any other std?

Edward W. Hook M.D.

13 months ago

Welcome to our Forum. Thanks for your questions. Before I address your specific questions, let me state that, without a doubt, the encounter you describe was a NO RISK encounter in terms of risk for HIV and other STIs. This is not an opinion! It is the consensus of the CDC, the WHO and virtually all experts. Mutual masturbation, even when partners get each others' genital secretions on one another, is a NO RISK event in terms of risk for HIV and STIs. STIs, including HIV are not transmitted by transfer of infection, including genital secretions on one person's hands to another.

I agree with the evaluation provided to you by the nurse practitioner who saw you.

In reply to your questions, which are no relevant to the no risk situation you describe:

1. Is it too early to reliably test for HIV?

It depends on the test. HIV PCR tests provide conclusive results 1- or more days after an exposure. 4th generation, combination HIV antigen/antibody tests are conclusive at 6 weeks after an exposure'

2. Is it too early to reliable test for syphilis? The test used was the syphils health check rapid test which the clinic performed twice to provide me with reassurance.

If your lesion was due to syphilis, it is likely that your syphilis Health Check test would most likely be positive.

3. Should I find another doctor to get a second opinion and look at the chancre?

4. The clinic also ran an RPR test to give me added reassurance. Is this test more reliable? Should I wait a few days and test again?

Given the exposure you describe, I see not need for testing at all. Any additional tests will most again be negative.

5. Should I be concerned about any other std?

I hope this information is helpful. Please don't worry. EWH

---

Edward W. Hook M.D.

13 months ago

These were your follow-up questions and my response. As I told you earlier, the encounter you described was a no risk encounter for STIs including syphilis. I've inserted my new responses below

I got my RPR results back and they were negative. Also, today while I was looking at the sore in my penis I scratched it a little and it the scab came off (there was no bleeding) I checked today and it looks like another scab/dry spot is appearing again.

Comment- syphilis lesions DO NOT scab. This sounds like some other sort of lesion. The no risk nature of your encounter and your negative test results also PROVE that this is not syphilis

Questions:

1. Is this description sound like it can be a syphilis chancre? Does it usually scab over where it’s easily to peel? It doesn’t feeel firm to the touch at all. It just feels like a dry grey spot.

See above, this sounds nothing like a syphilis lesion

2. Should I be at ease with a negative RPR test at 22 days post exposure? Some websites say that an RPR test at 22 days is highly accurate, while others sites say I need to wait 3-6 months.

This is an accurate test result which proves that your lesion was not syphilis. Technically, results are not quite conclusive yet but, given the no risk nature of your exposure, I would not be worried and would not test further

3. Also during our course of mutual masturbation he touched his penis then touched mine with the same hand? Could syphilis be contracted this way if he had a chancre on his penis?

As I said above, syphilis in not transmitted this way

4. Also can I pick up an std from anything that was on his sheets or if he tampered with the lube/oil that was used?

Absolutely not. STIS are not transmitted through contact with contaminated bedding.

I urge you to put you fears aside and move forward without concern. EWH

---