[Question #11710] Syphilis

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12 months ago
Hello Doctors good evening 
Exposure date June 06, intercourse oral and vaginal protected with stripper.
Tested on June 13 and July 12 Both Rpr and hiv and all stds negative non reactive. Tested again on July 21 same non reactive. I had unprotected sex with wife and finished inside June 07 so day after, what are the odds of passing something to her. Symptoms I have a small red bump on my shaft that I saw on July 20 not sure if appeared earlier. It’s really small and doesn’t look like a chancre.. today I scratched off the little red scab it had and I’m not sure if it can be syphilis ? There is no liquid coming from it or not noticeable because it’s small about 1.5mm in diameter. I have random little red bumps 1 on each arm and one by my knee as well. I am very afraid. Thank you. 
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12 months ago
Also forgot that she got tested on July 23 so 3 days away from 7 weeks of last time we had sex. 
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H. Hunter Handsfield, MD
12 months ago
Welcome to the forum. Thank you for your question.

You describe a very low risk exposure in regard top HIV and other STDs -- it isn't clear whether only the vaginal or also oral exposure was condom protected, but oral sex is such low risk (especially with a female partner) that it makes little difference. There is almost no chance you had anything you could have transmitted to your wife a day after the exposure you are concerned about.

The penile bump doesn't sound at all like syphilis, and as already mentioned there is no realistic chance you had syphilis. (And even if you did, syphilis cannot be sexually transmitted sooner than 2-3 weeks after exposure, so no risk on June 7.) And it's much too soon for the other skin bumps to be the skin rash of secondary syphilis.

As for your test results, the June 13 tests were conclusive for a urine gonorrhea/chlamydia test. However both the syphilis and HIV blood tests were too soon June 13 and borderline soon for HIV and syphilis.

I'm not sure which "she" was stated July 23. If it's your wife, it doesn't say much about the chance you were infected. If it was the stripper, you can be sure you were not exposed to the infections for which she was teated.

All in all, you really needn't be worried. But if you would like further reassurance, repeat HIV and syphilis blood tests at this time (i.e. more than 6 weeks after exposure) will be conclusive. But really, don't be worried in the meantime. You didn't catch any STD from the June 6 events.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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12 months ago
Hello Dr. Handsfield, I appreciate your response in detail greatly. 
The encounter was protected through all of it oral and penetration.
For my results: I took one on July 12 RPR was non reactive hiv as well and another on July 21 and same results and I took another test today which are pending results. The July 23 test was my wife test which was neg and her last sex was with me June 07.
So syphilis can’t be transmitted a day after even with ejactulation inside? And How about a handjob a month later? At the June 6 encounter i feel like condom was on correct and I may have grabbed it from outside and then touched my penis. Thank you 
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H. Hunter Handsfield, MD
12 months ago
With protected oral as well as anal sex, I would consider this a zero risk event in regard to syphilis and HIV.

I'm sure your wife's negative test result was reassuring, but there was no need and it means nothing in regard to your own syphilis risk. There wasn't nearly enough time for her test to be positive even if you infected her.

And no, syphilis is not transmissible until either a chancre develops (typically 10-20 days after exposure) or before about 3 weeks. This is the saving grace of syphilis control:  there is a 3 week window when partners can be contacted and treated before they can infect anyone else (very much unlike gonorrhea and chlamydia, which therefore are more difficult to control).

That your penis was "touched" as you took off the condoms makes no difference. Syphilis isn't so easy to transmit!
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12 months ago
No anal just protected oral and vaginal. Yes my wife negative test was good as I am more worried about me having had passed it to her not about my status, her test was negative at 6 weeks 4 days. My last negative was at 6 weeks 3 days, would you say my test today 7 weeks 5 days be conclusive non reactive? Thank you again. 
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H. Hunter Handsfield, MD
12 months ago
The lack of risk during the exposure plus your lack of symptoms plus your negative test results all add up to no syphilis. Stop worrying about it.

The completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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