I gave a sex worker unprotected cunnilingus i have tested on day 4 and day 5 oral and urine Gonorrhea and chlamydia results where negative, However I am reading online on reliable medical websites like webmd that chlamydia and gonorrhea can take up to 2 weeks to show up on a test. 

The clinic went ahead and treated me for syphillis due to Arizona having a syphillis epidemic that was on day 5 of exposure what are chances i was infectious within the 5 days of exposure before getting treated i did kiss someone during those 5 days ? 

I already know that my risk is really high for oral HPV i can assume the 51yr old sex worker has probably every single HPV strains possible as she sees hundreds of men. I only received one dose of G4 when i was a virgin so i know im not protected. 

As far as HIV i have took a RNA test on day 11 and that was negative, However i know that is not conclusive especially cause it does not test for HIV2. I have a opportunity to go into my local health dept tomorrow and test with a 4th gen lab test how ever it will only be the 26 day not 28. Will 2 days make a difference? 

Based both on this question and your previous one 9 months ago, you tend to be way over-worried about STDs based on the risks you have described. Cunnilingus is very low risk for all STDs, and there has never been a reported case of HIV proved to be acquired by oral-vaginal contact. That doesn't mean it can't happen, but obviously the risk is extremely low. Chlamydia also is very rare in this situation, and rarely infects the throat. Your urine gonorrhea/chlamydia tests were meaningless:  you cannot have genital infection without genital contact, and urine testing only checks for genital chlamydia and chlamydia, not oral. It is wrong that it takes 2 weeks for valid urine result; any time more than 4-5 days after exposure is valid. But since you could not have acquired a genital infection, there is no point in testing again.

If you're in a geographic area with high rates of syphilis in female sex workers -- which indeed includes some parts of Arizona -- then treatment to prevent syphilis was reasonable. What treatment did you get? I would have recommended a single oral dose of doxycycline (200 mg); but an injection of long acting penicillin would be even better. Nobody with syphilis is infectious for other partners until a syphilitic sore (chancre) appears, and rarely before 2-3 weeks. Even if exposed to syphilis, there was no possibility of you giving to anyone else, by kissing or by sex.

And it is definitely wrong that you are at high risk for oral HPV. First, oral sex rarely transmits HPV anyway. Second, newer research shows that even a single dose of the HPV vaccine is highly effective for at least 10 years. So your vaccination protected you from the four types of HPV covered by the G4 vaccine.

There was no need for HIV testing. However, your negative RNA test at 11 days shows you were not infected. HIV2 is extremely rare in the US. Also, some newer HIV PCR/RNA tests include HIV2 as well as HIV1. Check with the lab. And no, there is no significant difference between 26 and 28 days for the AgAb (4th generation) blood tests -- a negative result will be about 98% reliable; it takes 6 weeks for a truly conclusive test. But since you were at no significant risk for HIV anyway, any further testing is optional.

FYI, in the 20 years of this and our preceding forum at medhelp.org, with thousands of questions from people worried about HIV, nobody has yet turned out positive. You won't be the first! If and when it finally happens, it will be from a genuinely high risk exposure, not a near-zero risk event like you have reported.

Do do your best not to worry any more. You have no infection at all from the exposure you have described. If you have a regular partner, you can continue your usual sexual relationship without putting anyone at risk.

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

HHH, MD

What other STD/STI should i test for mycoplamsa, Trich, Hep B ? I was vaccinated as child for Hep B when i was born 25yrs ago but i think i have lost all immunity. 

As far as HSV-2 i never developed any mouth sores, However i have read on this forums based off of Terris comments that most HSV-2 symptoms are asymptomatic especially for oral. I was tested before this exposure and was negative for HSV-2. How often do you see oral HSV-2 on the mouth from cunnilingus ? 

Yes i was treated for syphillis on day 5 with two injections on the buttocks , However im afraid if i had a chancre i never noticed within those 5 days and infected my regular partner i kissed her. 

As far as HIV i dont think the RNA tested for HIV 2 the results only say HIV RNA 1, I will go to my local health department today on day 26th, Do you recommend doing 6 weeks and 12 week testing in case i got HIV2 from this exposure ? 

Last question i see you said one dose might be effective for 10years what study was that ? I would like to read that to feel a bit better, Sucks that i only had G4 now im worried i could have got another high strain not covered in the vaccine and pass it to my partner by kissing her or giving her oral. 

Beyond that, these additional questions repeat questions above, in different words. My advice has not changed.

HIV2 is exceedingly rare in the US and testing not necessary. But if you want further reassurance ab out it.

You can google "HPV vaccine single dose effectiveness" for lots of evidence on the topic. The first publication I see is this one:  https://www.cancer.gov/news-events/cancer-currents-blog/2020/hpv-vaccine-single-dose-long-term-protection