You mentioned my 7 days doxy would’ve probably prevented me from Syphilis infection, I would like to confirm if I’m being unreasonably anxious? My unprotected exposure was on 22nd Dec and the first intake of the doxycycline was on 31st, wouldn’t it be too late for me to take Doxycycline as a preventive measure? I saw that 14 days of doxycycline is a treatment of syphilis, so I’m just taking only half of it?

I’m still trying not to overthink the HIV from unprotected oral sex, but I’m still anxious so I will be taking another test. I’ve done a 4th gen on 15th and it’s negative, so as syphilis.

But my doctor says my doxycycline may result in false-negative. May I confirm if I do another HIV Ag/Ab p24 antigen test (or RNA Test if you suggest), together with a syphilis VDRL test after 28 days, can be conclusive enough for me to stop thinking about it? 

Last one: the red spot I mentioned before, the doctor said it doesn’t look like herpes and syphilis indeed and it looks like trauma, but it’s just not going away. I’m given Hydrocortisone 1% cream, I’ve read online that overusing this on my urethral mucosa is bad, but since I still have to pee and may rinse the cream away, may I know if it’s safe for me to just keep applying the hydrocortisone cream to make sure my red spot is being covered all day long? It’s still here and I’m frustrated despite it doesn’t really itch nor cause any pain.

Thank you so much, I don’t want to be repetitive but I just want to be less anxious and experts opinions are definitely going to help. I’m sorry if this sounds annoying.

Regarding HIV, as Dr. Handsfield told you, if you want to conclusively confirm what Dr. Handsfield said about being at virtually no risk, you can test with an HIV RNA PCR test at any time now.  If you are going to be tested with a combination HIV antigen/antibody test (4th generation), results wil not be totally conclusive until 6 weeks after your encounter.

Regarding syphilis and the doxycycline, Dr. Handsfield said " I would not have advised doxycycline treatment. But it does NOT cause false negative test results for bacterial STIs. If your test results are negative, it will mean for sure you do not have gonorrhea, chlamydia, or syphilis. You can never know whether you were never infected, or infected and cured -- but most likely you never were infected, since the risk was so low. "  The doxycycline you took was an amount which would prevent development of syphilis in an exposed person with a negative syphilis blood test - this is often referred to a therapy for "incubating syphilis", i.e. syphilis which has not yet proceeded to a point at which it causes a lesion, positive blood test, or can infect others.  This FACT was proven more than 30 years before the newer, low dose doxy-PrEP regimen was shown to be effective when taken soon after exposure to an infected partner.  While partial treatment might DELAY test positivity, it would not cause false negative.  Poor choice of words on your doctor's case perhaps.

Thank you for your comment. I feel much more relieved indeed after the comments previously given to me actually, I was just anxious as even though it’s not STI, there’s still something happening to my penis. However it was glad to understand more about the therapy for “incubating syphilis”.

Anyway, may I know, from your knowledge, can I keep applying  hydrocortisone cream 1% on my urethra? I’m assuming that it’s rinsed away whenever I pee, applying for 2 times a day wouldn’t be sufficient. However it’s been said that overusing the hydrocortisone cream will result in thinner skin. I know you can’t diagnose a case on the internet, it would be great if I can know more about the usage of this cream if you have any idea about this.

Thank you very much.

It is my knowledge that if a person has been infected with Syphilis in the past, even after proper treatment, the future test (antibody test ?!) may still show positive even if it’s treated. I’m not concerned about me being infected so this is just educational.

May I know if this doxy treatment for incubating syphilis would still lead to the result of future positive test or a 7days doxy would’ve killed the virus already even before my body starts generating antibodies to it?

Cheers.

In persons with previous syphilis who are successfully treated, some syphilis tests can remain positive.

The 7 days of doxycycline would prevent your syphilis test from becoming positive although, as you've been told repeatedly, there is no reason to think that you were even exposed to syphilis.  

You need to give up on the syphilis idea.  You are clearly having trouble doing this.  You have one follow-up remaining.  After that, no further follow-ups will be entertained, even if you purchase new questions.  EWH

I’m actually quite convinced that syphilis doesn’t even relate to me but Im just still curious on how the doxy works during this incubation period. I do hope the info spreads so people who have higher risk exposure can benefit from this type of info.

Yes I’ll wait for a few more days and see if the cortisone cream works.

Final question to you doc, regarding the HPV. 

As doctor has replied previously that HPV can’t be detected after weeks of exposure, may I also know how long on average, a dna genotyping test can detect the HPV virus? The genotyping test I did was a swab+urine. Again just for my own education as I don’t think when exactly I’m exposed is relevant anyway.

I acknowledge that strains 51/54/55 are unlikely to cause warts, just wanted to know how “unlikely” it is? When 90% of warts are caused by 6/11, have you ever had any diagnosis of warts on these 3 strains or the “unlikely” means “very rare”?

I don’t have anymore questions after this HPV thingy. Have a good day!

You really need to figure out how to get over the guilt or whatever is driving your difficulties in moving forward.

This completes this thread.  There should be no reason to return.  EWH