[Question #12697] Risk Evaluation, Symptoms, and STD Results

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6 months ago
Greetings Doctors, On December 30th, I went to a massage parlor and received brief unprotected oral sex and had protected vaginal with the sex worker. I don't remember seeing or feeling if the condom broke or was slipping off after I ejaculated. The effectiveness of the condom worries me because I have had many condoms break over my life and I never noticed until pulling out. The SW removed the condom from my penis once we finished intercourse. The following day I came down with a really strong flu like illness. After being better for about a week and a half, I had another strong flu like illness concern on January 16th, and I also started to feel a sting when urinating and having to urinate very frequently. I went to the urgent care on January 17th to test myself for flu, covid, strep and to do a urine test since it was too early to draw blood for the other stds at that point. I was negative for flu, covid, and strep and also negative for chlamydia, gonorrhea, trichomoniasis, and ureaplasma. On January 24th, still had flu like symptoms such as: chills, loss of appetite, brain fog, neck pain on sides of neck, cough, malaise, white tongue, diarrhea, swollen lymph nodes, mild headaches, and a mild to moderate sore throat. At this point I was extremely anxious and stressed that I might have caught something, so I went back to the clinic to collect my urine results and I tested positive for covid-19 this day. This same day(25 days post exposure), due to being panicked about my symptoms, I ordered a Qualitative HIV RNA test which ended up coming out negative. During this time, I have been having mild joint aches and occasional headaches primarily at night time. I am not sure if these symptoms are due to long covid or something else, Fast forward to 45 days post exposure, I ordered a full panel STD test from stdcheck.com and had my blood drawn at LabCorb. I will post my results in a comment below

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6 months ago

  • Chlamydia trachomatis Result: Negative 
  • Neisseria gonorrhoeae Result: Negative
  • HCV Antibody RFX to Quant PCR Result: Non Reactive
  • Trich vag by NAA Result: Negative 
  • Syphilis RPR, Rfx Qn RPR/Confirm TP Result: Non Reactive 
  • HIV Ab/p24 Ag with Reflex Result: Non Reactive 
  • HSV 2 IgG, Type Spec Result: Non Reactive 
  • HSV 1 IgG, Type Spec Result: Non Reactive 
  • HBsAg Screen Result: Negative 
  • Hep A Ab, IgM Result: Negative


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6 months ago

I have been really stressed and anxious over this whole ordeal so I am wondering if that could be causing my symptoms or could it be something else. I would like to know which of these tests are considered conclusive by this point and/or which tests are considered accurate at this point. I have not noticed any breakouts or seen a chancre sore yet. 

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Edward W. Hook M.D.
6 months ago
Welcome to our Forum.  Thanks for your questions and your detailed recounting of your symptoms and test results over the 45 days since your encounter.  Congratulations on your commitment to safe, condom protected sex.  I should point out that other than your concern, there is no evidence that the condom broke during vaginal intercourse and that oral sex is low risk.  More importantly however your test results are all conclusive and show that the symptoms you describe are not due to any STI acquired during the encounter.  

I suggest you work with your doctor to sort out the cause of your recurring symptoms.  They are unrelated to the encounter you have described.  EWH
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6 months ago

Thank you for your prompt response, Dr. Hook.

I'm confused about when these tests become conclusive, as different sources provide varying timeframes. At urgent care, I was told that syphilis, HIV, and herpes testing is only conclusive at 90 days. I’d like to know the accuracy of my blood tests at 45 days post-exposure:

  • Qualitative HIV RNA at 25 days
  • RPR Syphilis
  • HIV 4th Gen
  • HSV 1/2 IgG

Additionally, I had blood drawn at LabCorp around 3 PM in my small town, with samples sent to a lab 4 hours away. I received results early the next morning, which seems unusually fast. Could my samples have been compromised or not tested at all? My test timeline is:

  • Collection: 02/13/2025 15:21:00
  • Received: 02/13/2025 00:00:00
  • Reported: 02/14/2025 09:21:00

I’d appreciate any clarification on both the test accuracy and the quick turnaround time.

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Edward W. Hook M.D.
6 months ago
Sorry for your confusion but my assessment will no change.  If you are seeking information on the internet you will be misinformed.  If you choose to believe you can certainly continue test.  This will lead to unneeded expenditures and the results will not change.

The only possible test for which day 45 results might be debated are the blood test results for herpes.  Those tests are unreliable and commonly yield both falsely positive and falsely negative results.  Few experts would even recommend doing that test for the exposure you described.

The LabCorp labs 24 hours a day.  The times reported are certainly reasonable.  You should believe your results.  EWH
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6 months ago
Hey Doctor, I am having a discomfort on my meatus and around my frenulum. I am an uncircumcised male. As I have mentioned before, I have tested neg for chlamydia, gonorrhea, and trich on two separate occasions. I am wondering if I should get tested for Ureaplasma and Mycoplasma Genitalium. There are times where I feel something coming out of my penis, but when I check there doesn't seem to be any discharge that I notice, unless I am noticing wrong. I don't get burning/stinging while I pee, but do get it after SOMETIMES, not all the time. 
Furthermore, I am still having symptoms of fatigue, loss of appetite,  and joint aches. Could any of these symptoms along with the ones stated above, be contributed to HSV1/2? I have not noticed any significant outbreak.  I have lost 10 lbs since January 17th, I am wondering if any of this can be attributed to anxiety/stress. 
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6 months ago
I know that I am allowed one last post for this thread so I want to ask about one more concern. As stated above, I am experiencing discomfort from my penis hole. From my very limited research on Herpes, I have read that this can be a possible symptom of genital Herpes. I want to know if this is only due to the pee touching the outbreak or can this still occur without a visible outbreak? 
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Edward W. Hook M.D.
6 months ago
Final response.  Your symptoms are not those typical of ANY STI, including HSV.  Instead your symptoms suggest what we call genitally focused anxiety in which persons concerned about possible STI  are so focused on looking for signs of infection that they notice what are otherwise normal sensations, as well as anxiety symptoms.  Those who then repeatedly examine themselves tend to cause irritation through repeated self-examination adding to their symptoms.  Testing is always a personal decision, including testing for M. genitalium ( Do not test for Ureaplasma, it is NOT an STI but a normal part of the genital bacterial flora) but if you choose to test, I anticipate that you will have more negative tests.

It would be quite unusual for your symptoms to be due to HSV.  If you choose to test for that, you should have a swab test tested for the virus using PCR, not a blood test.

This now completes this thread which will now be closed.  I think you are dealing with the results of extreme anxiety.  EWH
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