I tested for gonorrhea and chlamydia via urethral swab at about one week and again at eight weeks, both negative. Trichomoniasis was also negative at eight weeks. My syphilis test at 90 days was negative. HIV tests were negative at 80 days and 112 days with a 4th generation test, and at 90 days with a 3rd generation rapid test. HSV-1 and HSV-2 IgG tests were negative at 80 and 112 days. A urine analysis showed no signs of infection, inflammation, or bacteria.

I have had intermittent irritation on my scrotum and at the base of my penis that comes and goes. There have been no sores, blisters, or visible lesions—just a sensation of irritation that varies in intensity. I have not experienced discharge, burning urination, or other classic STI symptoms. Additionally, I have noticed that my semen appears slightly yellow when seen on a white napkin.

Based on my testing and symptoms, is there any medical reason to believe I still have an undiagnosed STI? Would my urine test have detected an infection in my urinary tract or prostate if something was lingering? Can I confidently move forward in my relationship without fear of transmitting anything to my partner?

I appreciate your time and expertise.

It's good to hear you understand safe sex. Too bad the condom broke, but it happens. And your risk was less than you might have thought, given your actions afterward. Given your partner's statements about being clean and "tested regularly" were good evidence you were not at risk. You were over tested and the bottom line is that the test results are conclusive:  you can be completely confident you have none of the infections for which you were tested.

Your initial chlamydia/gonorrhea test (at one week) was conclusive, the later tests unneeded. Trichomonas isn't carried in the rectum and therefore never a risk with anal sex; that test was a waste of money and time. The syphilis blood tests and HIV AgAb tests (i.e. 4th generation) are conclusive at 6 weeks; the additional tests at later times were unnecessary. HSV blood tests never are advised by STI experts after a single exposure and in absence of symptoms. Your negative results are reliable, but it's lucky you didn't have borderline or weakly positive results, which are very common and difficult to interpret.

None of your symptoms fits with HIV or any STI. Your negative urinalysis was solid evidence against prostatitis or other urinary tract infection. And even if the symptoms had been typical for HIV or other STI, the test results overrule symptoms anyway.

The bottom line is that you can rely on your test results and can safely resume or continue sex with your regular partner. Had you asked right after the event, I would have advised there was no need to ever stop having sex with your partner.

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

HHH, MD

One lingering concern I’d like to ask about is an ongoing irritation on my scrotum and near the base of my penis. It feels like I’m rubbing against my underwear more than I used to, and I notice discomfort, especially when sitting, as the area presses against my clothing. There are no visible sores, blisters, or rashes, just persistent irritation that comes and goes. I’ve also noticed that my semen appears slightly yellowish when seen on a white napkin, though I have no pain, burning, or other symptoms.

Are there any non-STI-related explanations for this irritation and semen color change? Would you suggest any further evaluation, or is this likely due to something benign like friction, stress, or diet?

2. Since my symptoms are not STI-related, how can I mentally let go of the anxiety and stop worrying about something that isn’t there?

3. Would you say there is absolutely no medical reason for me to continue testing or worrying about this exposure?

4. Is there anything else you would recommend to help me move forward and stop overanalyzing my body?

2,4. "how can I mentally let go...? anything else you would recommend to help me move forward...? We're STI experts, not psychologists. Simplistically, believe the science; or perhaps professional counseling.

3. "absolutely no medical reason for me to continue testing or worrying...? Yup.