[Question #13023] Anxiety & Testing
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3 months ago
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Hi Dr,
Late 2021 I engaged with 5 different escorts and did not do any sti test. Back in late 2022 I engaged with escorts again and did STI tests for Chlam, Gon, Syphilis and HIV which all came negative six weeks post exposure. Recently in January I did another STI screening which all came back negative, and another one in April (all negative as well). My wife has been complaining about her eye twitching often this year, along with occasional pain in her pelvic region/vagina over the past year that goes away I think in a day or two. I’m paranoid that I gave her something even though all my tests came back negative. I’m paranoid that since I did not test back in 2021 I might have caught something and gave it to her. And by the time I took the tests in late 2022 they’ve all somehow resolved themselves and showed up negative. Is this possible dr? I’m particularly worried about Syphilis. Me and my wife have unprotected sex. Thank you
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Edward W. Hook M.D.
3 months ago
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Welcome to our Forum. Thanks for your implied confidence in our service. I'll be glad to comment. You can be comfortable that you were not infected with Chlamydia, gonorrhea, syphilis or HIV from the casual encounters you describe. The tests are very reliable and were taken at a time when they provided conclusive test results. If you had an STI which cleared but had been passed to your wife, you would have been re-infected by now and shown symptoms.
Your wife's symptoms deserve evaluation but are not particularly suggestive of an STI. Eye twitching is not a sign of any STI and pelvic discomfort in women has many non-STI causes.
I would not be worried in the least that you have an STI or that your wife's symptoms are due to an STI that you transmitted her. I see no medical reason for testing at this time although some clients choose to test a second time for the assurance that having a negative test provides. I am not necessarily suggesting this but if you choose to test, I am confident that your tests will show no evidence of an STI, including HIV. Please don't worry. EWH
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3 months ago
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Thanks Dr, that is extremely reassuring. Hypothetically if one were to contract syphilis and take doxycycline with the regular dosage of 100mg twice for 14 days straight, how fatal would missing one or two doses be? Would that negate the whole treatment? Thank you. Also how risky is protected anal with a female once in terms of STIs? Thank you.
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Edward W. Hook M.D.
3 months ago
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If you had syphilis or any other infection ( STI or otherwise) missing a dose or two would not prevent the doxycycline from being effective.
A single episode of protected anal sex would be a relatively low risk exposure EWH
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2 months ago
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Thanks again for the prompt reassuring replies Dr. Let’s say I had contact with three different escorts over the course of 2 days: escort 1 I engaged with twice with protected oral only (no sex); escort 2 I engaged once with unprotected oral and protected vaginal sex; escort 3 I had unprotected oral (vigorous deepthroat) and protected vaginal & anal sex. 10 days later I had a test for Chlam, Gon, Syphilis and HIV which all came out negative. 14 days later I decided to take doxycycline (100mg twice per day for 14 days) and missed one or two doses as I mentioned previously. My questions are:
1. I didn’t take the doxycycline with food sometimes, and the timing of the two doses is not strictly the same everyday. I also missed 1-2 doses. Is the doxycycline still effective for syphilis?
2. I’ve had zero symptoms so far, would you say medically it’s still necessary to do another testing at six weeks post exposure to rule out syphilis?
3. I have continued unprotected sex with my wife straight after day 14 of doxycycline, should I be worried at all?
4. I’m particularly worried about the protected anal, would you say my encounters I described put me at any risk for STIs? How high is my risk in your opinion?
Thank you.
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2 months ago
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I’d also like to add that by now I’m about 6 weeks post exposure with still zero symptoms
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Edward W. Hook M.D.
2 months ago
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Sigh. I'm not sure what has led you to these anxious, paranoid questions. You have proven you do not have STIs. Perhaps you are being misled by the misinformation that is all to common there. You need to move on. This will be my final response and then the thread will be closed. There should be no need to return with further repetitive, anxiety-driven questions. Should you return, you may not receive a response and your question may be closed without return of your posting fee.
Straight to your repetitive questions:
1. I didn’t take the doxycycline with food sometimes, and the timing of the two doses is not strictly the same everyday. I also missed 1-2 doses. Is the doxycycline still effective for syphilis?
Yes! Doxycycline is a very forgiving medication to take. None of the things you describe would have prevented it from being effective.
2. I’ve had zero symptoms so far, would you say medically it’s still necessary to do another testing at six weeks post exposure to rule out syphilis?
Absolutely not
3. I have continued unprotected sex with my wife straight after day 14 of doxycycline, should I be worried at all?
No!
4. I’m particularly worried about the protected anal, would you say my encounters I described put me at any risk for STIs? How high is my risk in your opinion?
As I've indicated below. the encounters you describe were, collectively low risk. You do not know if your partners were infected (most commercial sex workers were not), no have not been symptomatic and you have negative tests. There is simply no reason to be concerned that you might have had, or have, a lingering infection.
You need to move on. This thread is now complete. EWH
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