[Question #13152] Test results after rash
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2 months ago
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Hello, doctors!
Since my last question I have become single due to my lack of faithfulness and gotten tested yesterday due to a rash and have questions about ARS HIV and Syphilis testing.
31 days post protected vaginal, 10 days post unprotected oral (less than 20 minutes,) one day post fingering a woman, I woke up with a rash on both my thighs. Little red dots that burned, not itched too bad. Slight sore throat but could be anxiety looking for it. Went to the doctor and they gave me anti fungal powder but made me do a full STI panel.
That night after the shower, my full body broke out in two rashes. Large red areas that burned, and small dark dots that itched. When I woke up, they were still there but I got my HIV/Herpes results back and they say “non reactive.” I then went to urgent care and they seem to think it’s not ARS HIV or Syphilis.
Are my test results accurate after this testing with 31 days post protected vaginal sex, 10 days unprotected oral, and one day after fingering? I’m still waiting for gonorrhea and chlamydia results
Thank you! I know you said no repeat questions of risks, I hope test results are different and don’t make you guys mad. Thank you!
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2 months ago
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Also, still haven’t had sex with my ex since Mid March, she was reporting before we broke up she had a similar rash under her arm, would I have passed syphilis to her via kissing and she got a rash? So I can confirm I didn’t give her anything with these results
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H. Hunter Handsfield, MD
2 months ago
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Herpes causes no rash anything like this and is not a possible cause. HIV and syphilis are not possible causes; for both of these test results always overrule symptoms; it isn't possible to have a rash from HIV or syphilis and test negative for them; the test results are accurate. And the rash is much too soon for syphilis as well -- could not occur sooner than 2-3 months from catching it. Your doctor and the urgent care providers are correct. Not to mention the low risk nature of your sexual exposures. Your gonorrhea and chlamydia results also will be negative. Return to your doctor if your rash persists and/or you remain concerned.
HHH, MD
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2 months ago
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Thank you, doctor!
The advice given here is always so useful for my knowledge and understanding. Schools really never teach us this.
A couple follow ups:
1. If I’m showing symptoms and test come back negative, it assumed to be accurate that I don’t have either HIV/syphilis. I believe I read that you recommend testing at 6 weeks as a follow up. Since I’m 4 weeks out and got tested, do I need to retest in 2 weeks?
2. Is HIV/syphilis becoming more commonly transferred in the heterosexual community or is that online mumbo jumbo?
3. I know we’ve talked about men being symptomatic in most STD’s. In my new single life, I’ve been asking women of their status to ease my anxiety. I avoided one for her answer was “no symptoms so I haven’t been tested.” Do women show the same chances of being symptomatic as men?
Thank you again!
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2 months ago
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Also, about the rash. It seems to have “flair ups.” At some point it seems to be completely gone, then after a shower it seems to spread. Worry about it makes it worse too
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H. Hunter Handsfield, MD
2 months ago
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1. The negative tests prove your symptoms aren't due to HIV or syphilis. Correct you need retesting at 6 weeks to know you were not infected (without symptoms). But your risk was low enough you didn't need testing anyway. It's up to you.
2. HIV transmission patterns are pretty much unchanged for 3-4 decades. In the past 10 years, syphilis has become more common in some but not all heterosexual populations. It remains very rare I people with your sexual history.
3. For gonorrhea and chlamydia, asymptomatic infection is a lot more common in women and men who have sex with men than straight men. It's mostly determined by anatomic sites infected: rectum, pharynx and vagina are less likely to display symptoms if infected. For most other STIs, including HIV and syphilis, there's not much difference by sex or sexual orientation.
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2 months ago
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Thank you, doctor! One final round of follow ups!
1. Since the rash was very mild during my test, and got worse during the 24 hours to follow, will that still make my HIV/Syphilis test accurate? Would it be as strong in the blood during mild symptoms vs strong?
2. If you were in my shoes, and all results come back negative or non reactive tomorrow, would you test?
3. Kind of a question just for my own knowledge, what is an STD? I know it’s a viral/bacterial infection due to sexual contact. The history has me curious. Have they been around since the dawn of man and just evolved to what they are? Were they accidents from years of unhygienic sex through human history? Kind of a blog question that can be ignored, I just like to hear an experts history vs Wiki.
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H. Hunter Handsfield, MD
2 months ago
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1. This makes no difference in test accuracy or strength.
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2. Personally I wouldn't have tested at all if I were in your situation and I certainly would not do it again.
3. This could take a book chapter or a full book, which have been done in the past. For now just say they are infections that evolved to requires sex itself for transmission, with some exceptions in other highly intimate contact, like being born to an infected mother as one example. For purposes of the definition, sex means intercourse with penetration or at least direct genital-genital or genital-oral contact.
Final advice: Assuming your current pattern of sexual behavior continues -- with occasional sex outside your relationship -- I suggest you a) use condoms (including for oral sex so you won't worry so much) and b) get tested for common STIs (gonorrhea, chlamydia, syphilis, HIV) from time to time, like once a year -- but not after any individual exposure unless, for example, you learn your partner definitely was infected.
That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Please re-read the last comment in your previous thread about deletion of repeated anxiety driven questions without reply. That will definitely be our response with any more such questions; you may not keep coming to us every time you have an exposure that worries you. Thank you for your understanding.