[Question #13396] Risk for HIV, STD?

6 hours ago

I had two exposures:

First was protected vaginal and oral

Second (2 days later) was protected vaginal but unprotected oral (insertive)

Gonorrhea symptoms started 3 days after the second exposure, treated on day 5 with 1g IM ceftriaxone + 7 days doxycycline.

I began PEP within 3 hours of the first exposure and continued for 29 days (missed 30th due to kidney strain, eGFR just above 60). No exposures after the second. Since PEP is systemic, some sources say it should cover the second unprotected oral exposure.

At moment, tested HIV-negative using 4th-gen Elecsys combi PT at:

PEP completion

+17 days post-PEP

+30 days post-PEP

Question: Can gonorrhea spread from genitals to throat, rectum, or eyes without direct contact(like in clothes)? No kissing, rimming, anal play, or oral receiving. Kept my hands clean since I got diagnosed.

CDC recommends swabbing only exposed sites. Had negative urine PCR 2 weeks post-treatment (25 days post-exposure), but results took 10 days—can that delay affect accuracy?

5 hours ago

I tested negative for syphilis 25 days post-exposure using RPR. Could the gonorrhea treatment I received (ceftriaxone + doxycycline) have suppressed or aborted a possible syphilis infection?

It’s now about 2 months since the exposure. Do I need to be concerned about other viruses like herpes or HPV if no symptoms have appeared?

My 30-day post-PEP test (around 8 weeks post-exposure) included HBV surface antigen and HCV antibody—are these reliable at this stage? I was vaccinated for HBV, with antibody levels at 136 four months before exposure (I understand >10 is considered protective).

Is the HIV test at 45 days post-PEP (roughly 10.5 weeks post-exposure) considered conclusive, or should I stick to 12 post exposure according to CDC?

Lastly, how assuring is my last result at 30 days post exposure, some doctors say it's conclusive enough, since it's post pep not post exposure.

Apologies for the many questions, doctor—I'm just very anxious after contracting gonorrhea and want to be thorough.

5 hours ago

Forgot to mention PEP regime was a generic version TLD (tenofovir disoproxil, lamivudine, dolutegravir)

Edward W. Hook M.D.

4 hours ago

Welcome to the forum. Thanks for your questions. I’ll be glad to comment.

The exposures you describe or virtually no risk for HIV. There are no proven cases of HIV, which have been required from receipt of unprotected oral sex, and condoms provide excellent protection against STI‘s including HIV. It is possible that you acquired gonorrhea from your Receipt of unprotected oral sex, and the medications that you received in treatment would’ve prevented development of syphilis as well as curing gonorrhea and, if present chlamydia.

No, gonorrhea does not spread from one site of infection to another on clothes or through transfer on the hands. You’re gonna re-infection was localized and you have proven that it has been treated. There is no reason for further testing for gonorrhea. We would need to ask your laboratory or the person who ordered the tests why test results took 10 days.

Is mentioned above, even if you were exposed to syphilis, the treatment that you received for gonorrhea would’ve prevented any infection from occurring.

You are hepatitis B vaccination would have prevented hepatitis B if exposed and your follow up testing proved that you did not acquire hepatitis B or hepatitis C from the low exposures that you describe

At this time, my advice is to relax, to believe your test results, and move forward. There is no reason for further testing related to the exposures that you describe. EWH.

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