My wife and I have only resumed sex in the last ~8 weeks. We have had intercourse five times since then, always with a condom and only vaginal. No oral or anal sex. There were no condom failures that I’m aware of.

My testing after the encounter:

HIV (4th‑generation lab test/CMIA): negative at 9, 12, 13, and 28 weeks post‑exposure (different doctors/labs).

Syphilis (serology): negative at 9, 12, and 13 weeks.

Chlamydia (NAAT): negative at 13 weeks.

Hepatitis B and C: negative once at 13 weeks.

My wife’s symptoms over the past several weeks: migratory joint and muscle pains, beginning in the back/neck, then moving to elbows and wrists; currently elbows and fingers are most affected. No fever, no rash, and no red spots on the skin. Symptoms are worst in the morning and after prolonged computer work. She has also been more fatigued in the evenings. She returned to work about 2 months ago.

Questions:

1) Based on the exposure described (condom‑protected vaginal sex) and my repeated negative tests, how likely is it that I could have transmitted an STI to my wife?

2) Specifically, what is the likelihood of gonorrhea transmission under these circumstances?

3) Could my wife’s joint pains reasonably be due to an STI (e.g., disseminated gonorrhea or reactive arthritis), or should we primarily consider non‑STI causes (e.g., ergonomic/overuse, rheumatologic, endocrine)? What initial evaluations would you recommend for her?