[Question #13541] When Did I likely catch it?
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4 hours ago
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Previously I was STD free. The beginning of September, I had protected vaginal sex and unprotected oral sex with sex workers in Thailand, 3 different instances. I took doxypep in those situations. I had no known or obvious symptoms. 6 weeks later, I(top) had sex with a male unprotected anal and oral.. 2-5 days after, I gradually got discharge that stained underwear, pee streams started splitting and burning during urination. On day 5 I got tested and 2 days later results were positive for Gonorrhea. I told the most recent male and he got tested the same day. His results came back negative NAA by anal swab. He did not do a oral test. He also wasn't symptomatic. I kept in contact with male and he mentioned that none of previous tops bought to his attention any problems except me though I don't think he asked them.
When most likely did I contracted gonorrhea?
Also I had unprotected sex with wife in between those 6 weeks but I know she was std free beforehand so I know I couldn't have gotten it from her. What's the odds of her contracted it from me as she isn't showing any symptoms?
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H. Hunter Handsfield, MD
4 hours ago
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Welcome to the forum. Thanks for your question.
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This is a straightforward and quite common situation: i.e. an STI in only one member of a couple when both had to be infected. There is no doubt your recent male partner had gonorrhea and was the source of your infection. Not only was your test positive, but your symptoms and their timing were exactly as expected.
There are a few possibilities to explain your partner's negative test results. First and most likely, he probably had pharyngeal (throat) infection and the oral sex was the source of your own infection. (Why wasn't he tested for oral gonorrhea?) Second, the tests aren't perfect and miss some infections, perhaps especially when asymptomatic -- i.e. your partner may have had rectal gonorrhea despite his negative test result, although this is less likely than his having oral gonorrhea. Third, the immune system clears gonorrhea over time, without treatment; conceivably your partner was on the way to self cure when you were infected. Fourth, maybe he took an antibiotic, whether because he suspected gonorrhea or perhaps for an entirely unrelated reason.
This situation is one of the reasons that all sex partners of persons with gonorrhea should be treated for it, without waiting for test results -- and even if testing is done but is negative. Your anal sex partner must be informed and he has a responsibility both to his other or future sex partner(s) and for his own health to be treated for it. He also could have a throat gonorrhea test before treatment, and perhaps a repeat anal swab test.
As noted above, the timing of your symptoms is one of the indicators when you were infected -- i.e. typically a few days before onset of symptoms. Gonorrhea does not remain asymptomatic for weeks and then start to cause symptoms. There is no realistic chance you had gonorrhea 6 weeks ago; your wife was not at risk. She need not be treated or informed of your diagnosis (unless of course you and she had sex after your sex with your male partner, in which case she definitely must be informed, tested and treated).
I hope these comments are helpful. Let me know if any of this isn't clear.
HHH, MD
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1 hours ago
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No. I did not have sex with wife after my male partner. It's been 15 days since treatment. Took a test of cure and I was negative 10 days but it was a clean catch. I was later told I should have took a dirty(first) catch so I tested again at 14 days. Now waiting for test results. I guess those test results can be conclusive that I'm cured and can no longer infect anyone.
Also I don't know why he didn't get oral tested either when I told him. He took a previous std panel of test before and showed me after the act but the test was with blood and urine not swab for anal and oral. When he did get retested he wished he tested for oral also, that would have gave me more peace of mind that it was absolute that I got it from him.
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H. Hunter Handsfield, MD
3 minutes ago
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I assumed you hadn't exposed your wife since you said nothing along those lines, but glad to hear your confirmation.
Test of cure wasn't needed; for gonococcal urethritis as you had, just clearance of symptoms is nearly 100% assurance of cure. In any case, you are over-interpreting whatever information you found about urine testing for gonorrhea: clean vs non-clean urine catch makes no difference and you can be sure the repeat test will also be negative.
---Thanks too for the follow-up info on your partner. You don't mention treatment -- presumably he has now been treated, right? However, you do not need any more information to know absolutely he was the source of your infection. There is no other possibility.
