First to start off with my risks. A few erotic massages with handjobs and a few blowjobs from men and women, mostly women (always with condom and always with them only sucking the tip, because I’m a hypochondriac freak)

Now, I started checking yearly back in 2021 for STDs and always had negative rpr screens and other STDs as well negativo . 

But, I have acne, and usually am on and off doxycycline for this.

My concern is, could the doxycycline have been masking my rpr to keep it negative?

The reason I ask is because of this, I have a new clinic that does treeponoma reverse algorithm testing (I think, lol, new to this)

The lab order says treponoma EIA tests.

My concern is, what if I previously had syphilis (from above encounters) that the doxy kept the rpr negative? And now, what if the treponoma eia is positive (because to my understanding, it remains positive no matter what after infection) How the heck do I explain this to the mother of my children?

The new lab order/test really freaked me out. Do you think my risk was low that I never contracted syphilis anyways? Can I expect negative treponoma cia result as well based off these risks?

Please help. I hope I was clear. English isn’t my first language.

Lastly, are the above related risks any worry in regards to hiv and hep c, as well

As chlamydia?

First, you describe a near zero risk sexual lifestyle for all STDs and especially for syphilis. In my 50 years in the STD business, I have never had any patient nor heard of anyone with such exposures who had syphilis. Had you asked before being tested, I would have said it isn't necessary.

Second, doxycycline and other antibiotics do not make syphilis blood tests falsely negative. If the blood tests -- either RPR or EIA, or other confirmatory (treponemal) tests -- remain negative, it means that syphilis is not present. In theory, someone might have had syphilis between tests that had been cured by doxycycline. But false negative test results simply do not happen in this situation. In other words, your negative test results over the years show for sure you do not have syphilis -- and given the frequency of these tests, you can be sure you never did.

Third, there is no reason to be anxious about the reverse algorithm. Your new EIA test result will be negative. The reverse testing algorithm is just as reliable in both diagnosing and excluding syphilis as the standard algorithm.

Contrary to misleading information from several sources, the hepatitis C virus (HCV) isn't sexually transmitted at all except in one situation:  men having sex with other men that includes potentially traumatic (i.e. with blood) anal sex practices. Among heterosexual partners who have regular unprotected vaginal intercourse, if one partner has HCV, the chance the other has it is exactly the same as in partners of uninfected persons. HIV also is zero risk from the kinds of exposures you describe:  there has never been a case of HIV scientifically proved to be acquired mouth to penis (and only very rare cases from penis to mouth). Chlamydia also is rarely transmitted by oral sex; and periodic doxycycline always would cure chlamydia if you ever had it. Gonorrhea is a higher likelihood than anything else -- but absence of symptoms (pus dripping from the penis, painful urination) itself is very strong evidence someone isn't infected. You are at some risk of genital herpes due to HSV1, i.e. the herpes type that mostly causes cold sores; and nongonococcal urethritis (NGU). But for both of these, the absence of symptoms is strong evidence you were not infected.

All in all, you have nothing to worry about. And definitely put aside your concerns about syphilis testing. You have never been at significant risk of syphilis and your test results prove you never had it, which will be confirmed by the EIA result.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

You mentioned that chlamydia would be cleared by the doxy. Very reassuring.

But also scared me because doesn’t that apply to syphilis? Making a positive eia possible because I effectively cured it, making my yearly rprs negative in account of that?

I guess I’m meant to assume that chlamydia is easier to get and cure, than syphilis? Is that what you mean?

And why are you so obsessed about syphilis anyway? Do your best to transfer your worries to something more realistic in your life!

Dr I guess I’m concerned because when you mentioned chlamydia being cured by doxy, I figured you assumed any previous syphilis was also cured by it, meaning an EIA test which remains positive for life will show positive, right? I guess I just need your reassurance that you never thought I had syphilis, never self treated it, and that my EIA will remain negative.

In 2024, I had molluscum on the pubic region. It self resolved. But now I think back that if MC and syphilis are both skin to skin, could this be a possibility that I had also syphilis? (The guilt of the homosexual blowjobs, albeit ALWAYS condom protected, makes me worry)

After reading all of this, do you still think I  never had syphilis, and that my treponoma tests will be negative?

Thank you, and I’ll create a new post to share my results if you allow me. I’ll even pay another fee. Thank you.

Molluscum and syphilis require very different intensities of skin-skin contact. Having had molluscum in no way raises the possibility of syphilis. In any case, your blood tests prove you do not have syphilis. Let it go.

Please do not share your upcoming negative test result on the forum; there would be no point, we would simply confirm what we already know. But I'll make a deal with you:  in the extraordinarily unlikely chance the result is positive, please return to let us know and we'll refund your posting fee.