[Question #1764] STI follow up

79 months ago
Hello Doctors:

At the risk of being ridiculed for asking for clarity, i have two follow up questions to my previous one last week.

I fear I contracted ghonorrea or NGU 11 and/or 3 months ago, without symptoms, and passed to my wife unknowingly.

To recap, i had unprotected oral from CSWs in the USA.  Since both exposures, zero symptoms at all. 

Wife has a pap in the next week or so, it was rescheduled.

Last year, her pap was abnormal, so they are asking her to come in annually for HPV checking of the pap results.

Given her previous abnormal pap, would they be looking for other STDs on her follow up paps?

Is my anxiety and guilt and paranoia of being discovered having had these 2 encounters silly, unfounded and not based in reality given the medical realities? 

If i understand your previous replies, there is basically NO chance I was infected, thus NO chance a pap would detect anything?

Does a pap screen for anything besides HPV?

Thank you again.
Edward W. Hook M.D.
79 months ago

Welcome back to the Forum. since Dr. Handsfield and I take questions at random, by chance I'll be answering your questions today.  I have however read your earlier interaction with Dr. Handsfield and agree with all that he said.  i.e. That there is virtually NO chance that you acquired gonorrhea or NGU from the two exposures that you mention above and hence there is no reason for concern of being "found out" based on your wife's PAP smear results.

Having said that, I also notice a certain misperception on your part as to what a PAP smear is.  What I am about to write may or may not be relevant to your question and, hopefully will be clarifying and useful for you.  PAP smears are tests looking for abnormalities in cells collected from the female genital tract  as part of a screening test for cancer of the genital tract.  These specimens can also be looked at to detect HPV infection.  PAP smears themselves do not test for gonorrhea, chlamydia or other STIs.  On the other hand, if the doctor chooses to do so, he or she can test for other STIs using either the specimen collected for the PAP smear or by taking additional specimens at that time.  Drs.  are encouraged to tell patients what they are testing for and should inform patients on what tests are being informed.  Testing for STIs is recommended primarily for women under the age of 26 on an annual basis or for women felt to be "at risk" by their doctors.  The fact is that in the U.S. only about half of women for who STI testing is recommended actually get tested.  I cannot tell you what tests might be performed when you wife goes in for her exam. My guess that this will largely be HPV and cancer screening and nothing more but there are no guarantees. 

I hope this information is helpful to you.  EWH

79 months ago
Thank you,  Doctor, that is helpful.

She is 35 years old and has been married for seven years.

I am not certain why this is causing so much constant anxiety; i guess the 1 in 25000 chance i was infected and did not know it is killing me.   The very possibility that I have infected her or would be 'found out' is really getting to me.

Are there any other words or thought regarding this before we end the thread?

On a scale of 1-10, given the information provided, 1 being not sure, 10 being sure, would this rank a 9.9 in terms of being clear (no infection from exposures; 0.0 need to worry about her health or pap exam from these exposures?)?

Thank you

Edward W. Hook M.D.
79 months ago
I would estimate that your calculation of 1 in 25,000 which is higher than your chance of being hit by lightening ( 1 in 12,000  ) is too high.  I would put your odds of being "fond out as more like 1 in 9.999.  Get a grip on yourself and move forward. Things will be OK  EWH
79 months ago
1 in 9.999?

Doctor, do you mean your opinion is 9.999/10 sure that i was not infected and did not infect my wife and thus pap won't find anything?

I assume you are telling me I am not thinking logically and that anxiety has taken control and trumped common sense that my exposures did not lead to STIs. 

Is that correct?
Edward W. Hook M.D.
79 months ago

Correct, there is no evidence or reason for concern that you were infected by the exposures you described.  Similarly, there is no risk that you could have infected your wife with something as the result of those same exposures.

You seemed to have been overcome by your guilt and anxiety over these exposures.  If you cannot move forward without concern yourself, then I recommend seeking the help of a confidential mental health professional who can help you to address these problems.

this is my third reply to your questions.  As I suspect you know, we do limit the number of anxiety-driven posts from clients in order tot have time and space to help others.  this thread will be closed in a few hours.  there should be no need for further guilt-driven questions.  EWH