[Question #3202] Negative HIV/general STI test at 7 weeks-- conclusive?

39 months ago
Hello,

I had a sexual encounter (gave and received oral sex) in which I contracted Gonorrhea and/or Chlamydia (had symptoms withing a few days). I had the standard treatment for both and the symptoms went away quickly. I got a full panel STI test at 7 weeks after the initial exposure to guarantee that the treatment worked. My results came back entirely negative. Can I assume that I am free of HIV and other STIs, or should I wait to have any sexual intercourse until I can verify my results after 3 months post-exposure? Thanks in advance
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to our Forum.  I'll be happy to comment, partially to provide you with information regarding STI risks and partially to address the specific questions you ask.

First.  While oral sex (giving or receiving) is lower risk for STI acquisition than genital-genital or ano-genital sex, STIs such as gonorrhea or chlamydia are occasionally transmitted in this way.  When they are acquired however, the infections are most often asymptomatic.  The reason I mention this is two-fold-one, if you were not tested for oral infection your symptoms may or may not have been due to STIs (sore throat symptoms are most often due to non-STI community acquired viral infections).  Thus, in the future, you may wish to seek testing if you are concerned about oral STIs.

HIV is spread even less frequently through oral sex than other STIs.  The risk of getting HIV from performing oral sex on a male sex partner, IF he is infected, is less than 1 infection per 10,000 sex acts and there has never been a case of HIV proven to be transmitted through performing cunnilingus or receiving oral sex (Fellatio) from an infected sex partner.  Thus for the sex acts you describe, your risk for HIV even before testing was very, very low.

Finally, regarding your main question, the answer is yes- your tests 7 weeks after treatment do provide definite proof both that you were cured if you had oral gonorrhea or chlamydia and conclusively prove that you did not get HIV from the exposure.

I hope this is not too much information and provide you with sufficient answers to the questions you asked.  If not, please feel free to use your up to 2 follow-up questions to seek clarification.  EWH
---
39 months ago
Dr. Hook,

Many thanks for your quick and thorough reply!

My infection was actually genital-- roughly 4 days after exposure my genitals were warm and red, my scrotum was tingling, and I was experiencing pain in one testicle. An urgent care doctor told me that the symptoms were conclusive enough to warrant  gonorrhea and chlamydia treatment without the need to test (in hindsight, as you said, I should have taken a urine test anyway). I assumed that it was certainly one of both of these infections because the symptoms went away within a week.

The genital tingling continues to lessen in frequency as time passes, but still occurs occasionally. A primary care doctor told me this was likely a residual symptom from the gonorrhea or chlamydia. Does this sound correct to you?

Lastly, I am very happy to hear that I conclusively do not have HIV. Are there realistically any other STIs that I might have that would have been missed by the test at 7 weeks?

Sorry for the lengthy question and thanks again so much for your help!
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
I would not worry about your continued tingling.  sometimes when persons have had an STI they tend to focus/look out for further or continued genital symptoms and thus accentuate symptoms which might be present or have a heightened appreciation of what are otherwise normal sensations which go unnoticed when people are not looking for them. 

I see no reason for further STI testing of any sort.  EWH
---