[Question #3978] STI Testing Conclusiveness and Azithromycin Impact

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85 months ago
Hello, 

Bad decision, encounter w/female CSW in Spain stripclub. I am male. It was protected oral and then protected vaginal (with new condom).  At first no symptoms, but was scared and got tested (see summary of lab tests below via Quest). In addition, took 1g Azithromycin (never used before, never had STI before) at 1 week (day before first test). 

Tests (All NEGATIVE/NON-REACTIVE)
Week1 - HIV RNA PCR, Chlamydia & Gonorrea (Urine), Syphillis (RPR), Hep B/C, HSV (type specific IGG 1&2), 
Wk 6 (same as week1 + HIV 4th Gen Antibody/Antigen Combo)
Wk 8 (same as w6)
Wk 12 (Same as w6 + Trich)
Wk 13 (Same as w12, Except no HIV RNA test)
Wk 15 (same as w13 + Urinalysis to check bladder and for bacteria)

At this point (now 18 weeks) the only symptoms that I am having is a slight irritation after urination with more dribble than normal (which before the past couple weeks, I had next to none), feels like my urethra itches some too but very mild and my anus itches more than normal (also noticed what looks like a small skin tag next to the edge of anus, but never looked before.) The slight irritation and itchiness seems to happen more when I am thinking about it....last n

So, there is the background and here are my questions:
1) Would the Azithromycin impact any of the above results in a way that it would now show up (Haven't tested for Mycoplasma genitalium?)
2) Can all of the tests be considered conclusive or should I get another test at this point?
3) Would HPV show up with what looks like a small skin tag on the edge of my anus?  Would this happen that quickly? Do I need to worry?
4) Would masterbating 3 times within 24 hours using a new lubricant (KY gel) around 15/16 weeks cause the mild irritation after urinating I was describing?
5) Should I get another test (and Include MycoGen) or just let it rest and trust the results? 

Thanks for your guidance on this.....as I am embarrassed and ashamed. Would like to go back to having relations with my long term girlfriend. Very stupid decision. 


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Edward W. Hook M.D.
85 months ago
Welcome to the Forum.  The exposure you describe is very low risk.  Most persons to dot have HIV or other STIs and even when they do, most exposures do not lead to transmission.  The use of a condom makes the already low risk for infection lower still.  Finally, the testing you describe, effectively proves that you did not acquire an STI or HIV from the exposure you have described.  Your symptoms are not those of an STI but more consistent with someone who is looking harder for symptoms than people normally do.  With that preamble, on to your specific questions:

1) Would the Azithromycin impact any of the above results in a way that it would now show up (Haven't tested for Mycoplasma genitalium?)
No, the test results would not be effected by taking azithromycin a day before your first test.  The DNA from chlamydia and gonorrhea would still be there in the presence of antibiotics and azithromycin has no effect on HIV, trichamonas or herpes. 

2) Can all of the tests be considered conclusive or should I get another test at this point?
I see no medical reason for further testing.

3) Would HPV show up with what looks like a small skin tag on the edge of my anus?  Would this happen that quickly? Do I need to worry?
The chance of getting anal HPV without rectal sex is very low.  Skin tags are common.  Personally, I would not worry but if you are concerned, I would ask a dermatologist to take a look.

4) Would masterbating 3 times within 24 hours using a new lubricant (KY gel) around 15/16 weeks cause the mild irritation after urinating I was describing?
Perhaps.  The symptoms you describe are certainly not hose of an STI- the symptoms are not suggestive and the timing is wrong.

5) Should I get another test (and Include MycoGen) or just let it rest and trust the results? 
My advice is to put this entire unfortunate event behind you and to not worry further.  I certainly see no reason for further testing for the STIs you have already tested for and your risk for Mg is low.

I hope these comments are helpful.  EWH
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