[Question #4001] Testing Question

31 months ago

Hello Again Doctors,

It has been awhile since you calmed my irrational HIV fears. I appreciate that. I have another new fear that popped up due to new circumstances and was hoping you could do the same.

When I originally got tested for HIV the first time, 20 days post exposure, the Dr (who said I had no chance at HIV) said I had a very slight Ghon/Chlamyida risk so he tested be for those too. It was a urine, NAAT test.  They came back negative. It was so long ago I have NO idea how long beforehand I peed. COuld have been an hour, could have been 5 mins before I got to the office. The reason I'm worried is that my wife and I have reconciled and I began to have unprotected intercourse with her. About a month after our first time, she bled a little. Then we had  along dry spell and just last weekend we did it again and again a little blood. She also told me her period are a little heavy, but she claims it's been that way for awhile. No other symptoms to report besides pains during period but again she says that's normal for her. THe slight bleeding is not normal and that makes me fear I infected her.

With the HIV fear, I also got a full panel at labcorp done 90+ days post exposure. They also did a chlym/ghon test but I've read you both say that blood testing for those isn't very accurate, so if I read correctly then the only possible accurate test was the urine 19/20 days post exposure? So, if I went to the bathroom too soon or gave too much sample would that be an issue? Does my wife's symptoms lead you to believe she could have caught something from me? My risk, again, wasn't inter course. It was me f I n g e r I n g the woman, touching myself with the same hand I used to finger, her very briefly putting her finger in my behind, and her ONCE licking the tip of my p e n I s. But that was it.

Thank you,

Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
 I am sorry you still continue to worry about this encounter. Attributing minor variations in your wife's health (vaginal or otherwise) to your dalliance is not a productive thing to do.   There are many many possible causes of vaginal spotting and unless it persists or continues this is not a sign of STI ( and even then STI with me and I'm likely cause ). Further, the guidelines for specimen collection for urine gonorrhea and chlamydia tests are reflect the way these tests were evaluated  for FDA approval but not their true performance. Even if you had voided less than an hour before your specimen was collected, your test results would be reliable. I urge you to believe them. I urge you to stop overthinking this. Please try to move on without concern. BWH ---
31 months ago

Thank you Dr. I Appreciate your take.

To be clear as I realize it's hard to follow the path. I had my incident, 20 days later I received the urine naat test (along with hiv test). Then at 90 days received full panel (just looked at panel results and seems that the ghon/chlam/trich test was urine, I just don't remember peeing in cup but so be it). In had s e x with wife randomly while we were still split up once, then again one month later I f I n g e r e d her and that is when she bled. Then, a few months later, we decided to get back together and again in s e x she bled a little. So even though this was split months apart it happened both times.

I don't believe anyone else would have given it to her. We had a pretty frank discussion about that issue and she had no reason to lie. I do remember when we had s e x the first time after my incident, she did not bleed but I recall a lot of dry skin ending up on my shaft and head. I'm thinking perhaps if there is dry skin for her there that oculd lead to bleeding, if it isn't std related? Also, she had a papsmear a month back and that was normal, although she refused to talk to dr about my risk because she thinks I'm being ridiculous.

Lastly, I've had a consistent very slight sore through for almopst 2 months. Only in one spot and only when I swallow saliva, not food or drink. I know that can be a sign of std's. I went to my dr and he suggested it could be allergy related as I've had some post nasal drip and since taking Flonase it has improved dramatically, if not completely. Does any of this change your opinion?


Thank you again and have a nice weekend.

31 months ago
And lastly, considering she bled once in January and once in July and we had no intercourse or actions in between, I guess this could be considered persistent? I had 2 naat's for gon chlym and Trich whatever that is and they were both negative. I don't know how closely I peed before giving my sample though, as discussed. I'm horrified she could develop or already did develop PID. She gets very frustrated at my hypochonriasm (don't know if that is a word) and blows me off when I ask about her period. They have been very heavy but she claims it's been like that for a long time. Would a pap smear pick something up if irregular? And how long would It take for PID to develop if she caught ghonnorea from me in December (her first bleeding moment came a month after)? That will be all. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Your guilt and hypochodriasism are driving this and getting the best of you.  I appreciate your follow-up regarding the second test for gonorrhea and chlamydia.  It  PROVES that you were not infected.  You need to stop letting your own guilt and anxiety cause you to over interpret every possible abnormality that you happen to become aware in your wife as a possible STI related to your own missteps.  I agree with her- you need to stay out of her business and leave her own sexual health to her.  I will not comment on your theoretical "could PID develop" musings.

Your sore throat in no way changes my assessment.  The fact that you "know" that a sore throat can be a sign of STIs is wrong.  Most oral and pharyngeal STIs are asymptomatic and STIs do NOT cause prolonged sore throats. 

Get a grip on yourself.  You were not infected by your encounters while you were separated.  I hope my comments will help you to do this.  EWH
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31 months ago
Thanks Doc. And apologies, obviously I don't 'know' much. I seem to recall in other posts you saying a prolonged sore throat could be a symptom of HIV. If I was mistaken, I'm sorry. 

Like I said I don't particularly remember giving urine at labcorp, but when I type the name of the test on my report, gon trich chlym by NAAT and the code into google, labcorp comes up and description says it's either swab or urine, so I guess that's what it was.

Obviously despite my mistakes my wife's health is of utmost importance to me. I'm so scared to 'move on' with any possibility that I could miss something and she could be getting worse, theoretically. Would gon/chlym or PID produce more symptoms than spotting during sex? And, to be clear, was my experience even worthy of testing? I'm asking because with the earlier conversations we were talking specifically about HIV, but if you look back at the event would that even be worth of chlym or ghon testing? Thanks again. I know that's my last one. 
31 months ago
Sorry, lastly, I believe that she hasn't been with anyone else. That's why this is so troubling. To just spot now in the only 2 times we messed around makes me think it has to be me if it's an STI. Could it be something else?and the last question you didn't answer, understanding you're not a gyno but to your knowledge, would a pap smear show an abnormality if there was one? I know it won't test for STDs but if it developed to PID?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
I really have nothing more to say and your two repetitive follow-ups do nothing to change my opinion.  You need to believe the two negative tests you have.  Remember Einstein's words- "one definition of insanity is doing the same thing over and over again and expecting different results."  You've been tested twice and have negative results.  Further PID causes many symptoms other than vaginal spotting.  

I doubt that your wife has an STI and your statements about other partners are just further anxiety-driven paranoia.  Also PAP smears do not detect PID. 

This concludes this post.  My final advice (again) is for you to stop worrying about your wife's occasional spotting.  She is an adult and you projecting your guilt to think she has PID or other problems because of your misstep is paranoia on your part.  Furtherr repetitive anxiety driven posts may be deleted without a response.  If you need further follow-up, I suggest it be with a trained counselor or mental health professional to work through your issues.  I say this out of concern for you, nothing more. EWH
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31 months ago
Thanks Dr. I realize I'm over the limit but I'm hoping since I will be deleted with future questions that I can ask one more that slipped my mind please regarding antibiotics, please. The day before my exposure I finished a round of Zithromax for a URI. Then I was tested 20 days later. Would that round of antibiotics that was complete a day before exposure impact my testing at all? I genuinely appreciate a response here as I fear that realization will stick in my mind and I'm out of questions. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
It would make acquisition of infection even less likely (not that it was likely to start with)  and would have no effect on your second set of tests. EWH---