[Question #4111] FOLLOW UP TO #4073
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84 months ago
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Dear Dr Hook,
I'm so sorry for returning to the forum yet again and I'm sorry if i'm wasting your time but your expert advice feels me with great confidence and I need to admit with you that I suffer from some mental health problems- anxiety and depression and I can't relax about this whole situation. I am getting treatment for the problems in my head and I hope I can move on from these soon.
As you know from our previous discussions, i've had full STD screenings- in particular for HIV and Syphallis and as you told me last week, my HIV test at 6 weeks came back negative which comforts me and I feel I can move on from them, although may have a test at 12 weeks to be completly free. I
The test that is still bothering me is the Syphallis test, you said at 5 weeks without any lesions is enough to be conclusive but I'm still struggling with the 12 week window and I can't seem to move on from this. Am I 100% safe? Can I move on with confidence that I am not infected with anything? I found a small red spot on my testicles yesterday and now have convinced myself this must be a chancre appearing and this is the start of Syphallis even though I'm now in week 7? This then sends my mind into overdrive and I can't help but think what if my test results are wrong? What if the clinic made a mistake and i've got gonnorhea and Chalymida even though i got a negative result at 4 weeks.
I'm so sorry to bother and I know it's mainly all in my head but I want to be able to move on and get this out of my head. Hopefully the therapy helps!
Can I move on with safety and know that If i do happen to have unprotected sex with someone, that i won't be at risk at infecting them?
Thanks for your help and i appreciate that you may be exasperated by me now!
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H. Hunter Handsfield, MD
84 months ago
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Sorry to see you back and I can't help much. You're re-asking the same questions as in your two previous threads, in different words. I agree with all Dr. Hook said in those discussions. Ou are 100% safe and indeed "can move on with confidence" you don't have any STD and cannot infect anyone else.
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HHH, MD
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84 months ago
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Hi Dr Handsfield,
So the red spot on my testicle/scrotum isn’t syphallis related and isn’t a late chancre at 7 weeks?
I’m so sorry I just suffer so badly from anxiety and the whole “12 week window” confuses me terribly!
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H. Hunter Handsfield, MD
84 months ago
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No, such a red spot is not possibly syphilis. I don't know what "12 week window" you're talking about. With the normal syphilis and HIV blood tests, the maximum window is 6 weeks. Twelve weeks is old news and applies only to the older antibody-only HIV tests that have been little used for over a decade (even though some sources still state 12 weeks out of legal conservatism or because the writers don't understand the differences compared with the early tests. For syphilis, it's never been more than 6 weeks for 100% conclusive test results.
Simply hearing the facts usually isn't sufficient to overcome severe anxiety in situations like this. If you continue to worry despite the reasoned, science based advice you have had -- advice that is sufficient for 95% of concerned persons -- then professional counseling should be considered. I suggest it from compassion, not criticism.
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84 months ago
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Hi Dr Handsfield,
I am currently awaiting therapy for anxiety and will certainly get to the route cause of this!
I’m sufficiently happy about the HIV window and have been advised by many people that my test results are conclusive which I can accept.
However I only had a syphallis test at 5 weeks and not 6- does that make a difference? Here in the UK all the information appears to suggest you can’t rule out Syphallis until 12 weeks, hence the confusion and then with the red spot appearing it’s sent me into overdrive!
There’s so much conflicting information out there, that it’s so easy to get confused and added in the extra worry I put on myself it has a way of sprialling out of control!
What are the chance of a 5 week negative turning into a positive??
Sorry I really will leave you guys alone soon!
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H. Hunter Handsfield, MD
84 months ago
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The evidence you don't have syphilis is overwhelming. 1) Even among the highest risk men who have sex with men, at any point in time under 1% have transmissible syphilis (probably usually under 1 in a thousand). 2) Absence of symptoms (chancre) at the exposed site -- in this case, your penis (not scrotum etc) is strong evidence against infection. 3) Although it rarely can take 6 weeks for the syphilis blood tests to become positive, 90-95% of the time they are positive by 4 weeks and even more likely by 5 weeks. I have never had a patient negative at 4-5 weeks who later was positive. Could any one of these predictors break the wrong way? Yes, although very unlikely. But all three? No way!
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There simply is no realistic chance you have syphilis. Believe it and move on. And no more questions on this topic, which would be deleted without reply and without refund of the posting fee.