[Question #47] Concerned 2

98 months ago

First of all apologies for opening another thread, anxiety and guilt can play a lot on one's mind.

I appreciate the answers you gave me yesterday and I am as you can probably tell desperate to move on. The only variable in the 3 answers you gave me yesterday is the history of my partner.

Clearly sleeping with someone hours after meeting them is not a good sign (I know I did the same), whilst she told me that it is not something she normally does there is some doubt in my mind as I do not know the lady or have no way of contacting her.

I have even tried researching levels of STI in middle aged woman in the UK to try and gauge my risks - something that has not really helped!

My question are-

1) if the lady were higher risk of being infected or indeed was infected is the 3 day negative test (48hr results), the azithromycin dosage taken on day 3 (and possibly the negative rapid test that you do not trust) and no discharge adequate proof that I do not have chlamydia or gonorrhoea.

2) if the lady was 'higher risk' would you consider further testing?

3) Do you have any other advice to offer at this time?

Apologies once again, thanks for your time and I look forward to hearing from you.

98 months ago
I have just double checked with the practice who carried out the first test they gave me 1gram of azithromycin. (Taken 8 days ago)
The only additional question from my earlier post is - is retesting recommended?

I would appreciate if you can answer this & the 2-3 earlier questions. Question 3 maybe self explanatory depending on your other answers.

Many thanks
H. Hunter Handsfield, MD
98 months ago
I'm afraid you're into a pathological vicious circle. All the worst case scenario, "what if" questions make no difference in the objective, science-based advice I have tried to give. You are confusing apparent guilt, shame and anxiety over a sexual decision you regret with STD risk from that event. They aren't the same. You're going to have to find a way to deal with the former, but you should disregard the latter. Your new questions are asking exactly the same things as earlier, just with different wording.

1) The test results and azithromycin treatment are just as valid regardless of how high risk the exposure was. Even if your partner were known to have been infected, the test results and treatment would have treated and detected infection.

2) Same question, different words. It would make no difference.

3) My main additional advice is that you do your best to separate your guilt, shame and anxiety over a sexual decision you regret from STD risk from the event. They aren't the same. And that you also do your best to accept the objective, science-based evidence and advice you have had. Deal with the guilt part, but move on from the STD aspects. If you cannot, professional counseling would be a logical step. I suggest it from compassion not criticism.

Retesting? Already discussed (twice, I think) in your previous thread. No additional testing is recommended, unless you want to take the step of also having syphilis and HIV blood tests in a few weeks. As noted before, the risk is low enough that it isn't medically necessary -- but up to you if it would give you a bit more reassurance.

Best--  HHH, MD
98 months ago
Thank you again. I agree dealing with guilt versus science, they are 2 different things.
My main concern was testing 'early' at 3 days and again if worst case scenario would arizthromycin effectively also treat gonorrhea?

This is the last 'worry' I am trying to sort in my head then I will be able to deal with guilt etc separately.

Thanks again 
H. Hunter Handsfield, MD
98 months ago
Azithromycin would be about 90% reliable against gonorrhea. But don't forget the truth that the chance such a partner had gonorrhea was virtually zero; and that the test for gonorrhea was 100% reliable at 3 days. In addition, if you had gonorrhea, you'd know from symptoms, i.e. pus dripping from the penis. (Asyptomatic urethral infections occur, but very rarely.) And even if exposed, the risk of transmission female to male is around 20% for any single exposure, no where near certainty. Could any one of those issues (chance she had it, transmission risk if she did, lack of symptoms, negative test, azithromycin effectiveness) go the wrong way? Yes. But the odds that ALL of them would break in the wrong way is zero. It is a statistical impossibility.

Time for you to move on. That will end this thread. Good luck with it.
98 months ago
Thanks for the support. Anyone else in my position is best not spending hours checking out the web!!!

Really appreciate your words - time to move on