[Question #5035] How soon can I test?

24 months ago
Hello,
I am a 32 year old female - I went outside of my marriage with a coworker and deeply regret my decision. We engaged in unprotected oral both ways (fellatio was very brief), and unprotected vaginal for maximum 5-10 seconds in total.  I am on birth control and took plan b to be safe so pregnancy is not my concern.  This coworker is also married and says he’s clean, but I want to be safe. 

I am concerned about Chlamydia/Gonorrhea and how soon I can test — everywhere I read online  says 2 weeks but Dr Hook/Handsfield often say sooner than that is fine. I am 4 days since the exposure and and hoping to test at 7 days — is this enough time for vaginal swab? Do I need a throat swab?  

Thank you so much for your advice. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Welcome to the forum. Thanks for your question and for reviewing other threads on the topic.

This sounds like a very low risk event, both because it seems unlikely your partner has an active STD  and especially unlikely he has chlamydia or gonorrhea, assuming this was a one-off event for him as it was for you; and because oral sex is low risk and the vaginal sex was so brief. Given your concerns, it is reasonable for you to be tested, but you definitely can expect negative results. And yes, proper testing for gonorrhea and chlamydia would include a throat swab (at least for gonorrhea -- oral chlamydia is so rare that this is optional), in addition to vaginal swab or urine testing.

Finally, 7 days is fine, no need to wait longer. As you have seen on other threads, the standard gonorrhea and chlamydia tests are valid any time more than 4-5 days after exposure. For truly complete STD testing, you also should have blood tests for HIV and syphilis, both valid 6 or more weeks after exposure.

You also might consider asking your co-worker to be tested for all these. If negative, you'll know you weren't exposed. And you might find he is just as concerned as you are:  he has no more assurance about your low risk than you do about his. In addition, if you both are tested and negative now -- including syphilis and HIV -- you won't need to wait 6 weeks for additional HIV and syphilis tests.

I hope these comments rae helpful. Let me know if anything isn't clear.

HHH, MD
---
---
24 months ago
Hi Dr, thank you for your response.  To my knowledge this isn’t a frequent thing for him, but who knows. I do know he doesn’t engage with men and is not an IV drug user — I didn’t see any lesions anywhere on him either re: syphilis.  Should this be a huge concern for me?  I wasn’t concerned really at all and waiting 6 weeks to engage with my husband isn’t and option for me...

Also, I was wondering as far as pregnancy, I have irregular periods on my current BCP (I know I am not currently pregnant) so I took plan B just to be safe - however I am 182 pounds and I have read that it doesn’t work on women my weight, so this has me spiraling a little bit now. He inserted only a few seconds a couple times and never ejaculated. Do you think I should be more concerned about unplanned pregnancy? 

Thank you for answering my follow up concerns. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Thanks for the additional information. On one hand, visual inspection for lesions in the genital area or elsewhere is overrated on many websites and other resources as an STD prevention strategy. It almost never is helpful. That you didn't see anythiing provides little if any reassurance about STD risk. But more important, this still sounds even more like he is at very low risk for STDs. So the answer is no:  this definitely should not be "a huge concern".

With such a brief exposure and no ejaculation, the risk of pregnancy is miniscule, probably zero. And my understanding is that although Plan B might be somewhat less reliable in heavier women, it usually is still effective. Between the low risk nature of the exposure plus Plan B, you needn't worry about pregnancy.

---
24 months ago
Hello Dr,

Thank you for all of your helpful information — I went in for testing today. I should have results tomorrow night, thank goodness. I took your advice and tested for GC, Chlamydia, Syphilis and HIV.  (I realize unless my coworker tests for syph/HIV, it doesn’t help immediately).

When the PA was doing my exam he mentioned I do have a little yellow discharge near my cervix - he said this could be normal or may not be.  This makes me nervous — do you think the plan b could effect my discharge? I haven’t noticed abnormal discharge myself in the last week, but obviously he could see what I can’t...

Also, he mentioned false positives? How often do these actually occur  with the Hologic Aptima swabs? Im sick about the idea of a positive result and having to tell my spouse about this.... I’m worried about syphilis coming back false positive as well now as I’ve read that can happen...

Bottom line is I’m just sick about my decision - I wish I could go back in time as I fear I may have ruined my marriage.  Any last and additional information you can provide would be so appreciated.  

Thank you for all you do.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Thanks for the follow up information, and congratulations for being tested.

Judging cervical exudate is imprecise; one person's normal is another person's bad, especially for "a little" discharge. In any case, to my knowledge plan B isn't likely to have any effect.

False positive chlamydia or gonorrhea tests are very rare with Aptima, which is a nucleic acid amplification test (NAAT). This is a theoretical consideration only. If your test is positive, you can safely assume it is real. False positive syphilis tests also are rare.

Normally threads are closed after two follow-up comments and replies, but I'll leave this open for a few days so you can tell me your test results, if you would like to do that. But no other comments until then, OK? In the meantime, don't be freaked about unlikely scenarios. The odds are your test results will all be negative.
---
23 months ago
Dr Handsfield,

Thank you so very much for keeping my question open.  All tests came back negative.   I am grateful for this forum and for your guidance.  If you have any further advice on how I should proceed (sex with my husband, etc), I am open.   I will do my best not to be anxious about all the possible ‘what ifs’ (false negatives, pregnancy from brief intercourse, etc.)..

Again, I so appreciate this forum and the “real world” advice you offer — It gives people like me ease of mind and of course, some built in grace to be a flawed human being.  


Thank you.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Glad to hear of the negaitive results. Presumably your doctor found nothing else abnormal when she examined you and has been similarly reassuring. With that plus your negative lab tests, I see no reason for any change in your usual sexual frequency or practices with your husband.

Thanks for you rkind words. That's why we're here! Best wishes.
---