[Question #5372] Testing timeline for Gono and Chla

23 months ago
Possible exposure (can't remember if wore condom, but almost sure). Unprotected oral and protected vaginal sex. 
Happened on a Saturday and freaked out on Tuesday and took 2G of azithromycin in the morning. In the afternoon went to see a doctor and did urine tests for Chlamydia and Gono. I know this is ok timing to test for gono, but chlamydia is probably on the borderline right? 

Questions: 

1. If the results come back negative and specially after taking 2g of azi, is there any thing to concern about? 
2. Is there a need to retest? I've read not really especially given my medication and no symptoms every showed up. 
3. Should I wait 7 days just to be sure and then resume sex with my regular partner without fear of infecting her?
4. Dr. H - would you agree with this statement and that I can trust it after seeing negative tests - even if only after 2.5 days the event?

"
Could any one of those factors gone the wrong way?  Sure.  But the odds of all four going the wrong way (partner infected, you caught it, tests missed it, AND the treatment didn't work) are infinitessimal -- zero for all practical purposes.  You don't need further testing and need not worry about infecting your partner." 

Thank you so much.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Welcome to the forum. Thanks for your question about our services.

You haven't said anything about your partner and her likely sexual lifestyle. Can you add some information about why you consider her to be at high risk for chlamyida or gonorrhea? In any case, your risk was indeed low because of the condom use for vaginal sex. The oral sex was quite safe :gonorrhea is fairly commonly transmitted mouth to penis, but is far less common than chlamydia; and chlamydia is rarely passed mouth to penis.

I would have recommended against taking azithromycin before being tested -- and probably would not have recommended even after testing. That said, it probably would not have affected the tests done only a few hours later and has protected you against both infections if you were exposed. To your specific quesitons:

1) Antibiotics have no effect against viral STDs, so no effect on potential exposures to HIV, HPV or herpes; and azithromycin is no longer reliable against syphilis, so you should have HIV and syphilis blood tests in a few weeks.

2) No need for gon/chl retesting if the initial tests are negative.

3) With respect to gon/chl, you can safely resume sex at home as soon as you know the negative test results.

4) You have correctly quoted something I wrote in response to a past question. 

Let me know if anything isn't clear, or if you'd like to say more about your recent partner and her potential risk for various STDs.

HHH, MD
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23 months ago
Hi Dr H,

Thank you for your reply. 

This happened in Ho Chi Minh City, Vietnam. The exposure was with a CSW in a popular area for massages - aimed at foreigners (backpackers), no locals (or if any, rarely I would say). I had visited this parlor before and she promptly got condoms for the vaginal intercourse - and that's why I am almost sure that I used this time too -I just can't be 100% sure. They seem to be very careful about oral sex, making sure the penis is clean and wiping it and cleaning it properly - i assume they do this for their own safety too. I asked my urologist and he said that syphilis is very rare in Vietnam.

3) With respect to gon/chl, you can safely resume sex at home as soon as you know the negative test results.

With respect of these two, but does it mean that I shouldn't anyway?

Thank you for your time once again.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
No need to read between the lines. It means what it says. You can't transmit something you don't have!

Thanks for the thanks!
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23 months ago
I am aware of that, and maybe I should have been more clear.  I know that once I get the negative results, I won't think about transmitting something that I don't have. 
But you said I should be tested for syphilis and HIV, and my question is that regarding my exposure if it really requires and if I should then stop having sex with my regular partner until I can test in 6 weeks. Or if in your experience, with what you know, regarding this exposure and after getting negative tests for chl/gon, you think I can resume my sexual life normally?

I also added more details about my exposure, but maybe they weren't enough and I think this is the last opportunity for me to ask questions again before having to pay. So in your opinion, what do you think? Any other advice? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Sorry, I was still focused on gonorrhea and chamydia. don't know much about the overall STD risks in this situation, but your description suggests a safe attitude and overall low risk. And even if the sex worker had syphilis or HIV, the chance you caught it is very low.  That doesn't mean zero risk, but exceedingly low. If I were in your situation, I would continue unprotected sex with my wife -- and accepting the very small chance I would have to 'fess up if the 6 week test(s) were positive. But it probably won't happen.

Best wishes and stay safe--
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