[Question #549] Unprotected encounter and tested

91 months ago
Hi, I would like to have your opinion and expert advice on the following:
Approx 11 month ago I had sex with an (maybe not important, but Mongolian girl who was on holiday in my country). First it was protected, but as the condom slipt and I had to much too drink we kept going without for a while(stupid I know). I didn't really worried too much at the time, until I met my current girlfriend approx 6 month ago. Eventhough we only have protected sex, we decided to do a standard STI test.(both never did that before stupidly) I did the test in Hong Kong  when I was there for business and they only tested for Chlamydia, Gonno and HIV. All negative (so almost 6 month ago and therefore 5,5month after my unprotected encounter) the HIV test was 4th Gen rapid test duo/combo. But I was stupid and googled too much, so I got scared if I really was HIV free and more over if I might had Syphilis or not.  I never had any signs on my penis for Syphilis but I read that sometimes it's without any symptoms at all. So I would like to know:
1) Is one HIV test enough to be absolutely sure I'm HIV free for my unprotected vaginal sex? (I went even so far to check the prevelance in Mongolia, which by the way is really very very low, much below 0,10 but still)
2) what would be the chance for having Syphilis when I haven't had any sores and cancers on my penis or in that region and no other signs? (my family doctor didn't took my question seriously and just said only 500 pieces yearly get syphilis and more than 80% is with M2M.

thank you very much in advance for your reply and help.
H. Hunter Handsfield, MD
91 months ago
Welcome to the forum. Thanks for your question.

First, you had the right tests in Hong Kong. I would have added a syphilis test, but that plus gonorrhea, chlamydia, and HIV is all that most experts would recommend for routine testing. However, the chance of syphilis for any single exposure is low, and you are correct that absence of an obvious penile sore is good evidence you didn't catch syphilis. Second, I agree you "googled too much" about your risks. All things considered, there really was very little chance you acquired either syphilis or HIV.  To yoru specific questions:

1) Yes, a single HIV test is 100% conclusive. It is impossible to catch HIV and have a negaitve 4th generation HIV test any time more than 4 weeks after exposure. That single test proved you were not infected.

2) Your doctor was exactly right -- in his understanding of the risks, if not in his diplomacy. There is no realistic chance you were infected. But if you remain concerned, have a blood test. If you do so, it will be negative.

So all is well; there is no reason to be worried.  I hope these comments have helped. Best wishes and stay safe--


91 months ago
Thank you very much for this clear reply.

To hear this and get conformation from an expert in this field,  is very reassuring. (also that my family doctor is correct, as I had the feeling that he might be not really up to date with STD's as we life in a very very small village)

 By reading your comment I really had a the feeling the load falling from my shoulders!

May I ask  one last question about STD?  (it's just out of interest)

When I was in googling mode I also read about symptoms of Chlamydia and Gonnorhoe, when I thought back I have had some symptoms which might be related to chlamydia. I know I'm negative so I'm not worried about it

I had a kind of discharge drup in the morning and a feeling having to pee more often. Both symptoms where only there for approx a  week and at that time didn't really paid attention as I was quite busy at work and thought it could be related to that as I had to do presentations for large audiances. 
But would it be possible I've had Chlamydia and my immuun system cleared it within those 5,5month or would the symptoms  logically have been more related to many other  things like stress etc?

Again thank you very much for your time and help.

H. Hunter Handsfield, MD
91 months ago
You do raise a valid point. The transient symptoms conceivably were chlamydia or nongonococcal urethritis (NGU) that subsequently was cleared by the immune system. However, these usually cause discharge only, not urinary frequency. Was the discharge fairly thick, like mucus? What color? If entirely clear, it might have been pre-ejaculate fluid left over from normal nocturnal erections. Or might it have been a drop of urine? And exactly how long after the semi-unprotected exposure? If more than 2 weeks or so, it probably was unrelated to that event. Your closing question/comment is right on the mark: these symptoms also could have been due to genitally focused anxiety, especially if the "discharge" really was urine, or if it's scant clear fluid that drew more attention than otherwise because of stress or anxiety.

That said, people can acquire chlamydia, the immune system can clear it up, and then later testing is negative. So your negative test does not, in itself, prove you didn't have chlamydia that had been cleared before then. But it does show you weren't infected at that time and hence couldn't have infected your new partner, so at this point, it shouldn't be a concern.

91 months ago
Thank you for this informative reply. The discharge was it wasn't very thick like mucus, but slightly more thicker than urine (from what I remember, it's been a while ago). It wasn't completely clear but slightly more whitish imo. I checked my agenda (for when I had those presentations)  the discharge and frequent urination started somewhere between 2,5 to 3 weeks after the encounter.  As you mention that only the discharge is something which could relate to the Clamydia and you mentioned that the symptoms should start within 2 weeks, I really think also this was unrelated. :-) (anyway I'm negative, so no problem)

Like you mentioned, I don't need to be concerned anymore and gladly I'm not concerend anymore because of my negative results and now especially the confirmation that my HIV test was enough and that my doctor is correct about Syphilis. 

Again I would like to thank you for your clear information and confirmations.

I wish you all the best.

H. Hunter Handsfield, MD
91 months ago
Thanks for the thanks. I'm glad to have helped.

Having said 2 weeks, symptoms could appear as late as 3 weeks. So you might have had transient nongonococcal urethritis (NGU), about a third of which is caused by chlamydia. In any case, with the symptoms gone and negative chlamydia testing a few months later, you can be confident you were not infected when you began your current relationship.

Best wishes.