[Question #5936] Request for clarification

22 months ago

[Question #5928] Risky experiences 

So sorry for coming back again, but I have asked the same question on that day to your forum and another specialist forum and today I got the doctor or as said consultant feedback that scared me and needed your kind advise, the question I posted without repeating the encounter explained in question 5928 was as follows 


1- are these test accurate ? Only 10-15 mins ? They look like pregnancies test?

 2- what is the risk of this encounter? And should I just forget and proceed normally with my wife? 3- when should I get tested more? If I need? 

4- based on googling on the past week I see majority are saying the hiv don’t transmit via contact skin to skin but how would I know if she may have some minor scar and I do have many pimple on my back , or micro scar?

5- I have plenty of dead skin from pimples in my back and some are new ones, is their a chance that it can be source of transmission? 

6- what is the chance of syphilis and other STI? 

7- when I should get tested for syphils for a confirmed results? 


The answers I got from the doctor who is MBBS., CLINICAL MANAGEMENT IN HIV., PGDHIVM, I don’t know what this position is but the answers was: 


1. Tests are accurate and yes, they are like pregnancy tests. nothing to worry. 

2. Minimal risk and almost little chance of transmission. 

3. after 28 days, with western blot nad 4th gen test. 

4. it can be risky if she is infected. 

6. chance for syphilis - yes. 

7. need to.wiat for 45 days. mean whe observe for painless single ulcers and which heal automatically. 


coming to 4 and 5, HIV has tendency to infect in 2 ways, beings alone as HIV virus and a virus within lymphatic cell. A HIV virus alone, transmission is very impossible and HIV being with lymphatic cell can live longer but as there is no penetration, the rupture is unlikely. so, your situation is risky one, but have little chances of transmission. 


I am now back to square zero .. I need your kind help on answering or feedback on the above answers. Specially in japan the syphils infection is getting higher on the past years

Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome back to the Forum although I must say that I am sorry you felt the need.  On this occasion I will be answering your question. To prepare to answer it, I reviewed yesterday's interaction with Dr. Handsfield and agree with everything he said.  The activities you describe were a no risk event with no medical or scientific need for testing at all.  

I think that the answers you received from your other on-line source largely agree with the assessment Dr. Handsfield provided regarding HIV risk.  As far as syphilis risk is concerned, your other on-line source was slightly more conservative in their response than Dr. Handsfield but the message there is still that the risk for infection from the activities you describe is exceedingly low and should not concern you.  I agree with Dr. Handsfield and would not be worried about syphilis from the events you describe.  

Even though syphilis has become more common in Japan in recent years, it is still relatively uncommon and the risk for the interaction you r describe is virtually zero.  You are, of course, free to test for syphilis if you wish.  Results be largely reliable at 30 days and entirely reliable at 6-7 weeks (i.e. about 45 days) after exposure.  If you choose to test for syphilis, I am confident that the tests will show that you were not infected.

I hope that this information is helpful to you. EWH  
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22 months ago
Dear Dr Edward thank you so much for your kind reply and clarifications .. so I can understand that you somehow ( not entirely ) agreed on the other on line answers but still you think there is no need for testing. I can now rest assure that such event is not possible for HIV transmission. 
During the past period I have been googling a lot before sending these questions. However, I am still not clear with syphilis testing, window period and symptoms. 
1- how usually syphilis are transmitted? 
2- what are the symptoms and does any of the ones I have gotten is considered one? 
3- what are the painless ulcers means and is it something noticeable ? 
4- how reliable is the syphilis blood test that are like 10-15 min and you got the results at 28 days? 
5- finally, based on the prescribed events, can I presume my life with my regular partner or at least I should be away till I got tested and clear ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
I really think that you are overthinking your concern about syphilis and likely being led astray by the internet which is more often wrong or at the very least overstated in its message relative to what is warranted.  Again, if your are not having sex with other men you really are more likely to be struck by lightening than to get syphilis.  Further your follow-up questions fail to appreciate the variability of this rare and highly variable disease.  As a result, "could this be..." questions are non-productive and subject to misinterpretation.  If you really want to prove to yourself that you do not have syphilis (which is the outcome I anticipate, stop worrying and get tested.  With this preface, brief answers to your questions.  

1.- how usually syphilis are transmitted? 
Through direct sexual contact with the lesion of an infected person.

2- what are the symptoms and does any of the ones I have gotten is considered one?
The symptoms are highly variable but start with the appearance of an ulcerative lesion at a site of direct, unprotected sexual contact.

3- what are the painless ulcers means and is it something noticeable ?
A painless ulcer would be an open sore which did not hurt.

4- how reliable is the syphilis blood test that are like 10-15 min and you got the results at 28 days? 
Highly reliable.  The results should be believed

5- finally, based on the prescribed events, can I presume my life with my regular partner or at least I should be away till I got tested and clear ?
Dr. Handsfield told you, as did I, the events you describe were NO RISK events. If there was no risk, then logically, there is no reason to abstain from unprotected sex with your regular partner.

EWH
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22 months ago
Dear Dr Edward, 

Thank you so much for your kind reply and patience with us, I know we sometime sound panicked unnecessarily as guilt feeling .. today I have completed 29 days since that exposure so  I tested quick fourth gen HIV and syphilis test but I don’t know the type of the test it was through a blood sample. Both results were found negative as you predicted .. i know this would be my last reply and I wanted to thank you so much and Dr handsfiled for continuous support and great services with rich experience .. the last follow up would be : 
1- I don’t need any further STD testing for assurance? 
2- Recently I noticed some testis pains that comes without any direct hit but have the same feeling ,is it related to any STI any recommendation ? 

Thank you again and again ! 
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
As you point out, as per Forum Guidelines, this will be my final reply as part of this thread.  I trust you will now be able to believe both our repeated statements that the exposure you described did not put you at risk for HIV or any STI and that your test results serve to verify this.  Future questions on this topic may be deleted without a response and without return of your posting fee.

Final follow-ups:
1.  Correct, no further testing is needed.
2.  Any testicular pain or discomfort you have experienced is not due to STIs, including HIV that were acquired during the events you described in your original question.

This completes this thread.  Take care.  Please don't worry.  EWH
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