[Question #6785] Testing Conclusiveness

11 months ago
Hi Doctors,

I'll cut to the chase quickly I hope,

I've been out of the dating world for over 15 years, recently pushed back into it, I haven't been up to date on latest testing advice.

6 months ago I (a male) had unprotected vaginal sex with a woman of unknown status.  2 days later I had unprotected oral sex (her to me) with another female of unknown status. 

I took (2) "10-Test Panels" with STD check at 7 Weeks and 16 Weeks after last exposure" 
I also took a final HIV Test at 24 Weeks past last exposure.

Tests were:

HIV1/2 4th Gen
Clam/Gon by NAT (Urine)
Syphillis (RPR)
HSV 1/2

I now realize after coming to this site for some final advice/closure and reading some threads this may have been over-testing a bit.

Direct questions:

1.  Am I sufficiently clear to consider my self conclusively "STD Free"?
2. I've read other threads in which Dr. Handsfield says HIV Tests, in particular, "are of the most accurate diagnostic tests ever created for any medical condition, and when done sufficiently long enough after possible exposure the results are 100% reliable"  "For the Ag/Ab blood tests they are 98% accurate at 4 Weeks and 100% accurate at 6 Weeks.  Can you shed some light on the "100% accurate" statement?  I thought no test could be 100% accurate?  Is this just because so far  a negative at 6 weeks has never become a positive (that anyone knows about anyway)?

Thanks so much!
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to our Forum and thanks for your questions.  Thanks as well for reading our interactions with others who have similar questions.  our goal is to make this information widely available, as well as to provide personalized assessments when needed.  The dating world has changed a bit in the past 15 years.  As you move forward, my general advice is to encourage condom use, to ask your partners whether they have been tested or have any chronic problems you should know about, and to be prepared to answer the same questions when ask of you, not out of concern but out of respect for your partners within sexual relationships.  these steps will go a long way towards keeping you sexually healthy.  In answer to your specific questions:

1.  Yes, results for each of the tests you describe is conclusive and can be relied upon.  FYI for future consideration, I would point out that the major STIs of concern are gonorrhea and chlamydia.  HIV and syphilis are far rarer but are of concern.  As I suspect you may have seen in your reading, we specifically recommend against blood tests for HSV as these tests have a relatively high frequency of falsely positive results and can be misleading.   Further, as relate to hepatitis, if not already done, you may wish to get the hepatitis B vaccine.  Highly effective and can be given as a combination vaccine with the vaccine for hepatitis A which is rarely an STI except among men with other men as sex partners.  Hepatitis C, for all practical purposes is not an STI and there is no need for future testing in relationship to future sexual activity.   

2.  Correct.,  With the exception of persons who have taken anti-HIV medications in efforts to prevent infections, we are unaware of ANY infections which have not been detectable through testing at six weeks. 

Finally, you have not mentioned your age but many of our clients are concerned about HPV/genital warts.  As I'm sure you have seen, our stance is that these are incredibly widespread infections which are of little concern to more than 97-98% of those who get them but if this is a concern, you may wish to also consider getting the HPV vaccine which costs between $400-$600 but is highly effective for preventing HPV infection, particularly when caused by those HPV types which do rarely go on to cause problems.  Depending on your age, insurance may cover some of all of the cost.

I hope this information is helpful. EWH

11 months ago
Thanks so much for your reply.

Agreed things have changed alot in the last 15 years.

Your right forgot to mention my age....42.

I will definitely look into getting that Hep Vaccince you mention, as well as strict condom use going forward.

1. Regards the HPV Vaccine you mention....I did have probably 7-8 partners before I got married 15 years ago, from reading up in the forum seems like (though hate to admit it) I might already have acquired that infection since you mention in several threads how common it is?  If so is there any reason to still get this vaccination at my age?

2.  Just as a summation of both of my questions below, you are not recommending any more testing at this point correct chances of any infection are slim to none? 

Thanks again!

Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Thanks for providing your age.  The reason I asked is that the HPV vaccine if now recommended (and often paid for by insurance) up to age 45.

As for the hepatitis vaccine, you may have already had it.  It is the sort of thing that people tend to get and then forget about.

1.  The numbers of partners you have had puts your risk as about average. You may or may not but probably have unknowingly had at least some HPV infection in the past.  I do not feel strongly that you need it- your own risk for complication of infection is very low.

2.  the tests you have had are definitive and conclusive.  No need for additional testing related to the exposures you have had.  For persons who are in the dating scene at present and may have future encounters we do recommend periodic sexual health screening (that is testing even in the absence of symptoms) with the frequency determined by your own perception of risk and partner number.  On average, about once a year a urine test for gonorrhea and chlamydia is reasonable.  Easy enough to get blood tests for syphilis and HIV at that time even though the risk is quite low.  No need for routine tests for herpes of hepatitis. 

Hope this helps. EWH

11 months ago
Helps alot.  Appreciate the quick answers and thorough-ness...(wait..is that a word? Lol)

Feel free to close the thread.