[Question #7230] STD testing windows

6 months ago
Hi, I am a middle aged male with genital herpes.  
On 11/18/19 I had sex with a woman and she bled everywhere b/c she was at the end of her period.  We used a condom.  But the blood covered parts of me that weren't covered by a condom.  I didn't notice any cuts on myself or anything. I was tested for all STDs  2 days later on 11/20/19 and all were negative.

Then, around 12/15/19 I had sex again with the same woman and the condom broke.  No blood this time but the condom broke where a lesion used to be/or was healing for my genital herpes.  I was trying to insert my penis into her from behind.  She said I was not in her when the condom broke.  

I was tested for all STDs on 12/23/19 and all came back negative.  I have since been tested for HIV in February and May and it was negative.

I am worried I caught something from her.  I have always used a condom with her and I have never had a symptoms of anything since.  No rashes or burning or anything.  

I did get a sick around 2/4/2020 but it was mostly congestion and my lymph nodes were swollen.  I had a CBC blood draw  and also a blood draw for mono and it came back normal.

Should I be worried I caught something from her?  Were the test done on 12/23 valid with the testing window?  She insisted she was clean and has been tested before we had sex.  I'm very nervous.




6 months ago
I should add on that 12/23/19 Testing date, I was only retested for RPR, ghonorea and clamydia and those were negative. I was mistaken and wasn’t tested for all STDs on that date.
Edward W. Hook M.D.
Edward W. Hook M.D.
6 months ago

Welcome to our Forum and thanks for your questions.  I'll be glad to comment.  Concerns about non-mucosal/skin exposure to menstrual blood or genital secretions are a common source of concern for out clients.  The good news however is that such exposures do not lead to infections.  The reasons for this are likely the fact that the sort of cells which forrn non-mucosal/skin are quite different than the cells of mucosal surfaces where virtually all sexually acquired HIV, as well as other STIs are acquired.  Thus your November encounter was a no risk event, even if your partner did happen to have HIV (very unlikely unless there was something you did not say) or other STIs. 

Obviously, your condom mishap in December did pose a risk if your partner happened to be infected.  FYI, condoms do break about 1% of the time with breakage being more slightly likely with new partners or rectal sex.  Even without these factors however condoms do fail slightly less than 1% of the time.  The presence of a healing HSV lesion does not markedly change your risk for infection.  Your 12/23 testing conclusively proved that you did not acquire gonorrhea or chlamydia.  Eight days after the exposure was a bit earlier in terms of ruling out the unlikely possibilities of syphilis and HIV.  Syphilis blood tests are reliable after 4-6 weeks and HIV test results are conclusive at 6 weeks after an exposure.  As I said above however both syphilis and HIV are far, far less common than chlamydia or gonorrhea and statistically it is unlikely that you were exposed.

My guess is that you did not acquire any STI from the exposure you describe.  Your partner states she was tested and most people tell the truth.  Further, even most exposures to infected partners do not lead to infection.  If you want to be 100% sure that you were not infected with HIV or syphilis, repeat testing is reasonable.  The only other STI for which there is any realistic reason for concern about is trichomonas which can readily be tested for using a urine test and, like the other potential infections, is unlikely. 

I hope these comments are helpful. EWH

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6 months ago
Thank you for responding. I appreciate it.  When I said sex from behind I attempted “doggie style” vaginal sex but she said I wasn’t inside her when the condom popped.

You don’t think my slight illness in February had anything to do with it?  I just felt slightly congested and swollen lymph nodes in my neck but CBC blood work cane back ok. 

I’ve had an HIV test since then and that was negative. 

I was worried about hep B or C, ghonorrea, clamydia and syphillis.  

We did have protected sex one time after the testing in December but that was standard with no mishaps. 

So I shouldn’t worry? 
6 months ago
One more thing I forgot to mention. I noticed a red rash, non painful on my scrotum only. My dr prescribed me levofloxacin 500mg. But she didn’t think it was herpes related. Could that be an STD?
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
Thanks for the clarification on your condo mishap. My overall assessment however has not changed. You’re at this time it is most unlikely that you have acquired any STI for your encounters with this partner. 

Your February illness is unlikely to be related to any STI. That is too late to be the early syndrome associated with HIV infection and too late for most STI’s. My guess is that it was likely one of the run of the mill viral infections that we are require from time to time. I hope you have recovered completely.

Regarding the STI’s you specifically ask about: Hepatitis C is not sexually transmitted. Your tests for gonorrhea and chlamydia are conclusive. While both Syphilis and HIV are unlikely, as I mentioned above if you want to be absolutely sure you would need another test.

 Scrotal rash would be an unlikely manifestation of any STI as well. If I were you, I would move forward and not worry further. I hope my comments are helpful to you. EWH
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5 months ago
A couple more questions hypothetically 

If I do have clamydia or ghonorrea or syphillis and I perform oral sex on a woman would she be able to get it from my mouth on her vagina?

Thanks for answering my questions. Hep B I shouldn’t worry about either? So overall I can move on and not worry?
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago

Theoretically, if you have oral gonorrhea, chlamydia or syphilis you could transmit it through oral sex but only if you have oral infection.  Even then, transmission would be a rare event- remember, most exposures to infectious diseases, even STIs do not lead to infection.

If you have not been vaccinate for hepatitis B there is a theoretical risk of sexual acquisition of infection if exposed but this is quite rare. 

This is my 3rd response to your questions.  Thus, as per Forum guidelines, this thread will be closed shortly without further replies.  EWH

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5 months ago
Thank you very much so my likelyhood of getting anything from these encounters are quite low and shouldn’t worry correct? I know the story might have been hard to follow lol thanks!!
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
Correct.---