[Question #7865] chlamydia / gonorrhea

51 months ago

Back in Aug 2020 i had one an encounter of protected sex and a unpro BJ. In Oct 2020 i had protected sex with another individual. Prior to all of this i was rub n tug only. During the Oct 2020 intercourse session, i got sweaty and she wet, which caused condom to slide upwards to the point where i had to keep yanking it back down for it to not slip off inside. Eventually i pulled it off and changed it to a new one and completed. The lady told me a week later she got diagnosed with bacterial vaginosis. I'm assuming she did a panel, but when asked about Trich she said no, making me suspect. She was in the health care industry, a nurse. I got tested immediately and passed. However, later on i learned that the DNA test i took for the Chlam/Gon stated i needed to wait an hour to pee. Unfortunately, when i arrived at the UC I immediately peed, giving only 20 to 30 minutes later to pee again for the test itself. This has made my doubt the results. So I have had no sex with my wife until about April of 2021, 6 months later. Now, today, 5/15/2021, my spouse mentioned UTI symptoms causing me to have anxiety after learning about the amount of undiagnosed cases of STI being mistaken for UTI. I will get tested again today, but if i'm negative (i will hold the urine the proper amt of time) would that clear her of not having? Maybe That she could have gotten it from me back in April and i would have cleared it by now and her not? Now, Her last record of having an STI check is about 2018 when spotting led a lab false pos of trich later confirmed at her OBGYN. I got tested via swab back then as well since I was made suspect frivously and was negative for all. Today, Do i need to tell her to have the urgent care check for STI when she goes today for the UTI symptom, possibly opening up a can of worms unnecessarily? Regardless of how my results were to come back from my test i will do myself privately at an urgent care, just want to know the real risk before admitting something unes

H. Hunter Handsfield, MD

51 months ago

Welcome to the forum. Thanks for your confidence in our services.

The quick reply is that you can be sure you hae no STI for which you were tested, including both gonorrhea and chlamydia. Here are the details:

First, the exposures described were little or no risk: oral sex is low risk for all STIs, and condoms work -- even in the circumstances you describe. Second, diagnosis of BV in a woman is not alarming -- she did not catch it from you. (I don't know how to interpret your comment about trichomonas. What made you "suspect" when you asked about it?) Third, your test results were entirely valid. Although official instructions are to wait 1-2 hr after voiding, it in fact makes no difference in test accuracy or reliability. (When the gonorrhea/chlamydia tests were studied, the research protocol had patients wait that long, and therefore it became standard procedure and recommendations. But 20+ years of clinical experience has shown time since last urination makes no difference.) Fourth, if you had gonorrhea for sure you would have had symptoms, since asymtpomatic infection is exceedingly rare; and most males with chlamydia also would notice it, so absence of symptoms is solid reassurance. Finally, if you had acquired either infection 9-7 months ago, your immune system would have cleared it by now.

Finally, your wife's symptoms: It is true that some UTI symptoms overlap with those of gonorrhea and chlamydia. But this is uncommon, and when it happens, usually the UTI symptoms (e.g. urinary urgency, frequency, and painful voiding)a are also accompanied by more typical symptos like vaginal discharge. UTIs are common in women in general, and typical symptoms almost always indicate true UTI, not an STI.

So at this point, I see no need to say anything at all to your wife about your past sexual exposures. I am very confident she could not have acquired any infection from you on account of those events; and she need not be evaluated for STIs unless she is otherwise at risk. (It's common to take a sexual history and or test for STI in women with UTI, so maybe the urgent care will go that route. But you not worry about it or mention anything, especially if she is diagnosed with a standard UTI. I also recommend against you being tested again for any STI.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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