[Question #8127] STI Testing

48 months ago

Hi doctors!

my encounter is a bit confusing but i hope i could get some answers ..

I’m a female and i was dating a guy for about 2 months until i found out he cheated so i’m not sure if he had any sti’s or not.

we never had sex but our encounters were mainly just the penis rubbing on the opening of the vagina (with his precum). nothing more happened.

my questions are…

can i get any sti’s from this? we have done this about 5 times within a month and the last encounter was on June 20th. I got a chlamydia and gonorrhea urine test on June 25th which i understand may be too early to detect anything. i was experiencing a strong urine smell and frequent urination at the time i tested so i believe if i did have chlamydia or gonorrhea it would be positive right?

my biggest worry has always been hiv.. should i also get an hiv test? i spoke to a sexual health chat and they told me an hiv test is not needed but i would like to be sure.

i am also not experiencing any symptoms at the moment.

Thank you!

H. Hunter Handsfield, MD

48 months ago

Welcome to the forum. I'm happy to help.

Your STI/HIV risk from the events described is very low, and effectively zero for some, including HIV. First let's address HIV. Assuming your former partner doesn't have sex with men and is not an injection drug user, the chance he has HIV is nearly zero; and without penetration with ejaculation, the risk was exceedingly low (or truly zero) even if he had it. So I agree with the sexual health counselor you spoke with and do not recommend testing, at least not from a medical/risk standpoint. That said, many or most people anxious enough to seek such advice probably benefit from testing anyway: if you're typical, you're likely to keep worrying and wondering until you have had a negative test result. Enough time has passed for a conclusive antigen-antibody (AgAb, 4th generation) HIV blood test. You might sleep better after a negative result. (This does not imply I believe you actually were at risk. I do not. If you test, it is strictly for reassurance.)

Gonorrhea/chlamydia: Little risk, but not zero. However, your negative test results already are conclusive. I don't know what source you found, but 4 days is plenty of time for conclusive results on a vaginal swab or urine test. So you can dismiss these STIs.

Trichomonas? Conceivably, but probably zero risk. However, you could have a trich PCR test on a vaginal swab or urine. I don't really recommend it, especially in absence of symptoms like vaginal discharge. And by the way, I would discount your urine odor, which is not a sign of any STI.

You could have been at risk for those STIs transmitted primarily by skin-to-skin or genital contact without penetration, i.e. syphilis, herpes and HPV. Syphilis: Almost as rare as HIV in this situation. On the other hand, if you have an HIV blood test, consider including a syphilis test. You can expect a negative result. Herpes? Not likely in absence of symptoms (genital blisters, sores, etc). HPV? As a sexually active person, undoubtedly you have been infected with HPV before now (90% of all people acquire genital HPV at least once, often several times), and these events didn't raise your chance of infection significantly further.

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

HHH, MD

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48 months ago

thank you dr H!

So from your perspective i don’t really need any testing at this point? I will take a test for everything just for reassurance in september but your advice did help a lot.

another reason why i think i may have something is because he was reluctant in taking an sti test and has also never taken an sti test in his life even though he’s very sexually active.

I know HIV is hard to get this way but i just want to make sure i don’t need to test at the 3 month to 6 month period right?

thank you!

48 months ago

Hi dr H.

Sorry to bother again i was just wondering if you missed my last reply by mistake,

Thank you

H. Hunter Handsfield, MD

48 months ago

My apologies. I'm not sure how I missed this. So sorry.

I agree that your partner's reticence about testing is not reassuring; and it sounds like he is quite naive (even clueless!) about STIs, and that this may imply increased risk. I would suggest you be tested for gonorrhea and chlamydia -- ideally by vaginal swab, alternatively with a urine test. Also blood tests for syphilis and HIV -- not because the risk is high (it's very low!), but because the negative results likely would be very reassuring. The chance of HIV in particular is microscopic, but you'll sleep better knowing for sure.

Nobody ever needs to test for HIV beyond 6 weeks. Three or 6 months is old news, going back to older HIV tests now little used. A standard antigen-antibody (AgAb, "4th generation", "combo") blood test at 6 weeks is 100% conclusive. But don't be nervous as you wait for that time: you can count on a negative result.

Apologies again for the delayed reply!

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48 months ago

hi dr. H,

its no problem, thank you for your reply

I just want be clear about one more thing-

in the first reply you said i don’t need any more gono or chlamydia testing but you suggested i get tested for them in your second reply so should i just get tested for them regardless ?

thank you for your help!

H. Hunter Handsfield, MD

48 months ago

In my last reply I forgot you had already been tested and negative; I didn't mean to imply you should be tested again. (And that reply confirmed your test was long enough after the event for conclusive results.)

That completes the two follow-up exchanges included with each question and so ends this thread, which shortly will be closed. I hope the discussion has been useful. Best wishes and stay safe.

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