[Question #8407] Conclusive Tests
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45 months ago
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Looking for confirmation that my recent STI tests are conclusive so i can move on with my life. I am a straight male in a monogamous relationship for the last 13 years, I recently had a moment of weakness and had both unprotected oral(receiving and giving) and protected anal sex(giving) with a Transsexual female sex worker. This occured on 9/17/21 I had some STI testing done 2 weeks later on 10/1/21 Negative for Chlamydia, Gonorrhea, Syphilis and rapid HIV. Also had a oral swab done on 10/8/21 for Chlamydia and Gonorrhea both negative. At this point anxiety began to set in and i had a RNA HIV early detection test done on 10/4/21 this would have been 17 days after possible exposure also Negative results. Once again i found myself at the lab on day 41 for a 10 panel STI test(chlamydia, gonorrhea, Hep A,B and C, Herpes 1 and 2, HIV 4th gen and syphilis all negative besides HSV1 which is accurate ive had cold sores in the past. Unfortunately these negative results did not ease my anxiety and found myself having a HIV 4th gen test and Syphilis test done on day 62 one day short of 9 weeks. Once again both non reactive. A few questions for the doctors.
1. Are these tests conclusive? Any reason i should retest?
2. Why do i continue to read 12 weeks is conclusive for syphilis?
3. Is it possible for genital warts to appear 1 week after exposure?
Thank you for your time.
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H. Hunter Handsfield, MD
45 months ago
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Welcome to the forum. Thanks for your confidence in our services.
My first reaction is to congratulate you on having safe sex for the contact described. While your partner might indeed be high risk in terms of her own sexual lifestyle, condom use during anal sex with close to 100% protective against all STIs; and oral sex if low risk for all infections as well. A second factor is that absence of symptoms is pretty good evidence against many of the STIs you are concerned about. To your specific questions:
1. All these test results are conclusive, with the exception of HSV, for which conclusive results for HSV2 come at 12-16 weeks. (Blood tests are never conclusive for HSV1, since ~30% of infected people never develop positive results). However, absence of symptoms suggestive of herpes is itself strong evidence you weren't infected. If I were in your situation, I would not have had HSV testing at all and I do not recommend any further testing.
2. There have never been precise research on time to conclusive results with syphilis. However, most experts agree 6 weeks is plenty; I don't know of any agencies that routinely recommend waiting as long as 12 weeks. In any case, the combination of your negative result plus absence of a chancre (the sore of new syphilis) amounts to virtually 100% assurance you were not infected.
3. No. Warts cannot appear sooner than around 6 weeks, and they can appear many months -- perhaps up to a year -- after exposure. But getting and having genital HPV is a normal, expected consequence of sexuality and you can assume you and/or your regular partner are already carrying one or more strains of HPV. In the event you or your regular partner ever have warts or other HPV problem (e.g., abnormal Pap smear), it almost certainly would not be from this single event or even good reason to suspect it.
So all is well. I recommend against any further testing, and you can safely continue unprotected sex with your regular partner.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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45 months ago
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Thank you doctor for answering my questions and helping to put some of my stress at ease. Moving forward what do you recommend for anxiety and stress? It seems that whenever i feel a sore throat or just feeling under the weather my first reaction is to jump on line or go get tested.
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45 months ago
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Follow up to question about syphilis or possibly herpes right around day 24 i had a small red spot on my penis it didnt itch, wasn't painful, no oozing within a day or two it began to look like dry skin and on the 5th day the skin peeled off and penis was back to normal.
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H. Hunter Handsfield, MD
45 months ago
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No STI causes the sort of "small red spot" you describe. I am confident it isn't either herpes or syphilis and is unrelated to the sexual exposure described above.
I have no special advice about your anxiety and stress except to accept and believe the science and my clinical experience. But I hope that these will help, at least with thoughtful reflection and with the passage of time, when nothing else comes of this situation.
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44 months ago
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Hello Doctor ive been able to relax quite a bit and my anxiety has definitely decreased since you answered my previous questions. I believe i have one more follow up response so i might as well put it to good use. When it comes to herpes what type of risk was I in? Should i continue to look for signs of herpes? Ive read usually 3-12 days from exposure you will see symptoms but some people will not see any symptoms for months or years if not ever. Is that accurate?
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H. Hunter Handsfield, MD
44 months ago
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Having had oral herpes and a positive HSV1 antibody test, you are immune a new HSV1 infection, so that's not an issue. Conceivably your partner has genital HSV2, but that's uncommonly transmitted to the oral area; and the chance he was both infected and shedding virus from his penis is very low as well. I would put your herpes risk at zero, or close to it. Nothing to worry about, and I recommend against any further testing for HSV.
That concludes this thread. I'm happy to hear it has reduced your anxiety about the sexual event. Best wishes.
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