I had an encounter with a female sex worker (Russian descent) in the US, STD status unknown.  It was protected vaginal sex, protected felatio (which I thought was a good sign of someone who was acting safely) and unprotected cunnilingus.  

Nervous after the fact, I tested for HIV, Syphilis, Chlamydia and Gonorrhoeae at 13 days.  I know the HIV test was too early but since the new tests detect antigen I thought no harm.  At 13 days all test results negative.  Then I re-tested for HIV with HIV AG/AB CMIA test at 30 days and one at 43.5 days, both negative.

So my questions:

Is my last HIV test at 43.5 days considered conclusive?  I know I am 1.5 days short of CDC guidelines.  Do I need another test?

Are my other test results from 13 days sufficient?  I think Syphilis was too soon.  Are you concerned about that and should I re-test?  No known symptons except some I do feel some small raised bumps on bottom of under lips recently but I don't know if its my mind getting the best of me.  Exposure was over 3 months ago at this point.  Would other symptons have appeared for Syphilis by now, etc.

OK thats it.  Many, many thanks for your help and look forward to your feedback.

You really needn't worry:  there is virtually no chance you caught HIV or the other STDs mentioned. First, statistically it is unlikely your partner has HIV; it sounds like she is knowledgeable and health-conscious. Second, a condom was used for vaginal sex, and even for fellatio:  good moves! As for cunnilingus, there has never been a scientifically validated case of HIV transmission. The risk also is low for all other STDs.

HIV first:  Had you asked ahead of time, I would have advised you don't even need HIV testing, except for the expected reassurance of a negative result. In any case, your HIV AgAb (antigen-antibody, 4th generation) blood test results are conclusive. It is true that it was a day short of the recommended 45 days -- but this really isn't all that precise a figure, despite CDC advice. On this forum we round it down to 6 weeks (42 days) because that interval is just as reliable for all practical purposes.

Other STDs:  Urine gonorrhea/chlamydia tests are valid any time more than 4-5 days after exposure, so your negative result at 13 days shows for sure you weren't infected. You are correct that your syphilis blood tests take a lot longer than 13 days for conclusive results. The precise interval isn't clear -- the modern syphilis era can be said to be 120 years in duration, but there have never been precise studies on time to conclusive blood test results, especially in people without symptoms or with the latest tests. Six weeks probably is nearly conclusive, but some experts estimate up to three months. On the other hand, this was just about as low risk for syphilis as it was for HIV. And yes, if you had acquired syphilis you probably would have developed obvious symptoms, namely a chancre (syphilitic sore) at a site of exposure, i.e. your mouth or perhaps upper penis, above the limit of the condom. So you could have another blood test at any time. If somehow I were in your situation, I wouldn't feel the need and would be continuing unprotected sex with my wife without worry. But feel free if you remain a bit worried about it.

So at this point, you are home free, unless you decide to have another syphilis test.

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

HHH, MD

That winds up this thread. Stay mellow while you await the test result. I hope the discussion has been helpful. Best wishes and stay safe.