[Question #8732] Making a Change

40 months ago

Good Evening, Experts,

It has been well over two years since I have used this site. Recently, I accepted an invitation to serve in the Peace Corps, and the medical evaluation is tedious. I have not been screened for STDs since 2019 and I have had sex a total of six times, between February and May of 2021, with an NSA person. As with many individuals, I unprotected oral and protected intercourse.

The amount of testing feels invasive. I have to get a smear test to evaluate the possibility of HPV and cancer, however, I received the full series of Gardasil while in grad school. I will get the screening for HIV, Syphilis, Chlamydia, and Gonorrhea.

However, I was a little taken aback by the Peace Corps ' because I need additional testing for Hep B and Hep C, I have never been screened for this. Can you think of a reason why the Peace Corps may require this?

There is also a requirement to get screened for HSV I and II. My last negative test was in 2019. Because I did have sex a few times in 2021, it does make sense, however, I am curious if I am at high risk for HSV. I will say that I had some strange symptoms after I last had sex, I had irritated, itchy, and red labia majora. I never saw any type of bumps that would represent an outbreak. No real pain during urination, some itching. I thought it could be BV or Yeast because there was a slight fish smell. I remember using A&D ointment made it worse and I just started sleeping without undergarments and it got better after a couple of weeks. I did not go to the doctor because things were so backed up from Covid19. I do have an appointment next Monday. I am just blown away by the Peace Corps going so far with testing requirements. Keep me posted.

Edward W. Hook M.D.

40 months ago

Welcome to our form. Thanks for your questions. Thanks as well for your service through the Peace Corps.

I am not in a position to comment on the basis of the Peace Corps screening protocols however my guess is that the screaming that you will be undergoing reflects a generalized approach to screening persons entering Peace Corps. service. As a generalization, without any specific comments regarding you or your own behaviors, persons entering the Peace Corps tend to be relatively young and that’s such a risk at risk for a variety of STI‘s and other infections. Given the litigiousness world we live in, my suspicion is that Peace Corps screening protocols reflect a defensive posture on the part of the US government. From your history I see no reason for concern or any expectation that your test will be positive.

I suspect that this is simply another bureaucratic hoop which working for the government involves. At least that’s my interpretation.

I hope this perspective is helpful to you. Please don’t worry. There is no accusation involved here. EWH

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40 months ago

Good Evening,

What a whirlwind week of different types of testing. I have received my initial results for the following:

1) Treponema Pallidum AB, eia- non-reactive.

2) Urine test for Chlamydia and Gonorrhea-negative

3) Hepatitis B and C, non-reactive

4) HIV 1 & 2-Non-reactive

The pap smear results are not finalized. I did inquire with the NP in the obgyn office. She explained that results are taking longer because of a backlog. It will take a little more than two weeks. I was told not to become overwhelmed, this does not mean the results are bad. She said that the original Gardasil series I received in graduate school still offers protection and that I am much better off than I assume.

I was given a blood draw for HSV I & II. She reviewed my previous results and said that I am an outlier because most people have one type or another. I thought that comment was rude and condescending. Maybe she meant nothing by that comment, however, it was rude. I did explain my symptoms from May 2021. I had itchy, irritated, and red labia. She explained that it could have been BV, YEAST, HERPES I OR II, or Trich. I told her I still get the itchiness on the external labia, and from time to time, if it happens before I leave the country, I should go see her for a swap test. I am just awaiting both the HERPES SELECT and the smear results. Aside from that one comment, the NP was very helpful and down to earth. I will post final results when I can.

Edward W. Hook M.D.

40 months ago

Thanks for providing the follow up to your testing. I’m pleased for you that your tests were negative. This was good news. Please post your additional test results when you get them. There are nuances to both Pap smear/HPV testing and blood tests for HSV. EWH ---

40 months ago

Good Evening,

Per my smear test-mildly atypical cells were found, a pap is suggested in a year. No other feedback was given and I am WORRIED, this is my first smear with a result of this kind. I wanted to see if I could get a Gardisil booster at my age and if it would assist with possibly clearing a concerning infection. As I said, nothing was stated if it was HPV or any other infection. I would like to request an additional appointment as the vaginal irritation is still present. It does not feel like a yeast infection.

As this is my last chance to ask a question-Is there anything very concerning about my gyno health?

Here are my HSV results-

Component	Your value	Standard range
HSV 1 IGG, EIA	<0.90 Index
HSV 2 IGG, EIA	<0.90 Index
Hsv 1 IgM	Negative
HSV 2 IGM, QUAL	Negative

Edward W. Hook M.D.

40 months ago

Welcome back. Thanks for sharing your results. The presence of atypical cells on your PAP smear is not something to worry about. Atypical cells can result from a long list of benign processes and apparently there was no mention of HPV or HPV-related changes. Further, nothing bad in terms of HPV happens rapidly. Progression, when it occurs ( often atypical cells are seen once then go away on their own) typically takes years to occur. Thus repeating your PAP in the future as recommended is the right thing to do.

Your tests for herpes are entirely negative as well. You have no evidence of herpes.

Bottom line, you have nothing to worry about. Take care. Thanks for your service in the Peace Corps. EWH

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