about 2.5 years ago i found myself in a massage setting.   the masseuse licked my scrotum for a minute or two.  

i was unsettled about the possibility of syphilis exposure and was unclear if any possible risk of that was possible due to this exposure. 

my thoughts raced and. i used the opportunity to test for syphilis 2-3 weeks later which was negative.   i also had 3 4th generation alere determine ag/ab blood finger prick tests done 6,7 and 35 weeks later as realized i had not done hiv testing in many years.  all were negative. 

i have not had any such exposures since. zero. 

i was at ease until the other day i read that the syohilis test was done too soon.  

additionally, this year i has two dosages of antiobiotic regiments for other issues.  five days of amoxicillin and 7 days of augmentin, about 2 months apart.  

given my exposure of concern and these medications a few years later, do i need to have another syphilis test?

could i have even gotten syphilis given no penetration of my penis into her mouth vagina or anus occurred?   and would the augmentin have killed the syphilis if i had it?

and as far as the hiv tests are concerned, regardless of any previous exposures, are they final and conclusive?

thank you 

This was a zero risk event in regard to syphilis (and for any HIV or any other STI). Mouth/tongue contact with intact skin anywhere on the body is entirely safe. In addition, the statistical chance such partner has active (transmissible) HIV or syphilis is extremely low anyway. Had you asked at the time, I would have advised against testing for syphilis, HIV, or anything else. 

True the syphilis blood test was done too early to be conclusive. However, you also apparently had no chancre (syphilitic sore) at the site(s) of exposure, which itself is good evidence you weren't infected. And yes, if you happened to have had syphilis, the amoxicillin and augmenting treatments would have eradicated it. If you would like confirmation beyond my professional advice, feel free to have a syphilis blood test now. A negative result will prove you do not have it now and never did. (If somehow you had acquired syphilis 2+ years ago, the antibiotics would have cured it -- but would have left you with a positive blood test. So a negative test now will prove you never had it.)

Your first two HIV test results were conclusive, and confirmed by the (unnecessary) additional test at 35 weeks.

I think those comments cover all your questions. Let me know if anything isn't clear.

HHH, MD

just an academic follow up if you will:

id rather not test again — i’ve read that being covid vaccinated could produce false positives which even if follow up tests dismiss would send me into an unnecessary anxiety loop.  

so based on your professional opinions, given the no risk event, the syphilis and hiv tests, and the antibiotics i took, i can safely conclude i dont have either hiv or syohilis, and that an additional syphilis (or hiv test for that matter) would be over testing and completely not warranted from a medical standpoint?

thank you 

thanks for the answers.  

given that she does not engage her mouth with my scrotum, that seems wildly unlikely?

anyway sorry for the additional questions just want to get it all out there and answer per the forum purposes!

As I said, there was zero risk of syphilis from the massage worker licking your scrotum. I already said your "...syphilis blood test was done too early to be conclusive." However, if somehow you had acquired syphilis, you would have developed an open sore (chancre) at the site of tongue contact. And indeed the antibiotics you took later would have eradicated it.

All things considered, there is simply no chance you had syphilis or could have infected your wife. Do your best to move on with no further concern about all this! 

That completes the two follow-up exchanges normally included with each question, and this thread normally would be closed. However, having taken all the extra time to reply, I'll leave it open for 2-3 days in case there are any final clarifications you may need.

to clarify one last thing about the rapid 4th gen blood hiv tests i took - alere hiv combo i think it was called.  

the three tests i took would not miss any infection regardless of how long previous to the tests my old exposures were many years ago?

the three negative tests prove i don’t have and never had an hiv infection?

this might be a silly question i don’t know?

and thank you for the replies.   i forgot to add that thanks.  

So all is well -- you can move on without further worry.

Thanks for the thanks. I'm glad to have helped. Stay well.

sorry to be clear about my last question; the hiv tests i took were called alere determine hiv combo rapid finger stick 4th gen ag/ab not alere hiv combo as i incorrectly said. 

the alere determine tests i took prove no hiv infection ever regardless of how long ago exposures were?

also i had asked if they ever miss infections?

i won’t have further questions on this matter but just wanted to get the specific answers thanks!

My reply:  This additional question really was unnecessary. AgAb = combo = duo = 4th generation --  all different terms for the same thing. The finger stick AgAb tests are as accurate as the lab based tests. Please re-read my previous replies, which clearly say that theses tests do not miss any infections beyond 6 weeks after exposure.

I'll post this reply in your previous (closed) thread and then have this question deleted, with reimbursement of your posting fee.

Best wishes and stay safe.