I hate that my anxiety is continuing over my last low risk oral exposure. I’m just simply terrified. I’m sorry to be back!

Backstory: Oral exposure July 15, 2022, 2-3 min, no ejaculation (maybe precum), no visible sores or rashes on penis, 23 y/o heterosexual male. I’m a 20 y/o female. HIV test 4th gen at 32 days post exposure (negative), syphilis EIA negative at 32 days, HIV rapid Alere test at 8 weeks, negative. 

I’m now awaiting another syphilis test result because of the one potential syphilitic sore in my mouth a few weeks ago, the anxiety is killing me. I’m terrified if it is positive that I will have to retest for HIV with a fourth gen vein lab test. I absolutely hate testing for HIV.

& I read that syphilis positive patients should also be screened for HIV (because of false positives or just coinfections, etc.). I don’t want to go through that again right now. Do i HAVE to retest for HIV if my syphilis result comes out positive? :(

Sorry again for being so chaotic. This service has helped a lot but the mind is a terrible place sometimes. Thank you.

I first noticed it around 12 pm on Monday, and by 12 PM Wednesday it was almost completely gone with no treatment.

Have you thought of contacting your partner and asking him to be tested for HIV and syphilis? Maybe you would find he is just as worried about the event as you are, and would appreciate knowing that you have tested negative. If both of you have negative tests now, it will prove neither of you could have infected the other with either infection.

I remain confident that any and all additional tests you have -- either those pending or ones you might do in the future -- will remain negative. Do you "have to test" for HIV again if you have a positive syphilis blood test? First, there's under one chance in a million that you have syphilis or that a test result will be positive. Second, given the nature of your exposure, you do not (and did not) need HIV testing at all, so you certainly do not need another one. But that's up to you:  some people are perfectly happy with a reasoned, science based reply, but others need the additional reassurance of a negative test result. Only you can decide what to do.

Whatever you decide, please don't worry about false positive test results. If you were going to have that result, it would already have happened with the tests already done. This certainly is no reason to avoid additional tests. If you test, just have another AgAb (4th generation) lab-based test for HIV when you reach 6 weeks after the exposure; and perhaps another syphilis test a few weeks after that. (By the way, I have no patience with not testing for fear of the result. It is entirely clear that when people delay testing -- whether for HIV, or mammograms, or other screening for serious health problems-- anxiety declines once testing is done, even if the result is the feared one. Anxiety over testing always is worse than the fears that result from bad news. And in your case, there is no chance of positive results anyway.)

I hope these comments help you relax a bit. All this is a big nothing burger!

HHH, MD