Thank-you for previously answering question #9527 It helped to reduce my anxiety quite a bit and I am hopeful that some further questions help clarify a few things. I can appreciate some of the questions are somewhat anxiety driven and I apologize for that. I wanted to add a little bit more information as I forgot to mention a couple of things and wanted to ask a couple more questions. I could not seem to access my other account so posted here.

Approximately 5 years ago (Before testing for Syphillis, HIV, Hepatitis Ghonnorea and Chlamydia I had two experiences where I had sex with an unregistered sex worker and the condom broke. Does this change any need for testing (I had blood and urine tests twice since then) which were negative for the above? 

I gave cunnilingus to a woman after another man had ejaculated inside her approximately 4-5 years ago (have not had pharyngeal testing but as previously mentioned have had urogenital testing twice) does this change the need for any testing? 

Approximately 12 months ago with one of the mutual masturbation encounters I had with a transexual (male with a penis) rub their shaft against mine for approximately 1-2 minutes there was no direct contact with the urethra. She/He also pressed her bare penis against my anus for about 20 seconds, did not insert I told them not too. I do not recall any lesions on their penis. Does this change the need for testing?

Approximately 10 months ago my partner advised that she had a sore throat 24 hours after giving an unprotected blowjob, it lasted for a couple of days and went away with antibiotics. Could this have been from an STI? 

I have used this rapid test twice for syphillis which was negative. Is this rapid test accurate at all? Can I safely rule it out. I have had no noticeable rash https://www.jalmedical.com/icare-syphilis-rapid-screen-test/

I am not sure I have ever been tested for Trich or Mycoplasma genitalium . Do I need to be tested? 

That said, I reviewed your previous discussion with Dr. Hook and agree with all he said. I also agree with your self-assessment that these questions likely are primarily anxiety driven. And although Dr. Hook may not have said so explicitly, most STDs never last more than a few months. Chlamydia, gonorrhea, Mycoplasma genitalium infections, trichomoniasis, and nongonococcal urethritis (NGU) all are eradicated by the immune system within a few weeks or months; persistence for years never happens. (Maybe very rarely for chlamydia in women, but even here the longest reported persistent infection was 4 years, and usually it's gone within a year.) Even if you had never received any antibiotics at all, it would not be possible for you or your partner to now be infected from exposures all those years ago. And although syphilis persists if untreated, you had several treatments that would have eradicated syphilis if you had ever had it.  Finally, all your negative tests prove you were not infected.

Those comments pretty well cover these particular infections, except for the opening one about chlamydia. There are few data on roxithromycin for chlamydia. It was deemed to have too many side effects in early research to allow its production in the US, where it is not available. I'm surprised to hear it is used in Australia. However, other drugs of the same class (erythromycin, azithromycin) are active against chlamydia and probably would have eradicated chlamydia if you ever had it. But as I also said, this really doesn't matter:  no male has ever been documented (or suspected) to have carried chlamydia more than several months. That fact plus your negative test results should be 100% reassuring. You can move on without further worry about it.

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

HHH, MD

"Approximately 5 years ago..."  Nope; these issues change nothing in Dr. Hook's replies or mine.

"I gave cunnilingus..."  Oral-vaginal contact is very low risk for all STDs; this also does not change our replies or your zero risk of any active infection.

"Approximately 10 months ago..."  No, not possible. Anyway, sore throat is almost never an STD symptom; and of course common upper respiratory viruses account for >99.9 of al sore throats.

Negative syphilis rapid tests done more than a few weeks after the last possible exposure are 100% conclusive proof that the tested person never had syphilis.

No genital blisters is good evidence, although not proof, that you do not have genital herpes.

Asymptomatic males never are tested for either trichomonas or M. genitalium; and as I said above, neither of these would persist this long, even without treatment.

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