[Question #9653] STD

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30 months ago

I’m a 29 year old male. In 2014 I had active and passive anal sex with another man. I was scared and took PEP but no other STD tests besides HIV and syphilis (both negative) were done. It was the only anal experience in my life. About half a year later I felt anal itching and I was diagnosed with proctitis. no one told me to take and std test at this point. the itching stopped after a few months but the following year I had some bowel problems and  crohn‘s disease was suspected, but a colonoscopy was not conclusive. the symptoms stopped and I did not think about it anymore. 

because of testicle pain an urologist gave me a single dose of antibiotics (I guess aizthromycin?) in late 2014.

after that I did not engage in any sexual activity for a long time. since 2016 i’m in a relationship with a woman who i sleep with regularly. 

In june 2022 I had oral sex with a male. two weeks later I slept with my girlfriend. In early august I had another MSM encounter, where I received oral sex. 4 days later I had urethral discharge and went to an std clinic where blood tests and swabs for gonorrhea and chlamydia (pharyngeal, urethral and anal) were taken. all negative, but since there was inflammation I was diagnosed with NGU and took doxycycline for 7 days. in mid august i slept with my girlfriend again several times. over 6 weeks after the MSM oral encounter I retested for stds to be sure and was negative again. in january this year my girlfriend and I both took std tests which were negative, except I had positive IgG antibodies for chlamydia. I don’t know why they were taken. 

I have a few questions now:


  1. might what I had in 2014 have been LGV? if my anal (and all other) swabs in august last year were negative can I assume I don’t have chlamydia or LGV? Im really concerned LGV might not have been diagnosed back then and that it progressed over the years.
  2. I was so scared to have infected my girlfriend with some STD. but if all my tests were negative can i assume i didn’t? My concern was i might have gotten an std from the first oral msm encounter in june and passed it to her after two weeks, while it wasn’t detectable anymore in my urethra or pharynx in august when i took the std tests? is this possible? does an chlamydia or gonorrhea infection go away on its own in a few weeks?
  3. what should I do? can i ignore the IgG or what reasons are there for them to be elevated?


thank you for your help.

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Edward W. Hook M.D.
30 months ago
Welcome to our Forum and thanks for your questions.  I'll be glad to comment.  In the 9 years since your encounter in 2014you've had occasional unprotected exposures with a variety of partners which potentially put you at risk for acquisition of STIs.  For persons in you r situation, we do recommend periodic "screening" (testing in the absence of obvious symptoms) every six to 12 months just to assure your sexual heat\lth.  That said, what's done is done- yet this time, based on your negative tests for specimens collected at all sites of potential exposure, as well as your doxycycline treatment, you can be confident that you are STI free.  Many of your specific questions deal with past issues so I'll now address them"

  1. might what I had in 2014 have been LGV? if my anal (and all other) swabs in august last year were negative can I assume I don’t have chlamydia or LGV? Im really concerned LGV might not have been diagnosed back then and that it progressed over the years.REPLY-Indeed, rectal chlamydia (including LGV) can mimic crohn's disease and is sometimes misdiagnosed.  there is really no way to know wheter or not you had LGV back then.  Irrespective however, at this time you can be confident that you do not have LGV- if you did, your rectal swab would have been positive for chlamydia.
  2. I was so scared to have infected my girlfriend with some STD. but if all my tests were negative can i assume i didn’t? My concern was i might have gotten an std from the first oral msm encounter in june and passed it to her after two weeks, while it wasn’t detectable anymore in my urethra or pharynx in august when i took the std tests? is this possible? does an chlamydia or gonorrhea infection go away on its own in a few weeks?  Reply:  These infections can clear without therapy.  Best however to assume that you were not infected and did not infect her. 
  3. what should I do? can i ignore the IgG or what reasons are there for them to be elevated?  REPLY:  The antibody tests for chlamydia are unreiable and have little clinical value.  My advice is to believe your swab tests and move forward

I hoe that this information is helpful.  If any part of my answer is unclear or there are additional questions, please don't hesitate to use your up to 2 follow-ups for clarification.  EWH
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30 months ago
thanks a lot for your answer!
I do have a few followup questions:

1. so if my swab result says ”chlamydia trachomatis - negative“ it also means I don’t have LGV?
and even if I had it back then 9 years ago I can be sure it’s gone if the chlamydia swab is negative now? It can’t have left my rectum and moved to other parts of my body where no swabs can be taken?

2. So I should not worry about having infected my girlfriend? I guess if I had and slept with her several times ater infecting her I would have reinfected myself at some point, but since my latest results are negative again we should be fine?
she also got swabs taken, the only thing is it was a general practitioner who did it so it was taken from the vagina I think, not from the cervix like a gynecologist would do I guess. are those results still reliable? he also took an urethral swab and urine test from her.

3. I‘m also scared of developing anal cancer at some point from this one anal experience 9 years ago. What are the chances?

Thank you again. I would really like to be sure me and my girlfriend are STD free and move on with our lives.
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Edward W. Hook M.D.
30 months ago
1.  Yes.  LGV strains of chlamydia are detected with standard nucleic acid amplification tests for chlamydia.  If your test is negative, you do not have LGV.

2.  Correct, no need to worry.  In addition, vaginal swabs are now the preferred tests for testing women for gonorrhea, chlamydia and sometimes trichomonas.  They are easier to collect for patients and the results are equal to or perhaps slightly better than the results of cervical swab testing.

3.  I would not be worried about cancer (I presume you're worried about HPV) from a single encounter.  Just pursue regar should be vaccinated (in fact it's recommended whether or not your worried)

Time for you to move forward with confidence.  Take care.  EWH
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30 months ago
thanks a lot for your help!
I just have two more questions.

1. Is it possible to get genital warts from receiving oral sex? I found a tiny single little dot on the shaft of my penis, less than 1mm in size and white/yellowish in color. looks kind of like a pimple but it’s not. could this be a condyloma? 

2. Having taken Doxycycline for a week because of NGU in August can’t have made my syphilis test false negative in October and January, right?

Sorry I am asking so much, I just want to be sure I got out of those sexual encounters without contracting STDs and want to stay monogamous now.
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Edward W. Hook M.D.
30 months ago
Final responses:

1. Is it possible to get genital warts from receiving oral sex? I found a tiny single little dot on the shaft of my penis, less than 1mm in size and white/yellowish in color. looks kind of like a pimple but it’s not. could this be a condyloma? 
Genital warts as a result of receipt of oral sex are very rare.  The lesion you describe is sounds like nothing like HPV.  There are many non-STI lesions which may normally occur on the penis.  If you have concerns that this lesion as an STI (I am confident it is not), please see a dermatologist

2. Having taken Doxycycline for a week because of NGU in August can’t have made my syphilis test false negative in October and January, right?
Correct

This completes this thread.  I hope that the information I have provided will allow you to move forward without continuing concerns.  EWH
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