[Question #9997] STD scare, please advise

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26 months ago
Hello doctors. First off thank you for your service on this site. I (male 31 y/o) had protected sex with a massage worker (female in her 30s)
The condom was put on with her mouth and we had quick oral & vaginal sex. No breakage / slippage occurred. After the incident I was having anxiety/thought I had symptoms (fever, diarrhea, body aches, etc.) so I got tested at 5 days for all STDs (duo HIV neg + all others neg), tested at 12 days for all STDs (HIV RNA neg + all others neg), tested at 28 days for all STDs (duo HIV neg + all others neg). Just want clarity on the below:
1. From what I read, a neg HIV RNA at day 12 + neg Duo test at day 28 is conclusive, right?
2. Syphilis has been my bigger fear recently. I haven’t seen a chancre but they can go unnoticed. No rash or anything yet but that can take some time. Was my exposure high risk for syphilis?
3. All other STDs came back negative (gonorrhea, chlamydia , HSV1&2, all HEPs) for all tests. Should those be deemed “conclusive”? I did not test for Trich, do you think that is necessary?
The answers to the above will really help ease my anxiety and allow me to continue sexual encounters without the fear of spreading anything. Thank you again!
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Edward W. Hook M.D.
26 months ago
Welcome to our Forum and thanks for your questions.  Congratulations as well on your practice of condom-protected sex.  It will do much to protect you from STIs, including HIV.  In reply to you2 specific questions:

1.  Correct.  You have proven that you did not acquire HIV from the exposure you described.  There is no reason for further testing.

2.  The exposure was very low risk for syphilis.  Overall syphilis is a relatively uncommon STI and most commercial sex workers to not have syphilis, nor do most single exposures (even unprotected exposures) result in infection.  Further, at this time, more than 60% of all syphilis is occurring among men who have sex with other men.  Finally, your use of a condom and the absence of any lesions which would have occurred by now if you had acquired syphilis provide assurance that you did not get syphilis.  I would not worry about syphilis further. 

3.  Your gonorrhea and chlamydial tests are absolutely conclusive,  The absence of lesions, your negative tests, and the low risk nature of the exposure make is most unlikely that you have acquired HSV and hepatitis is not really a concern.  I see no need for further testing, including testing for trichomoniasis.

I would not worry further and see no medical or scientific reason for additional testing.  Time for you to put any concerns you might have about the encounter you describe behind you.  EWH

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26 months ago
Thank you so much for your reply Dr. Hook, it is very reassuring to hear all of that from you. I do have a few follow ups.

1. Post all testing I have had continuous stomach growling/some muscle & joint weakness/tingles in my hands and feet. I know that some of these symptoms can be tied to STDs but it is most likely due to anxiety, stress, or another unrelated illness, is my assumption correct?

2. I wasn’t able to mention this in the original question but I believe I had HPV at some point and time. Would that increase the chances of me getting one of the STDs I listed in my original message and if that’s the case would you then consider to get tested further for anything else?

3. I did have sex with a woman during the time that I was testing for everything and my concern is that I gave this person something. They are experiencing fatigue, weakness, stiff neck (no fever/rashes). Should there be any concern that I have passed anything to her? Or are these symptoms related to something else as I tested negative. Just want to be certain.

Thank you again!
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Edward W. Hook M.D.
26 months ago
1.  Correct.  I would not associate these symptoms with an STI and, as you suggest, anxiety would be higher on the list,
2.  Most sexually active 31 year only men will have had HPV at some point in the past unless they have received the HPV vaccine.  Over 80% of sexually active unvaccinated persons will have had HPV. The presence of HPV would not be expected to change your susceptibility to other STIs.
3.  Negative tests mean that you would not be infectious to others. The symptoms you describe are quite non-specific,  If these symptoms persist or worsen she should see her own health care provider for evaluation.

Hope this helps.  EWH
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26 months ago
Thank you doctor, you have answered all of my question and you have really helped ease my mind. I appreciate the prompt replies as well. 

I will trust the results that I received from my tests and will not move forward with any more testing based on our conversation & the fact that my exposure was relatively low risk for all STDs.

Again, thank you for your service. The information you are making available to the general public is such a great resource and really helps with informing users of what they need to know about STDs. 

Appreciate all of your help again and hope you have a nice day.
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Edward W. Hook M.D.
26 months ago
Thanks for your thanks. It is gratifying that we are able to help.  I'll be closing this thread shortly.   Take care.  EWH---