I was exposed to Syphilis, And Im worried about HIV now.

I am a 22 y/o gay male In Canada.
On Sept 24 at a local gay bar I met a 29 y/o Bi guy. Before I agreed to go home with him I asked him if he was clean and he reassured me that he was.  
We used condoms and I was bottom.  The condom broke he told me that he felt the condom snap. He put another one on and continued.  We also did  oral sex on each other. what if he ejaculated in the first condom before it broke? I was beyond drunk that night therefor I don’t remember much I’m also scared that he didn’t even put a second condom on.
After 23 days he got tested.  He told me that he tested positive for syphilis and apologised. He says his HIV test was negative but I’m having a hard time believing him
I went in at 4 wks I had a Combo HIV 1 HIV 2/ P24 Antigen test.  I also notified the nurses about my syphilis exposure they prescribed me 100 Mg of Doxycline twice a day for 7 days she asked me if I had any sores which I didn’t. Apparently he says that he had the sore under his tongue which he thought was cancer.
Anyways so a few days later I got my results and I was negative for Hiv syphilis and all the other stds. The nurse however told me its not for sure.  
1) How likely was it that I got syphilis With a negative test at 4 weeks? Also if the syphilis was incubating would the Doxycline have aborted it? Or just cured it?
2) I read that the recommended dosage for doxycline is 2 weeks 100 mg twice a day. They only gave me a dosage of  100 Mg twice a day for 1 week. This has me worried.  What if the Doxy doesn’t work what do you recommend as an alternative Im allergic to penicillin.
3) What are the odds that I contracted HIV from this exposure? How accurate is my HIV COMBO test the doctor said nothing is conclusive till 3 month.
4) What do you recommend as a professional at this point ?
5) Also Today I went in for my 51 day they did another HIV combo test as well as a syphilis test.  The results don’t come back for a few days.  I'm petrified!

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to work through them question by question.

1) How likely was it that I got syphilis With a negative test at 4 weeks? Also if the syphilis was incubating would the Doxycline have aborted it? Or just cured it?

You were exposed to syphilis.  Seven days of doxycycline is a recommended therapy following exposure to an infected partner.   If you took all the medication, that should take care of things.  

2) I read that the recommended dosage for doxycline is 2 weeks 100 mg twice a day. They only gave me a dosage of  100 Mg twice a day for 1 week. This has me worried.  What if the Doxy doesn’t work what do you recommend as an alternative Im allergic to penicillin.

The 2 week course of therapy is for treatment of established infection. There was no evidence that you had established syphilis, thus the therapy you received will suffice and further therapy is not needed.

3) What are the odds that I contracted HIV from this exposure? How accurate is my HIV COMBO test the doctor said nothing is conclusive till 3 month.

An HIV combo test at 4 weeks is definitive.  You did not get syphilis from the exposure you described.

4) What do you recommend as a professional at this point ?

Your fine an do not require further therapy.

5) Also Today I went in for my 51 day they did another HIV combo test as well as a syphilis test.
See above.  I anticipate your tests will both be negative. When they are there is no need for further concern or for further testing

Hope these comments are helpful. EWH

[scaredaloot]

Hey doctor thank you so much for your quick response :) I really do appreciate your help as I was clueless to STD's up until this point. I'm still a tiny bit confused about a few things and I'd love to just clarify my questions.

With a 4 week negative test, Would the Doxycline have aborted syphilis?
Basically I'm worried I don't even want my blood to be tainted for life by syphilis and I read a few of your post that say that doxycline would abort it.

By the way on a side note, in the passed 7 weeks I've learned so much from you and Dr. HHH you are both remarkable people that have so much knowledge and patience at doing what you do. I feel like you have both taught me so much about STD's that now I am prepared to go through life with knowledge about them. I was clueless to STD's despite living in canada most of my life. I come from an Arabic conservative family (lol so imagine talking to them about GAY sex and my recent adventure!) haha. Thank you so much I really can't wait till this is all over and I can continue to move on with my life. Say hello to Dr. HHH from me :)

[scaredaloot]

Hello again, in reading back your question I also noticed that in question 3 you said that "you did not get syphilis from the exposure you described" did you mean HIV? also what is the likely hood that I had syphilis on a scale of 0 to a 100?

[Edward W Hook, MD]

You asked questions about both syphilis and HIV.  Both were answered.

Your HIV CoMBE test at 4 weeks is definitive and proves that you i not get HIV from the exposure you described.

Similalry, the 7 days of doxycycline is recommended therapy following exposure to syphilis.  It will have prevented syphilis, IF you were developing it. EWH

[scaredaloot]

I'm so glad to read this. It has been the most difficult 8 weeks that I've had to deal with in my whole life. I've been hearing conflicting reports from doctors and nurses that I've been dealing with and it seems that no one has a straight forward answer for me expect for you. When I went in on Monday to do my second blood tests the doctor said that he would not rule out Syphilis or HIV infection until at least 3 month (he said 6 month would be ideal for HIV testing). He even said that I might still be infected with syphilis despite treatment which has me so scared. I've been in a state of anxiousness and panic for the past 8 weeks and now its at its height because I'm waiting for the damn results.

On a side note: They offered me a hepatitis A vaccine, at the present I refused it because to be honest with you I don't really trust vaccines. I would like to hear your opinion on it and what you recommend (if i should take it or not).

Every time I have been having anxiety I come back and read your replies and it puts me at ease thank you so much!  

[Edward W Hook, MD]

I would have taken the vaccine,.. It is recommended for all adults.

Glad I could help.Take care. EWH

[scaredaloot]

Thanks for your quick replies. I will definitely be getting by hep a shot then.

What do you think about my doctors comments? are they something I should be concerned about?

[scaredaloot]

Hello.
I got my results today and as you predicted they were both negative!!!! i'm so greatful for your help thank you!

A few last things I PROMISE.
Am I in the clear?
what are the odds of getting hsv 2 from this type of exposure?
at 7 and a half weeks ive had no symptoms. Could I have missed them?

Thanks again so much!

[Edward W Hook, MD]

You can forget about syphilis at this time.

If you have not had an outbreak of herpes since the exposure, you did not get HSV either.

Similarly, you had a negative COMBO test at 4 weeks- you did not get HIV either.  

Time for us both to move on from here. This will be my last reply. EWH

[scaredaloot]

Thanks for your time and quick responses I really appreciate it. Now I just need to teach myself to move on from this. Take care :)