Question about risk and conclusiveness of tests

I am a male married heterosexual male. My wife is pregnant and I'm nervous of passing anything along to her or the unborn child. I want to confirm a few things for peace of mind.

4.5 weeks ago I got drunk and had a single encounter of unprotected vaginal sex with a female friend. She is in a monogamous relationship and informed me that she has been tested and was negative for hiv and other std's since she has been with anyone outside of her current partner. I have no reason not to believe her, though I haven't seen proof. I have not had symptoms other than a sore throat my doc attributed to allergies and/or reflex and a few things I attribute to anxiety.

At 4 weeks I did a urine test for Chlamydia and Gonorrhea, both negative. I did a blood test at the same time for HIV (antibody test), Hep Panel and Syphillis (syphilis). The blood results have been delayed, though they expect to have them tomorrow. Here are my questions:

1. The chlamydia and gonorrhea tests are 100% conclusive at this point, correct?
2. If my blood work all comes back negative at 4 weeks is the Syphillis (syphilis) conclusive at this point? What about the hep panel? I realize HIV is 90% likely to show up by 4 weeks, but even if this test is negative I plan to do another test at 6-8 weeks to confirm. And wondering if I need to do a follow-up on syphillis (syphilis) and hep as well.
3. My doctor told me an initial Herpes outbreak would have shown up by 4 weeks, so he did not test for that. Do you agree?
4. He also stated that he wasn't aware of a good test of HSV for men, so he did not test me for that. Is there a test I should do for this? Would I likely have seen genital warts by now if infected?
5. I do not believe I received or gave oral sex, however it is possible that also took place. Do you recommend testing for anything else orally?
6. Should I be concerned the blood test results is taking longer than expected? I'm worried I was told results would be ready today but they're not.

Thank you for your time.

[Edward W Hook, MD]

You had a single encounter with a low risk partner.  You know feel guilty an want reassurance that you do not have HIV or any other STD.  While there are no real absolutes, your risk from the exposure you describe is very, very small.  

For starters, your partner states she does not have other partners and states she has been checked and is negative, this is quite likely to be true.  In addition, following a single exposure, even if she did have an infection of some sort, the majority of exposures would not lead to transmission of infection (probabilities of transmission following a single organism vary by disease; for HIV the risk of infection from a single encounter with an infected partner is less than 1 in 1000 while for gonorrhea it is less than 1 in 3). Furthermore, a month after your single exposure you have not had symptoms and you have negative tests - you really should not be worrying about infection at this time and instead need to be working through the guilt associated with your actions.  

In response to your specific questions:
1.  Believe the tests, they are highly sensitive.
2.  Syphilis and hepatitis are rare infections in the U.S. and even more so amongst heterosexuals.  There is little risk to you of either disease an your tests will make it even less likely.  For syphilis a 4 week test is conclusive, for HIV 8 weeks and for hepatitis B, 12 weeks.  If the information you have given me above is accurate however, I would be willing to bet at his time that you did not get any of these infections.
3.   I do agree that there is no reason for testing for HSV.
4. I believe you mean HPV.  If so, there are no good/recommended tests.  Genital warts typically appear within a month although occasionally they can take longer- as long as 2-3 months.
5.  No.
6.  No, the labs sometimes take a while to get their results back and offices sometimes are delayed in providing results.  

I repeat, you really should not be worrying about infection at this time and instead need to be working through the guilt associated with your actions.   There is very, very little chance you got any STD from the encounter you describe.  EWH

[anon9876]

Thank you for your responses. In regards to number 4, yes I did mean HPV.

I have been feeling alot of guilt due to my actions and I can't disagree with your assessment. Thanks again for your time.