STDs Expert Forum
Confused
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Confused

Hello Doctor,
I'm a heterosexual male in a serious long term relationship in the UK. I stupidly made an out of character mistake when extremely drunk a couple of months ago. My concerns largely stem from the fact that this one night stand of unprotected vaginal intercourse and fellatio was with a very recent immigrant from Africa to the UK. I was so drunk I don't remember where she was from but my concern was that she was from a high risk area. I have researched your site for answer so I fully expect some of your answers to the below questions to be yes/no.

- I have had a negative HIV duo test at 8 weeks post exposure. Can i take this as being conclusive that I do not have HIV? Would this be the same if anal sex was involved (i don't think it was I just can't remember because I was so drunk)
- I had bitten one of my finger nails so short that the next layer of skin was showing and may well have bled when fingering this girl. I also had a piece of skin next to my nail hanging off which would have meant there was a very small cut that also could well have bled when fingering this girl. My understanding is that this would have been no risk. Correct?
- I am extremely confused by the Hep B testing. I've had an antigen test at 8 weeks which was negative.  Does this mean I did not get Hep B from this encounter? I'm completely confused as NHS sites states a 3 month window period but I'm confused by the antigen and antibody testing. I know I've not been infected before and have never been vaccinated. I just want to be sure I wasn't infected from this encounter.
- Is my negative syphillis (syphilis) blood test at 8 weeks conclusive? I've been looking out for chancres and nothing appeared - would this be apparent on the head of my penis or could it be in the urethra where I wouldn't see?
- A negative swab for white blood cells after 2 weeks after this event would mean that I didn't pick up an NSU infection from this encounter?

Thanks Doctor
239123_tn?1267651214
Welcome to the forum.  Thanks for your question, and for reading other threads for preliminary answers to your questions.

1,2) The duo tests are definitive any time more than 4 weeks after the last possible exposure, regardless of high or low the risk was, like anal vs vaginal exposure, or a scratch.  Your negative result is conclusive.

3) As used to be common for HIV, lots of experts recommend an HBV antibody test at 3 months, even if an earlier antigen test is negative.  The odds of HBV transmission during any single exposure are very low; combining that fact with your negative antigen test at 8 weeks, it is exceedingly unlikely you were infected.  My personal professional advice is that you could safely forego the 3 month antibody test -- but you'll have to decide whether you'd like to do it anyway, since it's apparently the advice you have had at the GUM clinic (assuming that's where you picked up on the NHS recommendations).

4) Syphilis is extremely unlikely if you didn't have an obvious penile sore (the chancre) -- but in any case, 6 weeks is the time for definitive blood testing.  Your negative 8 week test is conclusive.

5) Yes, you can be confident you didn't acquire NGU (same thing as NSU, just different terminologies on opposite sides of the pond).

I hope this has been helpful.  Best wishes--  HHH, MD

4 Comments
Blank
Avatar_m_tn
Morning Doctor,
Thank you very, very much for the above responses. You've no idea how much stress they're relieved as I fell into the trap of trawling the net and tieing myself in knots. I have a couple of follow ups if you don't mind, I have searched your site for answers you may have given to others but couldn't find any so hopefully you're responses will be useful for other users in future:

1. Re. the conclusive Syphillis (syphilis) test, is the 6 week mark the definitive time no matter what blood testing was done - I don't know what the NHS would have used and from my research I understand there are several different tests - eg. EIA, IgC, IgM, RPR

2. The risk of HBV from any single exposure would be 'very low' even if the individual had HBV?

3. I've read that urine tests for the standard STIs (ghonnoreah, chlaymdia etc) are most accurate with a 'First Void of the day' sample. However, I have a very active bladder and really struggle to hold my urine through the night. Is there any measurable difference in accuracy between holding your urine for 8 hours or just 3. eg. If I last urinated at 6am before my urine test at 9am?

4. Finally, linked to the above, i go pass urine much more than is normal and have done for years. Something I need to get checked out by a Doctor. I just wanted to check that any Non-STI related infection or kidney problem would not hav any detrimental impact on an STI test detecting an STI ?

Once again, thank you for your advice and thanks in advance to these last queries.


Blank
239123_tn?1267651214
1) Six weeks should be fine for all the syphilis tests.

2) Correct.

3,4) You found some misinformation about urine testing.  All the research on urine chlamydia or gonorrhea testing was done randomly through the day, and there is no evidence that the first day's void, or that holding urine more than a few minutes, makes any difference in test reliability.  And no reason to suspect underlying kidney disease or urine volume have any effect.
Blank
Avatar_m_tn
Thanks a lot for all of this Doctor. Much appreciated and enjoy the weekend.

(Amazing job you and Dr. Hook do on this site).
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank