Guilt, anxiety or STD?

[justneedanswers191]

Dear Doctor, thank you so much for answering my question

I am a 24 year old male in a long term heterosexual relationship. Recently I received an unprotected ** from a male I did not know.

I noticed an ache in my penis after I received this oral and I needed to urine a little more frequently. I then stupidly slept with my gf on the Sat night. Even more foolishly I self medicated with 1g of azthromycin late on the Sunday evening following the act (which was on the previous Wednesday). However, still unerved I went to clinic for STD screening on the Monday morning (not 12 hours after taking antibiotics) - I know how stupid my timings were but I really was going out of my mind! tested neg for Chlamydia, Gonnoreah, Mycoplasma and Ureaplasma. However, I was feeling some varying levels of discomfort in my urethra at the clinic and the doctor agreed to give me azthromycin and cipro to kill off any threat of STD's as of course I didnt get my negative results for three days after.

This all happened over 6 weeks ago, however I am still suffering from urethral discomfort even after taking what is now 2g of azthromycin and one dose of cipro. I went back for more STD testing including herpes and syphilis along with chlamydia, gonnoreah, ureaplasma and mycoplasma - all of which came out to be negative. However, my symptoms nor my minds attention to it has subsided. My questions to you are:

1. are there any STD's that I could have aquired through the receipt of oral sex that would survive after this level of treatment.

2. did my 'foolish' self-medication (12 hours before my first STD screen) sacrifice the validity of these results.

3. If so... is it likely that I infected my girlfriend on the saturday night before i had treatment (is there a period in which STD's have to be in the body before you can transmit them, or are they instantly transmissable).

4. Is it possible that guilt and focalised anxiety can cause urethral pain that lasts even after negative results.

[Edward W Hook, MD]

Boy, your sense of timing is not the best.  You have really done things in reverse sequence.  Having said that, it is unlikely that you got an STD of any sort from the exposure you describe.  Part of the reason I say this is statistics - most people do not have STDs, STDs are poorly transmitted from the mouth to the genitals and even when people have STDs, most exposures do not lead to infection.  The other reason I say this is that many of the tests for gonorrhea, chlamydia, etc would still be positive 12 hours after taking azithromycin as many tests can detect non-living organisms for several days after treatment.  Furthermore, it you had been infected, I would have expected the therapy you describe to have eliminated them, suggesting that your symptoms may be due more to anxiety and guilt than true infection.  In answer to your specific questions:

1.  No, none of the bacterial STDs
2.  See above. it may have reduced the sensitivity of some tests slightly but not much.
3.  If you were infected, her risk of infection would be about 30-35%.  Odds are however that you were not infected.  If you are really concerned however, she should be checked.
4.  Absolutely.

Hope these comments help.  EWH

[justneedanswers191]

It was a swab test that I received first that was negative, does this increase the chances of an accurate reading even after taking the antibiotics. I hear this is the gold standard?