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STDs (Expert Forum)
I got gonorrhea even though I practiced safe sex
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
I got gonorrhea even though I practiced safe sex
by DownInTheDumps, May 30, 2006 12:00AM
Dear Doc,
I did a really stupid thing (doesn't it alway start like this?) Anyway, I'm a 35 year old guy and started seeing escorts here on a semi-regular basis. First experience was March 29th, with a total of eight separate visits to eight separate escorts. The last experience was on May 3rd. I received protected oral, and penetrated some but not all of the escorts vaginally. At all times I used condoms for both the oral sex and the vaginal sex, and there was no skin to skin contact at anytime. Anyway, about mid-April I was on a routine doctor visit and he told me that my liver enzymes are both out of the normal range, on the high side. AST was 55 and ALT was like 135 (I might have switched them around, but it gives you an idea of the ranges). I'm not a drinker, so I know it can't be from booze. I went to an STD clinic on May 24th and tested positive for gonorrhea. I took one capsule for the gonorrhea and am currently taking doxycycline hyclate with breakfast and dinner for seven days as a preventive measure for syphillis. I practiced safe sex at all times while visting the escorts; I haven't been intimate with my wife since November (a whole other story) and I know that she has not been with anyone else in years. My questions are:
1. How did I get gonorrhea so easily? It had to be from one of the escorts. Since I took the one capsule on the 24th, what are my chances of a re-infection? The clinic has me coming back on June 7th for the syphillis results and the week of August 24th to be rechecked for re-infection.
2. I took an HIV test on May 24th, the kind that swabs the top and bottom of your mouth between the lips and gums. Came back negative. Am I out of the woods yet for HIV? Will a negative re-test on June 7th be relatively conclusive?
2. How soon does it take for hepatitis antibodies to show up once infected? Is it relatively common among prostitutes? If there is any saving grace, I suppose it is likely from a previous condition, but I just want to know for sure.
Thanks for all of your help not only for me but for all of the readers of this forum.
I did a really stupid thing (doesn't it alway start like this?) Anyway, I'm a 35 year old guy and started seeing escorts here on a semi-regular basis. First experience was March 29th, with a total of eight separate visits to eight separate escorts. The last experience was on May 3rd. I received protected oral, and penetrated some but not all of the escorts vaginally. At all times I used condoms for both the oral sex and the vaginal sex, and there was no skin to skin contact at anytime. Anyway, about mid-April I was on a routine doctor visit and he told me that my liver enzymes are both out of the normal range, on the high side. AST was 55 and ALT was like 135 (I might have switched them around, but it gives you an idea of the ranges). I'm not a drinker, so I know it can't be from booze. I went to an STD clinic on May 24th and tested positive for gonorrhea. I took one capsule for the gonorrhea and am currently taking doxycycline hyclate with breakfast and dinner for seven days as a preventive measure for syphillis. I practiced safe sex at all times while visting the escorts; I haven't been intimate with my wife since November (a whole other story) and I know that she has not been with anyone else in years. My questions are:
1. How did I get gonorrhea so easily? It had to be from one of the escorts. Since I took the one capsule on the 24th, what are my chances of a re-infection? The clinic has me coming back on June 7th for the syphillis results and the week of August 24th to be rechecked for re-infection.
2. I took an HIV test on May 24th, the kind that swabs the top and bottom of your mouth between the lips and gums. Came back negative. Am I out of the woods yet for HIV? Will a negative re-test on June 7th be relatively conclusive?
2. How soon does it take for hepatitis antibodies to show up once infected? Is it relatively common among prostitutes? If there is any saving grace, I suppose it is likely from a previous condition, but I just want to know for sure.
Thanks for all of your help not only for me but for all of the readers of this forum.
Doctor's Answer
by H. Hunter Handsfield, M.D., May 30, 2006 12:00AM
, May 30, 2006 12:00AM
1) Obviously I cannot say when and from whom you acquired gonorrhea. You don't say what symptoms you had, but if there were no symptoms, you might have had it for several weeks, maybe even a few months. (Asymptomatic carriage of gonorrhea in the urethra is rare, but happens.) If you had typical symptoms (urethral dishcarge, pain on urination), the odds are you caught it 3-10 days earlier. Finally, perhaps you had a false positive lab test; the chance of that depends a bit on exactly what test was done.
2) The chance of HIV is low, although higher than it would be if you didn't catch gonorrhea. Your negative test result is highly reliable, but not perfect, since it was done only 3 weeks after your last sexual exposure. Have another test at least 6 weeks (many experts say 3 months) after that exposure to be absolutely sure.
3) I don't think it is possible to generalize about hepatitis B carriage by commercial sex workers. Blood tests for viral hepatitis are complex, typically including tests for hepatitis B virus itself, plus antibodies to types A, B, and C; and for HBV there actually are several different antibody tests that are commonly done. All these can become positive at different times. The provider who did the tests is in a better position than I am to tell you when your particular tests will be reliable in relation to the possibility of recent exposure. As you seem to realize, it is more likely that your abnormal liver function tests are chronic, not related to a new hepatitis infection. Whatever else happens, do follow up on that with your provider.
A final minor comment: the purpose of the doxycycline isn't to prevent syphilis, but to cover chlamydia. About 10-20% of men (and 20-30% of women) with gonorrhea also have chlamydia, and chlamydia treatment is routinely given to people with gonorrhea.
I hope this helps. Best wishes-- HHH, MD
2) The chance of HIV is low, although higher than it would be if you didn't catch gonorrhea. Your negative test result is highly reliable, but not perfect, since it was done only 3 weeks after your last sexual exposure. Have another test at least 6 weeks (many experts say 3 months) after that exposure to be absolutely sure.
3) I don't think it is possible to generalize about hepatitis B carriage by commercial sex workers. Blood tests for viral hepatitis are complex, typically including tests for hepatitis B virus itself, plus antibodies to types A, B, and C; and for HBV there actually are several different antibody tests that are commonly done. All these can become positive at different times. The provider who did the tests is in a better position than I am to tell you when your particular tests will be reliable in relation to the possibility of recent exposure. As you seem to realize, it is more likely that your abnormal liver function tests are chronic, not related to a new hepatitis infection. Whatever else happens, do follow up on that with your provider.
A final minor comment: the purpose of the doxycycline isn't to prevent syphilis, but to cover chlamydia. About 10-20% of men (and 20-30% of women) with gonorrhea also have chlamydia, and chlamydia treatment is routinely given to people with gonorrhea.
I hope this helps. Best wishes-- HHH, MD
I did have burning feeling in the tip of my penis but it went away. Prob irritation? Yea i know 3 docs is alot but two were at the same place at the same time. Not really flipping out about it i just dont want to move on with this and end up giving something to my girlfriend or having this comeback and bit me in the butt. The burning feeling comes back alittle bit after masturbation . Could this be just irratation as i dont use lube and im just noticing it cause im thinking about it? Thanks