On Vacation - Discovered I have STD

First, WONDERFUL site.  You people should be commended for the fast and professional responses you give to people.

I am in Canada on a vacation with gf and realized that I had some pain in urethra and discharge (clear and milky) for a bout 3 days. I had unprotected vaginal sex about 3 times in past 2 months with another woman. Last time was about 20 days prior to symptons. At the time of my discovery (last week), I had unprotected sex with my girlfriend also last week (once, and total twice in past two months). I contacted the hotel doctor, who said most likely std (chlamydia) and he gave me 1gr zithromax first day, 500mg the second, then 100mg doxycycline twice per day for 7 days.  My gf had a sorethroat from the air conditioning, so he gave her 500mg of zithromax, once per day for 6 days, which he said would take care of her if she was infected by me as well. When I get home I will undergo the full bout of std testing just to be safe.  

Some questions: 1) based on symptons, are the meds he suggested appropriate for me, and for my gf is she was infected?

2) how long after finishing my meds cycle can i take the std tests (is one day after cycle too soon, or will i be asking for potential false negatives)?  how long for results if i go to a lab in USA and request rapid testing?

3) if I come back clean, should my gf go in for tests?  she claims i am her only partner over the past few years and tested negative for everything early in our relationship. i will provide her the results of my tests when they come in.

thank you for your time!

[H. Hunter Handsfield, M.D.]

The meds were a little atypical for both you and your girlfriend, but will work fine if you have chlamydia or non-chlamydial nongonococcal urethritis (NGU).  Normallly azithromycin 1.0 g once; OR doxycycline for a week, so you got a double hit.  Azithro 500 mg daily for your partner is big overkill but will work; she could stop after 2-3 doses.  The main issue is that since you apparently didn't have diagnostic tests, you don't know for sure you don't have gonorrhea; instead of or in addition to chlamydia.  (You don't say whether you were tested for STDs before you were treated--your last question suggests maybe yes.)  The treatments you were give usually are OK for gonorrhea, but not always.  But if your symptoms clear up and don't return, you can be confident this isn't a problem.  Because multiple STDs often go together, you aboth should be examined, including blood tests (syphilis, HIV) (not that I think there is a high risk for either, it's just routine). You both should be tested and examined as soon as possible. But if you weren't tested before treatment, you'll never know for sure about gonorrhea and chlamydia; once treated testing will be negative regardless.

You can be sure you were infected by your other partner, if your girlfriend is being truthful about other partnerships.  Make sure you tell the other woman, so she can get examined and treated.  (That's probably the only way you might eventually learn whether you had chlamydia, gonorrhea, both, or neither.)  Up to you whether you fess up to your girlfriend--but it's probably inevitable.

Good luck--  HHH, MD

[elvis123]

I forgot to ask, are there preventative vaccinations that are new that are smart to take? I am mid 30's and have not had vaccinations since i was a child, and i understnad that now children are given hepatitis and other vaccinations.  Just wondering if any of them are smart for adults as well.

[H. Hunter Handsfield, M.D.]

Immunization against hepatitis B isn't a bad idea, and your sexual history implies you might be a moderate risk.  There aren't any other STD vaccines at this time.

HHH, MD

[elvis123]

Thanks Doc for the answer.  I will be done with treatment in 2 days.  When is the soonest I can get a full blown STD suite of tests done?  AND - due to meds, should I do a suite of tests again in a month or so?

Also, If you think we are at risk of Gonoreah, but after the meds believe the tests will come out negative for it, would that be a false negative?  Could I still have it and pass it on later after meds wear off? Should I retest for gon. later as well?

Thank you

[H. Hunter Handsfield, M.D.]

Except to check for other STDs (syphilis, HIV blood tests), you don't need further testing at all, unless your symptoms don't clear up.  The treatment you received will reliably cure chlamydia, and is very good if not perfect against gonorrhea.  But if you have gonorrhea, you'll have symptoms; discharge and/or uncomforable urination.  If those don't reappear within a week of completing treatment, you are  home free.

HHH, MD

[elvis123]

Thank you for your help.

[worriedintaipei]

Sorry to jump in on this thread but I tried my credit card details and they didn't work.

My story is; I recently tested positive for HSV 1 and Chlamydia . I had the tests after showing high red blood cells and mucus in my urine sample. the reason I went for the urine sample was that the end of my penis and foreskin became red though not really sore.
This was after cunnilingus and what I thought was protected sex once in Vietnam 7/7/05. The HIV test came back negative after 33 days from exposure. The HSV 1 seems to be on the inside my lips, I have had three bumps there for the past 18 days that won't go away. I thought you wern't supposed to get HSV 1 from cunnilingus?

The thing that is confusing me the most is that after the Chlamydia positive test, the doctor here in Taiwan wasn't going to give me any medicine as he said it wasn't sure the test was showing up a previos infection or not. (About 10 years ago I had an STD which took over a year to clear up. I was also diagnosed with prostatitus at the time.) His advice was to wait and see. By the way the rash cleared up in a couple of days with Tetracycline cream. I have no discharge except for when I ad a bowel movement this morning there was a milky discharge which I have seen before.

I told him that I have some pain sometimes in my penis and he relented and gave me Trimerin which I looked up and found it is used for urinary infections.

My questions are;

1. What is the doctor talking about when he says, even after a positive Chlamydia test that he couldn't be sure it is chlamydia?

2. When he gave me the medication, why wasn't it the recommeded Doxycyline?

3.I had the HIV test at 33 days which was negative is there a need for another test. Taiwan seems quite progrssive when it come to HIV so I would hope they are doing modern tests.

If I have HSV 1 on my lips I shouldn't have it down below, is that right?

Many thanks

[elvis123]

Hi again Doc.
Woops, I amde a mistake on the antibiotic name. It was not doxycycline, it was MINOCYCLINE HYDROCHLORIDE, to be taken 100mg per day, twice per day.  He had written the Doxycycline on a separate note to me, along with the MINOCYCLINE HYDROCHLORIDE at the top, with a note that i coudlnt read, but the pharmacy gave me the MINOCYCLINE HYDROCHLORIDE and the azithromycin (as i said in my first post.) So all was correct, just replace the Dox. with the Min.Hyd.  - does that change anything as to your views.  Sorry for the confusion on my part as to the medicine names.

[H. Hunter Handsfield, M.D.]

Minocyclline is equivalent to doxycycline, doesn't change my responses.

HHH, MD

[mike1759]

two days after her giving me oral  sex i had a tender tip of my penis went to dr. he gave me cipro xr 3 dose at 500mg and 1 gm zith. never had any discharge.he thought it might be gonorrhea.but  finshed cipro and zith. one week ago still the tip and penis still hurts. going to get tested.could you think of any reasons other than an std why my penis would hurt. would another round help or maybe a different drug.