Super High Risk Exposure!!

[user1975]

To make a long story short I had three prolonged (minimum 30 minutes) unprotected vaginal sex with a CSW, that I found out is addicted to Meth and possibly other drugs!  Last sexual contact was on November 20, 2007.  Since then I have had two STD screens done, the first on December 14, 2007 and the second on January 8, 2008.  Below are the results from the January 8, 2008 test.

HBsAg Screen- Negative
HCV Antibody- Negative
HIV-1 Ab- Negative
HSV-1 aBIgG- 3.85 H
HSV-2 aBIgG- 0.94 H
Chlamydia Trachomatis DNA, SDA- Negative
Neisseria Gonorrhoeae DNA, SDA- Negative
Syphilis RDR w/Refl Titer- Negative

By looking at these results I assume that I have Herpes Simplex 1 and a possible false positive to Herpes Simplex 2.  I have a couple of questions regarding the results.  I am a healthy 32 yo male.

1.  At 7 weeks how sure can I be that I have not contracted any STD’s?
2.  At what point should I be retested to absolutely positive that I have not contracted any?
3.  On my first test my HSV IgG score was 1.64 H and dropped to 0.94 H on second test, is it safe to assume I do not have Herpes Simplex 2?
4.  Are there any tests that I can take right now that would prove conclusively that I contracted any STD’s?
Thank you very much for taking the time to answer these questions.

[H. Hunter Handsfield, M.D.]

Regardless of the riskiness of the exposure, you were over tested.  (Looks like you went on line instead of seeing an STD knowledgeable provider for personal care.  Most males with new STD develop tell-tale symptoms, so lack of symptoms itself was highly reassuring.  The risks of catching hepatitis was too low to worry about (and HCV isn't even sexually transmitted in heterosexuals).  Gonorrhea without symptoms is very rare, ditto for syphilis.  And the odds of herpes after any single exposure is low, especially if no symptoms occur.

OK, lecture over.  To the specific questions.  

1) Yes, for practical purposes you can consider yourself home free.  It takes up to 4 months for herpes, but the combination of no symptoms plus negative test at 7 weeks adds up to no risk worth worrying about.

2 and 4) No more testing is necessary.

3) Yes.  I agree the initial HSV-2 result was falsely positive (and anyway it was so low it should have been repeated, as you did).

Best wishes---  HHH, MD

[user1975]

Thank you so much for you answer, now I may be able to sleep at night.  I hope you realize how much help you are giving people by answering our questions.