Question about timing and test results.

[srj1979]

Hello,

Thanks for answering my questions.

Here are the details. I'm male and 31 years old, had protected sex two times with two different CSWs within two days. Tested at 11 days from last exposure with an 8 panel test. All negative except HSV I, which I already new I had. So my question is this, at 11 days is the Nucleic Acid Amplification Test for Chlamydia and Gonorrhea reliable? And do I go back and get tested again another week from now? I know that Syphilis, HSV II, HIV need to be tested further out to be near 100% sure, 6 weeks for Syphilis/HSV II and 3 to 6 months for HIV correct(?), but I’m not 100% sure on Chlamydia and Gonorrhea. Do you recommend more testing or do you think the testing and negative results at 11 days post exposure is a solid result for Chalmydia and Gonorrhea? Do you recommend anymore testing for this last exposure for Syphilis/HSV II/HIV?

Thanks for taking the time to talk with me.

[H. Hunter Handsfield, M.D.]

Genitally focused anxiety, which certainly is common in situations like this, often causes the sort of symptoms you describe.  STDs do not.

You can tell your PA friend that you WERE being careful.  That's what condoms are all about!

[srj1979]

Thanks for the update! Yea, the whole panel was ~300 and was done through private channels. I know, I probably deserve the lecture, I also probably deserve the lecture for calling a PA friend of mine and having him prescribe me a no questions ask Z-PACK (although I think he knows what it was for) as I got the "you need to be careful" lecture from him. I may go back at 6 weeks for the second two tests just for peace of mind. The only reason I went in the first place was due to some discomfort in my testicles and a very strange pulling feeling near the base of my penis just above where it meets my body and a pain in the area between my testicles and anus, I think I may actually have a hernia, or pulled a muscle, so I need to go see my PCP for that. Thanks again.

[H. Hunter Handsfield, M.D.]

I meant to say that the urine tests for both gonorrhea and chlamydia are 100% reliable at 11 days.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'll try to help.

Even without a condom, the chance of STD transmission during any single exposure is low, both because most CSWs aren't infected and even when an STD is present, most exposures don't result in transmission.  Your risk was further lowered to near-zero levels because of condom use.

Some of the tests you had were unnecessary (including some of the more expensive ones) and most were done too soon.  Most people who wish STD screening after a specific exposure are smarter to visit a doctor or clinic, such as the local health department STD clinic.  If you had done so, you would not have wasted the money that you did.  The only recommended tests in this situation are urine for gonorrhea and chlamydia and blood tests for syphilis and HIV.  My guess is you paid $300 or more; even with a private physican, the total cost of the visit plus the proper tests probably would have been half that amount.

OK, lecutre over.  The gonorrhea results are completely reliable at 11 days; for sure you did not catch either one (which would have been impossible through a condom anyway).  All your blood test results are meaningless; 6 weeks is the minimum.  Given the essentially zero risk nature of the exposure, I don't recommend you repeat them.  But if you feel you need to do so, have another HIV and syphilis test (but nothing else) at 6 weeks.  And in the future, keep your local health department STD clinic in mind!

Regards--  HHH, MD