Is it too late to test/treat?

[goodguy180000]

Hello all.  I'm a 30 year old male with a few basic (I think) questions that I'm very anxious to get some answers to.  I hope you all can help!

Some brief history.  I have been "playing" in a not-so-responsible manner for  like 6 years or so.  I have never had unprotected vaginal or anal sex, but have received many, many unprotected blowjobs.  I have also performed and received analingus with bunch of partners in the past.

About 2 years ago, I had my first genital herpes outbreak.  I went to a free STD clinic here in NYC that confirmed it, but they could not tell me if it was HSV-1 or HSV-2 - they don't test for the strain.  This experience scared me into getting an HIV test, which was negative.  I have since had several HIV tests well outside of the suggested window period - all of which were negative.  I have only received one instance of oral sex since then, so I don't see any reason to retest for HIV.

HERE'S MY REAL CONCERN - I have never had a "full STD panel done,", but am going to go down and do this - and here's where my questions lie:

1.  IS IT EVER TOO LATE TO TEST FOR STDs, specifically: gonorrhea, chlamydia, syphilis, hepatitis, and other non-HIV STDs?  I don't ever recall having symptoms of a primary infection, but am now concerned.  If I contracted any of those STDs months, or even as much as 6 years ago, would they still show up on a test, or do they become dormant/undetectable over time?

2.  IS IT EVER TOO LATE FOR TREATMENT OF THE ABOVE?  Is there a point where antibiotic treatment just won't work anymore?  Out of the blue, I started feeling some groin pain that has since progressed into feeling like arthritis in my hip joint.  I've had leg problems (the other leg) in the past, and have been attributing it to that - until I read that arthritis could be a sign of a late-stage STD.  If that is my only symptom, and I am in fact diagnosed, is that a sign that it is too late for standard treatment?

3.  Are the tests administered at the NYC Health Department clinics accurate and up-to-date for non-HIV STDs?

I had been long obsessed with the thought of having HIV, but have neglected the other STDs.  So, is it too late for a simple clinic test now to be accurate for STDs?  Is it too late for common treatments to work if I am diagnosed?

Please - any information you have to share will be helpful.

THANK YOU!

[Squady]

I am Squady,and I am 30 years old,pls I just noticed a syphillis symptom now on my body like rash and a painless red secluded spot on my genitals,am scared now,pls Aj what do I do,what antibiotics should I take for treatment,your answer would mean a lot to me pls

[munda1]

hi Dr. i have a question last yr 2010 probably in november i had sex , i had oral and anal sex without condom and in september my ex girl friend told me this yr october that i m infected STD and so i m really worried. I had an HIV test in sep 2011 and it was negative and i will be getting tested for STD on comming moday 11/7/2011 so...is it too late to get cure??? (
  plzz reply
                                                        thanks for reading

[gracefromHHP]

No reason to retest for syphilis from what you've posted. And yes , genitally focused anxiety is a HUGE issue for many of the posters here.  When you are worried about an encounter you tend to start focusing way too much on stuff you usually don't think twice about.  A "heavy" feeling isn't likely to be a sign of anything other than thinking about your nether regions way too much.

grace

[goodguy180000]

Hello all,  I just got test results from the STD clinic.
All they said was I was negative for gonorrhea, chlamydia, and syphilis.  They did not mention any specific numbers, they just said negative.  Should I just take that for what it is?  Negative is negative?

If that's the case, it proves that I never had gonorrhea, chlamydia, or syphilis.  The tests were taken 12 days after my last encounter of any kind.  Should I assume that if no sore develops on my penis that I do not have to test again for syphilis, and that my gonorrhea and chlamydia tests were 100% conclusive?

Also, they did not test for NGU.  I have been feeling a "heavy" feeling in my penis, but absolutely no drip of any kind.  Dr. HHH on the doctor's forum has said many times that "genitally focused anxiety" can often cause STD-like symptoms.  I will say that I have been UNBELIEVABLY stressed and wracked with guilt over the whole thing, so I know I've had extremely heightened anxiety.  Just wondering if I had no drip and symptoms seem to "appear" when I'm searching the Internet and forums like this one, should I be overly concerned?  Maybe I'll see if they go away now that I'm not as anxious...

I'd just like to hear your thoughts on my concerns.

Thank you.

[Vance2335]

If you don't see a sore then you have no reason to test again.

Yes gonorrhea and chlymida test at this time frame will give you a conclusive result.

If you come out negative it means you are negative...that you don't have them. if you had gonorrhea for 5 years and tested now it would come up positive.

what you did for the urine test was perfect.

[goodguy180000]

Hello all.  Today, I went to one of NYCs public health clinics and got tested.  They DO NOT test for hepatitis (any of them), so what I got tested for was HIV, gonorrhea, chlamydia, syphilis.  The rapid HIV test came back negative (as expected, since I don't think I had a risk), and the rest of the results will be ready in two weeks.

I know it was OK to test for gonorrhea and chlamydia at this time, but it would be too early for a syphilis test to yield accurate results (12 days).  My reasoning is this:  If the syphilis test came back positive, that would likely mean that I've had it for a while, because it would be too early to show up on this test if it were from my 10 minute receptive oral sex event of 12 days ago.

If the syphilis test is negative, would it be smart to say that, unless I notice a chancre on my penis between now and say 6-8 weeks from now, then there is no need to go back and get another syphilis test?

And to be clear, any result from the gonorrhea and chlamydia tests will be accurate and conclusive at this time (12 days from the oral)?

I have been tested for HIV before, but this is the first time I've been tested for gonorrhea, chlamydia, and syphilis.  I'm assuming that if they are negative, it's because I truly don't have those diseases - not because I have waited too long to test?  The gonorrhea and chlamydia tests were urine tests, while the syphilis test was a blood test.  I waited all morning and did not urinate since I went to bed last night, so I could get the first one - I'm assuming that's OK?

Thank you!!

[auntiejessi]

Yes, that is including syphilis.

Aj

[goodguy180000]

Wow - it's amazing how generous you are with your time and answers.

You say that oral sex is in general less of a risk than vaginal/anal intercourse - but what about specific to syphilis?  Do you know?

Thanks.

[auntiejessi]

Its higher, yes.

Here are some reports I found -

http://www.health.state.ny.us/statistics/diseases/communicable/2007/new_york_state/by_age.htm

http://www.nyc.gov/html/doh/downloads/pdf/std/std-quarterlyreport2007-4.pdf

http://www.nyc.gov/html/doh/downloads/pdf/std/syphilis_alert_2007.pdf

I couldn't find anything conclusive past 2007.

[goodguy180000]

I also am to understand that syphilis is rare in the U.S. overall - but I fall into a high-risk category, being a MSM bisexual in NYC, with a history of random oral hookups, where I always received the oral, never gave it.  Is there any data that could help me understand how prevalent syphilis is in my case?  I assume it must be much, MUCH higher than the U.S. in general, right?

Thank you.

[auntiejessi]

Yes, that's fair, as oral sex in general is less of a risk than intercourse.

Aj

[goodguy180000]

Would it be fair to say that it's tougher to acquire syphilis from oral sex than it is from anal/vaginal sex?

Thank you.

[auntiejessi]

I don't know that we know why.  Syphilis is as easy to transmit via vaginal sex as it is anal sex, so we don't know why.

Here's an article for you - http://www.cdc.gov/std/syphilis/STDFact-MSM&Syphilis.htm

[goodguy180000]

Can someone explain to me why syphilis is much more present in the MSM community, rather than the heterosexual community?  Is it because anal sex is the easiest way to pass on syphilis, and not so much via vaginal or oral sex?  Or is it some other reason.

Thanks.

[auntiejessi]

You can get syphilis from oral sex and intercourse (vaginal and anal).  Oral sex is somewhat lower risk than intercourse, but its possible.

Aj

[goodguy180000]

Well, that certainly simplifies that!

Can I ask a general question?  What are high risk activities for getting syphilis versus low risk ones?  Or is that even a valid question where syphilis is concerned?

Thanks.

[auntiejessi]

That's not true.  You would test positive for it.

And yes, it would mean that you never had it.  Many people who have had it and got it treated will still test positive at low levels forever, so you wouldn't have to worry that it would miss something.

Aj

[goodguy180000]

OK, thanks for the answer.  Is it possible to test negative for syphilis if you've waited WAAAYY too long to test?  When I search some of the responses here, I'm seeing that if syphilis is in the later stages, it will not show up on the test, yet your body will continue to be affected by it.  Is this true?  Is it possible to have waited too long (years and years), missed symptoms if they occured, and then have a test falsely give you a negative result?

I'm just waiting a little longer to test, but if it indeed comes back negative, is that 100% that I NEVER had syphilis, even when I was younger?  I hope you understand my question.

Thank you!

[auntiejessi]

Technically, it can take longer than 6 weeks, but its rare for it to take that long.

If you are concerned, test again.

[goodguy180000]

Is a syphilis test at 6 weeks past potential exposure considered conclusive?  There is a very reputable HIV info site that is stating in a current thread that the window period is the same as HIV, at 13 weeks.  It seems difficult to find more info, so I guess I'm asking why there is such a disparity.

Also, is a syphilis test done with urine, blood, or some other way?

Thanks.

[Vance2335]

Yes you can tell the difference. Google syphilis sore pictures and you will see the difference.

[goodguy180000]

Thanks for the continued info.  Myself having genital herpes, I'm assuming it would be  difficult if not impossible to determine if a sore on my genitals was indeed a syphilis chancre or a herpes outbreak, right?  Can you tell the difference?
Thank you.

[auntiejessi]

Ahh ok.  

Syphilis is not asymptomatic.  You'd get a sore, called a chancre, at first - within weeks, average is 21 days.  Then that would go away after a few weeks, give or take, and then you would get a rash on your body.

A syphilis test isn't accurate till about 6 weeks, but its uncommon in developed countries, so its not that concerning.

Aj

[goodguy180000]

Whoops!  Good catch - I meant Friday, 2.13 (just oral sex).  Does that change anything?

Also, can syphilis be a-symptomatic?

Thanks!