Please help me wrap this up

[TEXMEX40]

Hi.  First of all thank you for the great service you guys provide.  I’ll try to narrow down my situation as much as possible, chronologically.  

I have had unprotected sex in the past with different girls, about 2 years ago.  During a backpack trip to Europe, six months ago (mid july this year) I had protected sex with a prostitute once (I used a condom and she used her hand to prevent my parts touching hers), and two days after that I had unprotected sex with a different girl who’s not a prostitute, she’s actually a friend of mine (twice with a condom, and another one without).  I kept contact with her for a while and as far as I know she hasn’t been diagnosed with any STD.  

Right after that (from july 2008 on), I started sexual relationships with my current girlfriend, and we consistently have used condoms since (except for ONE TIME where the condom didn’t slip but I stayed inside her long enough for my penis to lose blood pressure and probably something escaped down the base of the condom?)  and after a lot of thinking and lots of fear and anxiety (which persists), I told her that I cheated on her and we both decided to get tested for STDs.  These are the tests and what we did after them:  Please consider all of them are taken 6 months after my possible exposure to STDs

Me:

-HIV negative at 6 months
-VDRL negative at 6 months
-HSV 1 and 2, negative at 6 months
- HPV by urethral swabbing, negative at 6 months
-Chlamydia by urethral swabbing POSITIVE at 6 months

My girlfriend:

-Pap smear negative at 4 months
-HPV Hybrid Capture negative at 4 months (that’s 4 months from that night we didn’t use the condom correctly)

Two weeks after the pap smear and hybrid capture came back negative she got her first shot of Gardasil, and we both took azythromicin for the chlamydia (4 doses of 500gr each, one every 8 hours)  and after that I’m taking a week of doxyciclyn.  

The thing that really anguishes me is that this weekend, while having sex with my girlfriend, I noticed what I think could’ve been an anal wart on her.  I haven’t had the courage to tell her, since all this has been pretty difficult and I don’t want to worry her over something unnecessary.  So, with all this background (I’m sorry it’s long, but I’m guessing it helps to improve your answers), I want to know:

1 ) What other test should we take? I think gonorrhea is the only one left, but since I’ve had no symptoms of ANYTHING at all, my urologist said it’s ok to assume it’s not there, and the antibiotics would kill it anyways.  Is this true?

2) Is it safe for my girlfriend to take the Gardasil shots even if she could potentially be infected with HPV? I’ve read it just won’t cure it but will provide insurance against many other strains, right?

3)  If what she has is actually an anal wart, is it possible that it developed during the lapse of two weeks, after a negative hybrid capture test (that specifically says it detects strains 6 & 11 and many other)??  How does hybrid capture work? If she had HPV in her anus, would the test have showed it even if it’s taken by urethral swabbing?

This is what worries me the most, since it would mean that I am HPV infected too, but then how could my urethral swabbing come back negative? Can the virus live in the outer skin and not be detected by swabbing?? And how would’ve the virus traveled to her rectum from the vagina if we have had only vaginal sex?

What I’m trying to ask, and I really am anxious about, is that it just seems pretty unlikely to me that after all the testing, and all the negatives (except for the Chlamydia), the gynecologist could’ve missed an anal wart during the revision.  How likely is this? Is it routine for a GYN to look at the anus? And can warts appear just like that over the lapse of 2 weeks? And also, how likely is it that she didn’t feel it? And what else could it be if it’s not a wart? I didn’t really take a good look at it, and maybe I’m over worrying, but is there a chance that she has something in her rectum that is not a consequence of my cheating 6 months ago?

[auntiejessi]

You are worrying WAY too much.  The odds of something like that happening are very low, if at all.

You have tested negative.  Its ok to move on.

Aj

[TEXMEX40]

Thanks a lot for your answers.  We talked to the dermatologist and the gyn today, and they said it's not warts and we shouldn't worry anymore.  You've been great, and I just want to ask about one final question.  What about rectal ghonorrea??  I never had anal sex with anyone, and my girlfriend and I have always used protection.  So, my question is :

Can you get anal ghonorrea from protected vaginal sex? Or any other infection for that matter? Are there infections that could be asymptomatic in the genitals and somehow spread to the rectum and become symptomatic there? And if there were, what would be the symptoms??  

I ask because when we checked, effectively there were no warts, but I noticed really tiny (less than 1mm maybe, and just one or two) saliva like things..... The doctor said they're most likely normal secretion/discharge from the rectal lining/mucose, but i mean, after NO anal sex, PROTECTED vaginal sex, and all the tests that have come back negative, what would be the odds of this being a sign of something? and of what if it was? are there any STDs that could cause any infection to spread from the genitals to the rectum? Also, please consider that this is a whole 2 weeks after taking azythromicin (2 gr oral ) for chlamydia. would that kill ghonorrea as well?

thanks AJ.

[Vance2335]

You should be good.
HPV-there is no test for men, doesn't matter what is done.

[TEXMEX40]

yeah, i actually am very anxious, and I will get counseling, but I just need to make sure this is finally over before I can start thinking everything is alright.  Would you say it's fairly safe, with all the tests that we took, that we're going to be ok? I know warts are an aesthetic issue mostly, and won't really affect us at all, and might even clear by themselves with time, but I just really need to make sure. Thank you anyways AJ :), I do feel a bit more relaxed after reading your post.

Oh and I just re-checked on my tests, my HPV test was a PCR test, the sample taken by swabbing. does that make it any more accurate, if at all? =T

[auntiejessi]

Ok lots of stuff going on here.

First - the chlamydia.  You are probably cured, but since you both took the zithromax wrong - it should be 1 gm at one time - you might want to get a follow up test in a month to make sure its gone.  It probably will be, but you'll want to make sure.

The wart - you don't know that its a wart.  It could be a skin tag, or a hemorrhoid, etc.  You are going into a lot of worry for something that you aren't even sure about.  Given that she tested negative, and has started her vaccinations, I'd doubt it.  However, since there is a possibility, you should tell her as getting the vaccination is contraindicated when someone has an active HPV infection, and she should wait till its gone to continue the vaccines.  Her doctor can advise her best about this.

If she does have HPV, your urethral swab won't show a thing.  There is no commercially available approved HPV test for men, and if there were, it wouldn't be a urethral test as HPV is a skin infection.

I don't see any big need to test for gonorrhea, either, but test if its going to help you put all this behind you.  

I know STDs can be scary, but you seem really anxious about this.  I don't know if its guilt, or what, but if this has become a focus for you, you might want to see a therapist about it all.

Aj

[TEXMEX40]

on question 3 i meant hybrid capture is taken by VAGINAL swabbing, not urethral. sorry.