Aa
Potential syphilis exposure
Dear Dr. Hook,
I a female who had protected vaginal sex 9 weeks ago with my boyfriend. Afterwards, when I went to remove the condom, I noticed he had a 8-10mm sore at the bottom of the shaft of his penis. The condom was covering the sore. He told me the sore was there for 3-4 days and was painful and draining pus. Then he dropped the big bombshell, he said he had protected anal sex and unprotected oral sex with another male 3 weeks earlier. I did not know of his bisexual history. I made him see his family doc who thought the sore represented nodular cystic acne which he has a history of and was placed on doxycycline 100mg twice daily x 14days. When I asked him if he told his doc about the recent gay sex, he said he was too embarrassed. I made him go back to his doc and disclose his full sexual history. His doc just to be sure ordered an RPR and syphilis IgG EIA. His tests were done 1 week into the doxy course. His tests were both negative. Repeat RPR, syphilis EIA, and 4th generation HIV were done 2 weeks later and were all negative (6weeks after gay sex episode, 1 week after finishing doxy). I have not seen any lesions on my inner or outer labia. I had 8 week RPR, syphilis IgG EIA, and TPPA which were all negative. My questions are:
1. Have you ever seen someone test negative at 8 weeks who later lasted positive for syphilis at 3 months?
2. If my boyfriend did have syphilis, can I assume the antibiotics he took cured it? Can we resume sexual relations or wait until testing at 3 months?
3. Does his negative syphilis EIA indicate no syphilis exposure in past?
4. Can antibiotics taken early in syphilis affect both RPR and EIA results?
I a female who had protected vaginal sex 9 weeks ago with my boyfriend. Afterwards, when I went to remove the condom, I noticed he had a 8-10mm sore at the bottom of the shaft of his penis. The condom was covering the sore. He told me the sore was there for 3-4 days and was painful and draining pus. Then he dropped the big bombshell, he said he had protected anal sex and unprotected oral sex with another male 3 weeks earlier. I did not know of his bisexual history. I made him see his family doc who thought the sore represented nodular cystic acne which he has a history of and was placed on doxycycline 100mg twice daily x 14days. When I asked him if he told his doc about the recent gay sex, he said he was too embarrassed. I made him go back to his doc and disclose his full sexual history. His doc just to be sure ordered an RPR and syphilis IgG EIA. His tests were done 1 week into the doxy course. His tests were both negative. Repeat RPR, syphilis EIA, and 4th generation HIV were done 2 weeks later and were all negative (6weeks after gay sex episode, 1 week after finishing doxy). I have not seen any lesions on my inner or outer labia. I had 8 week RPR, syphilis IgG EIA, and TPPA which were all negative. My questions are:
1. Have you ever seen someone test negative at 8 weeks who later lasted positive for syphilis at 3 months?
2. If my boyfriend did have syphilis, can I assume the antibiotics he took cured it? Can we resume sexual relations or wait until testing at 3 months?
3. Does his negative syphilis EIA indicate no syphilis exposure in past?
4. Can antibiotics taken early in syphilis affect both RPR and EIA results?
MEDICAL PROFESSIONAL
What' to clarify- there is no data on male to female transmission. Ona purely theoretical basis males may be slightly more likey to transmit infection to females than theother waound but there are no data to be sure about, or quantify this. EWH
Can you clarify your last comment about male female transmission? Thanks.
MEDICAL PROFESSIONAL
No, there is no need for your BF to be tested further.
Syphilis is transmitted by direct contact. The receptive partner may be a bit more likely to become infected than the receptive partner but this has not been studied.
Take care. EWH
Syphilis is transmitted by direct contact. The receptive partner may be a bit more likely to become infected than the receptive partner but this has not been studied.
Take care. EWH
Thank you for your prompt response. I think for peace of mind I will test again test after the 3 month time for definitive results. Two more questions: Does my boyfriend need additional testing? If one has syphilis is transmission easier from male to female or from female to male and what is the % risk of transmission for syphilis with one episode of unprotected vaginal sex? Thanks again for your replies.
MEDICAL PROFESSIONAL
Welcome to the Forum. I will be glad to comment. Let me first congratulate you for inspecting your partner and urging him to get checked, as well as your BF for having the courage to tell you of his indiscretion. I hope he now appreciates that this was a high risk event.
The fact that his blood test was negative and that you used a condom for the encounter you describe makes your risk for syphilis low and, more importantly, your own negative blood tests 8 weeks later, as well as the fact that you did not develop lesions in the month after exposure are both VERY strong evidence that you did not acquire syphilis from this encounter.
With this background, let's address your questions:
1. Have you ever seen someone test negative at 8 weeks who later lasted positive for syphilis at 3 months?
It is said to occur but I have not seen this to be the case. At most it is VERY rare. Blood tests are absolutely reliable at 3 three months.
2. If my boyfriend did have syphilis, can I assume the antibiotics he took cured it? Can we resume sexual relations or wait until testing at 3 months?
Yes, 14 days of doxycycline is a recommended alternate therapy for syphilis. Between the fact that he took the therapy and that he has had negative blood tests, I would not worry about intercourse again relative to the events you describe.
3. Does his negative syphilis EIA indicate no syphilis exposure in past?
Probably. I wish there were absolutes but there are not. Most people who have ever had syphilis however would have a positive EIA from then onward.
4. Can antibiotics taken early in syphilis affect both RPR and EIA results?
Yes they can but again, when all his considered- his antibiotics, his test results, and your own test results, at this time the two of you can move forward without further concern about syphilis. EWH
The fact that his blood test was negative and that you used a condom for the encounter you describe makes your risk for syphilis low and, more importantly, your own negative blood tests 8 weeks later, as well as the fact that you did not develop lesions in the month after exposure are both VERY strong evidence that you did not acquire syphilis from this encounter.
With this background, let's address your questions:
1. Have you ever seen someone test negative at 8 weeks who later lasted positive for syphilis at 3 months?
It is said to occur but I have not seen this to be the case. At most it is VERY rare. Blood tests are absolutely reliable at 3 three months.
2. If my boyfriend did have syphilis, can I assume the antibiotics he took cured it? Can we resume sexual relations or wait until testing at 3 months?
Yes, 14 days of doxycycline is a recommended alternate therapy for syphilis. Between the fact that he took the therapy and that he has had negative blood tests, I would not worry about intercourse again relative to the events you describe.
3. Does his negative syphilis EIA indicate no syphilis exposure in past?
Probably. I wish there were absolutes but there are not. Most people who have ever had syphilis however would have a positive EIA from then onward.
4. Can antibiotics taken early in syphilis affect both RPR and EIA results?
Yes they can but again, when all his considered- his antibiotics, his test results, and your own test results, at this time the two of you can move forward without further concern about syphilis. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
