STD assurance

[Garyhart1234]

Dear Doc,
I am referencing the same experience previously posted about unprotected sex with a female CSW. I am now in a relationship and need reassurance. The last set of tests were at 4wks post exposure. Have not been sexually active since. Here are my questions:

1. Will chlamydia & gonorrhea clear on their own with time? Typically how long? Is it possible to have been 8 months with no heavy symptom? Only symptoms I have had is and occasionally urethra burning after urinating and occasional testicular pain & lower abdomen pain, are these symptoms or pretty normal bodily functions never noticed before?

2.  Have heard urine test are not very accurate tests and the amount of the urine sampled can effect the results. How accurate are urine test in general? I filled my sample cup up about half way, could this have gave me a false negative? What is the suggested sample amount?

3. For my test I went through a website stdtestexpress.com done through LabCorp. I paid $300 for this panel that included a HIV PCR test, which seems a little cheap. Are these reliable tests? Here are the test and results I was provided:

HBsAg Screen: Negative
Hep. C: <0.1 Negative
RPR: Nonreactive
Chlamydia and Gonorrhoeae, NAA : Negative
HSV1 IgG Type specific: <0.91 Negative
HSV2 IgG Type specific: <0.91 Negative
HIV DNA, PCR/HIV HIV DNA RT by PCR: Negative Not detected
HIV 1/O/2 Abs-Index Value: <1.0
HIV 1/O/2 abs, Qual: Nonreactive

4.With it being a quality test can I rule out HIV with this negative PCR and Antibody test at 4 weeks ?

5. Is Hep B easily transmitted female to male through unprotected sex? Should I re-test bc of being outside of window period?

6. Lastly, Herpes, I have had no symptoms but was outside the window period for blood test. With no symptoms after 8 months, along with the negative blood test at 4 weeks is there any reason to worry ab infection? Would you recommend re-testing?

[H. Hunter Handsfield, M.D.]

I'm sorry to learn you are still having difficulty adjusting to your regretted sexual decisions several months ago.  From an STD standpoint, there is no need.  Directly to your questions:

1,2) It is irrelevant how long gonorrhea or chlamydia can persist without treatment.  It's generally a few weeks to maybe 6 months, so you're beyond that period anyway.  But your test results prove you were not infected anyway.  The urine tests are fully accurate.  This is an entirely unnecessary worry.

3) All those tests are accurate and all except herpes were done sufficiently long after the last possible exposure for conclusive results.  See below re herpes.

4) Yes, you can rule out HIV with 100% certainty.

5) The chance of hep B is extremely low after such an exposure and in any case your test was done long enough to be definitive.  You don't need any more testing.

6) The chance of herpes for any single exposure is under 1 chance in 1,000, and if you had it probably you would have had symptoms.  However, the blood tests do take longer to become positive, up to 3-4 months. Personally I see no need for further testing, but if for emotional reasons you need to have a definitive test result, you can be retested accurately at any time now.

It seems obvious your concern is way off the map given the nature of the exposures.  You may think your worries are all about STDs and HIV but they are not.  The problem here is your emotional adjustment to the sex itself.  I think your worries about it are permanent, i.e. will never clear up on their own -- only with professional mental health care.  I suggest it out of compassion, not criticism.

That will be all for this discussion.  There is nothing else I can help with from an STD/HIV standpoint.  Good luck.

HHH, MD

[H. Hunter Handsfield, M.D.]

Thanks for the thanks. Good luck to you.

[Garyhart1234]

Thanks Dr. HHH,

First I want to say thank you for all that you do on the forum. The postings are of great resource to many people dealing with the anxiety of a sexual mistake and truly help.

On an emotional standpoint, I was seeing a therapist about the problem for a couple of months and it helped to the point of which my anxiety ceased, so I quit seeing her. I have been fine up until entered this new relationship, out of respect for the individual, I could not help but worry about the possibility of an STD slipping through the cracks of my test and passing it along to her.

I have been denying to myself that this is an emotional problem but your comments have confirmed that it is. I will be scheduling an appointment with my therapist tomorrow and see if I can put this behind me once and for all.

Thanks again for all of your help and compassion, it is greatly appreciated.