STDs screening/prevention

[AndyCCC]

Dear Doctors, I am a 30 years old man, hetero.

I feel healthy and without any symptoms. In my life I had my first girlfriend for 7 year. I have been single between 26 and 28 and now I have been with same girlfriend for last 2 years and some. In my 2 years as single (up to mid 2011) I visited up to 30 CSWs receiving unprotected orals and having protected vaginal sex. I had 1 time a condom failure, completely broken off with a CSW. Never symptoms of any sorts.
In mid 2011 when I met my girlfriend and before having unprotected sex with her, I had a 4th gen blood HIV test Negative.

Since then I am monogamous and I think my girlfriend had only 1 sex partner before me and never unprotected sex. I got worried as she will take a PAP test (control) in future. I am afraid I could have given her some STDs which maybe I have and I don't know it. Would you suggest any STD screenings to me at the moment? Which test should I do if I am worried I have STDs from my past experiences with CSWs? As a man with my sexual history, what should I do to be sure my experiences with CSWs will not give me problems in future? I am relaxed about not having HIV but afraid I can have something without knowing. I regret unprotected orals with CSWs. Me and grifriend we are planning to get married and we would like to have babies in next future.

Best regards and thanks for your help in advance, Andy.

[Edward W Hook, MD]

Welcome to our Forum.  I will be pleased to comment.  In general, you have taken good precautions against STIs and in the absence of symptoms the likelihood that you have any STI at the present time is low.  If you wish to be entirely sure, a single STD screening with testing for gonorrhea, chlamydia and syphilis are all that you need.  Your HIV test as you entered your current relationship provides you with solid information that you do not have HIV and I see no reason for further HIV testing unless you have new partners.  We do not recommend routine blood tests for herpes. The tests are not reliable enough and sometimes give false positive results.  

The only STI that either you or your GF might have at this time is HPV and it is probable that one or both or you may have this infection already- most adults do.  There is no reliable test for HPV in men and in women, the consequences of are routinely checked as part of annual examinations.  If one of you has HPV, it does not mean that the other gave it to you.  This is not something to worry about.

I hope these comments are helpful to you.  Your overall chance of having any STI is low but, as I said, with a single, simple testing visit, you can be completely sure that you do not have any STI to worry about if you wish.  EWH

[Edward W Hook, MD]

Your risk for syphilis, based what you say is very, very low and if you have not been tested for syphilis, I would not worry about it. On the other hand, most of the time when people ask to be tested for STIs, syphiis testing is included if blood is drawn becasue it is relatively cheap, easy and accurate.  EWH

[AndyCCC]

I am very glad you helped me. I feel I know how to move thanks to you.

Just one final question about syphilis if I could.

Do you think is possible I took syphilis from my sexual history? From what I read on this forum I thought I was not at risk.

I will proceed surely with tests for gonorrhoea and chlamydia and I am unsure about syphilis testing (also for what I understand there are very different testing procedures).

Do you think I can be safe not testing for syphilis?

I am happy and relaxed thanks to your advice.
Have a great day and I wish medhelp to grow more and more.

Best, Andy.