Dear Doctors, I would be extremely grateful if you could help me with some questions.
I foolishly had a drunken encounter with sex worker in Thailand eight and a half weeks ago. As best as I can remember the vaginal sex was protected, but we engaged in unprotected oral sex (both ways) and French kissing, but I was rather drunk. She suggested the condoms before I had to, and put them on. I am hopeful I was protected for the vaginal intercourse.
Anyway, there began a long period of intense anxiety and worry until I got home, and I was tested for HIV by DUO test at 7 weeks and 3 days. I got my result three days later which was negative. Can you confirm that I can treat that result as conclusive and that I did not get HIV from the exposure?
Nipping back in time for a second, I was tested just over a week after the exposure itself for Chlamydia and Gonorrhoea, in a Thai clinic, and those tests were negative. I had picked up a UTI however, the offending bacteria was apparently gram positive cocci, which the doctor said I would have got from fellatio. I was given Cephaloxin 500mg x 2 for 5 days and I have had no symptoms since. Should I have any further concerns about this? I was diving, and about a week later got a left side middle ear infection. I went to the same clinic which attributed the infection to diving and prescribed Amoxycillin 500mg 2x2 for a week with anti-inflams. Again this cleared up as predicted.
I am now worried about Hepatitis and Syphilis exposure. I do not know much about these conditions, or testing procedures. That said, am I correct that my chance of Hepatitis C is very remote given the above?
I understand that Hep B is rife in South East Asia. I did not have time to get immunised before I went to Thailand (I was on one of the quieter islands) save for Hep A. What is my risk in light of the exposure described?
Obviously I want to be tested. Should I be tested for Hep B and C? Also, when can I be reliably tested for Hepatitis and Syphilis? At 8.5 weeks post exposure can I be tested now? If so, are there particular tests I need to ask for pertinent to this period after exposure? I will likely have to go to the NHS clinic as I can't really afford more private testing (the HIV test was private, as I wanted the results quickly). Will they likely have the right tests available? Sadly they do a no news is good after 3 weeks thing, but you pays yer money I guess.
Is syphilis curable if caught early enough?
When flying home from Thailand I had a stiff neck come on (up the back and to the sides). I also had a mild sore throat (left side) for a day or so. I generally felt a bit unwell, which lasted for maybe just over a week to a week and a half. I don’t think I had a fever. It was immediately prior to my DUO test and went off just before it. In addition, for several weeks I have had discomfort in my underarms (and occasionally my groin). It seems to move around (e.g. underarm, more towards chest, down the side, onto arms, etc), is sometimes in the left, sometimes right, sometimes both, but is not constant (and some days I do not have it at all), nor especially painful. I have felt for lumps and cannot feel anything obvious. I did read that underarm pain can be a sign of anxiety, and I have certainly been susceptible to health anxiety related aches and pains in the past. My questions with regards these symptoms are, do they sound like either Hepatitis or Syphilis, or were my 6+ weeks of extreme anxiety over HIV, and possibly a cold or something, the more likely culprits? I still have the underarm symptoms now, although again they are not constant or severe.
I have also noticed some itchy spots above my right knee. I noticed them at least a week ago, and they are still there. Sometimes they go down. They can be itchy, but not all the time, and look like tiny pimples. They cover an area of about an inch by half an inch.
My two last and most pressing concerns are these: My father practically ordered me to use his beard trimmer a couple of days ago as mine had broken. He was being kind and I couldn’t really say ‘But I might have hepatitis’ so I had a go with it. I am now concerned I might pass hepatitis onto him if he uses it. I did not break the skin when I used it that I am aware of, and passed a lighter across the blade several times in a crude effort to try and sterilise it. Should I have hepatitis can it be transmitted to him in this way? (I haven’t given the trimmer back yet). What should I do?
Secondly, on Saturday night I went to birthday party and I snogged somebody. I have just seen on here that syphilis can be transmitted by kissing (I had no idea). In fact, I’ve casually kissed loads of people since the exposure, might I have inadvertently infected half of my friends and relations? I have not been aware of any symptoms on my lips. My tongue has been slightly sensitive on occasions but I smoke a lot and anyway this is not altogether unusual for me. If I had syphilis symptoms in my mouth or lips would I truly know about them? I just looked at some pictures online and I have had nothing like those. I am panic stricken that I may had passed one of these illnesses onto these poor people.
Sorry for so many questions, but I seem to have a lot of things to sort out it seems. I hope you can help me, and thank you so much for your time.
Anyway, there began a long period of intense anxiety and worry until I got home, and I was tested for HIV by DUO test at 7 weeks and 3 days. I got my result three days later which was negative. Can you confirm that I can treat that result as conclusive and that I did not get HIV from the exposure?yes - absolutely
Quote:
Nipping back in time for a second, I was tested just over a week after the exposure itself for Chlamydia and Gonorrhoea, in a Thai clinic, and those tests were negative. I had picked up a UTI however, the offending bacteria was apparently gram positive cocci, which the doctor said I would have got from fellatio. I was given Cephaloxin 500mg x 2 for 5 days and I have had no symptoms since. Should I have any further concerns about this? I was diving, and about a week later got a left side middle ear infection. I went to the same clinic which attributed the infection to diving and prescribed Amoxycillin 500mg 2x2 for a week with anti-inflams. Again this cleared up as predicted.this is fine - the clinic was correct, the treatment was correct and you got better - ideal
Quote:
I am now worried about Hepatitis and Syphilis exposure. I do not know much about these conditions, or testing procedures. That said, am I correct that my chance of Hepatitis C is very remote given the above?you are correct - the hepatitis c risk is remote in the extreme. The risk on the other hand of syphilis is higher but still remote.
I've read all the rest of your post - which as you say is very very long.
You may test for syphilis, hepatitis C, hepatitis b etc now if you wish. The NHS is unlikely to want to test you for hepatitis C as the risk is very small.
I don't think there's any realistic possibility of you having any of the diseases you are concerned about.
Thanks for your reply. I want to to confirm with you what test should I do for Hepatitis B & C at this period (9 weeks finished) to get a colculsive result? . Is an anti HCV & HBSAG reliable after 9 weeks?
For Hep B, it would be HepBsAg and this can be considered conclusive at 9 weeks. However for Hep C, the Hep C antibody test is fully conclusive after 12 weeks. Even though I would agree with my colleague Dr Sean with the fact that you do not really need these tests.
Best wishes,
José
Cheeky monkey - that wasn't the original poster asking the second question, but I suppose being unregistered that happens. Probably good questions though so I'll let him/her off pretending to be me.
Anyway, I just wanted to thank both doctors for taking the time to read my very very long post (so sorry about that) and for their kind responses, which were about ten thousand times more uplifting than I thought they ever could be when I posted my questions.
Above all, does this mean I can give the beard trimmer back?!
Thank you so much Dr Cummings, and now Dr Gonzalez-Garcia, for your time and advice, I am extremely grateful.
STI risk and testing
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