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About Mark Behar
Expertise
Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience
Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations
Distinguished Fellow, American Academy of Physician Assistants; Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
Florida Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP)
Publications
Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials
Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors
Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology
Past/Present Clients
Brady East STD Clinic, Milwaukee, WI
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You are here: Experts > Teens > Health for Teens > Sexually Transmitted Diseases > tested negative, now more freaked out
Expert: Mark Behar
Date: 10/10/2008
Subject: tested negative, now more freaked out
Question
Mark,
About a month ago I had unprotected sex. About 3 days after that I began experiencing symptoms associated with Chlamydia or Gonorrhea, specifically burning after urination (at first it was only a few moments after, later in the day it was during as well), frequent urination, and a small amount of discharge (a note on the discharge, it was the heaviest, though still not 'heavy', in the morning after I just woke up). I immediately scheduled an appointment for std testing.
a few days later at the appointment I took a urine test for Chlamydia and Gonorrhea and was treated for chlamydia with zithromax (since it was most likely that according to physician)
my question is this, I just got the test results back as negative for both, so what was likely the problem before? Should I ask to be retested? is there another common cause that would explain these symptoms (they are completely gone by the way, they had all but disappeared even before the testing)? could they have possibly been psychosomatic?
thanks for taking the time to share some info.
Answer
Hi Jon,
I agree with the doctor's initial assessment, and your treatment with Zithromax was appropriate. But since the gonorrhea and chlamydia tests were negative, what did you really have? You could have still had one of these infections, but the test was falsely negative. Or, you could have had ureaplasma or mycoplasma, both of which have very similar signs and symptoms to chlamydia. The treatment may not be effective for ureaplasma or mycoplasma, however. The symptoms can also be caused by a prostate infection, as well.
What you had was not psychosomatic. The actual discharge was due to some degree of inflammation, which is ususally caused by an infectious germ. Make sure your partner is co-treated before resuming unprotected sex, or you may develop symptoms again from reinfection.
Good luck!
--mark
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