Sexually Transmitted Diseases/gonorrhea

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Question
I'm a 30 year old American male, living in South Korea.

3 days ago I received unprotected oral sex, from a sex worker. I did not ejaculate while receiving oral sex.

With in 24 hours of the act, I got and took the CDC recommended antibiotic single dose regimen, oral not injection, for gonorrhea. (I am acting as if I have 100% chance of contracting the disease for safety sake.)  

1. Is taking this medicine this early effective against possible contraction / infection of the disease?

2. Or is it so early that it will not work because the bacteria has not incubated?  Will it kill the bacteria anyways, before it can even incubate?

3. Is it accurate to take a test of cure, seven days after taking the medicine?

Thanks,

Steve

Answer
Hello Steve,
The CDC's guidelines for gonorrhea are designed for people in the US, since there is more evidence of antibiotic resistance, especially to gonorrhea, and especially in SE Asia. You could follow the CDC's recommendations for high risk for antibiotic resistance, as you did not mention which specific antibiotic and dosing regimen you chose.  Note, that chlamydia is more common than gonorrhea, and the treatment may be different.

Taking correct medication early is effective against contracting gonorrhea. If the germ is present, regardless of whether you have symptoms or not, than it should be effective treated with the correct antibiotic.

Test of cures are not necessarily recommended, but if you do it, it somewhat depends on which tests you use. The commonly used DNA test is very sensitive, and may cause false positive if you do it within 2 or 3 weeks of treatment if you were really positive before.

Hope this is helpful!
--mark

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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; answered 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
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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