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Syphilis and other STDs

May 10, 2010

Dear Doctor,

I have been HIV+ for over a decade, but only started meds around a year ago. UD and CD4 stable at 460 (27%) as of March 2010. I was very safe when it came to sex and my last full STD panel was done in Dec 2009. I did something very stupid about 2 months ago - barebacking with another HIV+ man. I should have tested earlier but held it off, hoping I didn't catch anything.

But a few days ago I noticed a small red spot on my penis, and promptly asked my GP for a syphilis test (should have ordered others, but they will be done soon). At around the same time I noticed red blood in stools; my GP checked and said it was probably caused by hemorrhoids.

In any case the syphilis test came back reactive 3 days, with a titer of 1:64. I will see my ID doctor tomorrow. Now other than syphilis, I worry that I might have also contracted rectal gonorrhea and other STDs. I am also since earlier this week began to feel a lot of muscle ache (couldn't start a day without a over-the-counter painkiller), general tiredness and more than usual night sweating.

I am fully prepared for the penicillin treatment and even lumbar puncture (if doctor orders). I want to know what advises you might in turn of other possible STDs, in particularly regarding the tiredness and muscle ache. What other tests I should do? And if I am co-infected with gonorrhea or other STDs, how will they affect the syphilis treatment.

Thanks in advance for your help,

Response from Dr. Holodniy

Yes, you need to be tested and possibly treated for other STDs besides syphilis. Blood in the stool would be unlikely from syphilis. Anoscopy and rectal screening for other STDs should be performed.

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Is my baby truly not infected?

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