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Fitness and body

Could I still have an STI if my results were all negative?

That guy you hooked up with two weeks ago just told you he has syphilis. But you got tested last week and all your results were negative. Are you in the clear?

Could I still have an STI if my results were all negative?

You got tested last week and all your results were negative.

But that guy you hooked up with a couple of weeks ago has just told you he tested positive for syphilis. You consider getting tested again, but it seems like overkill. You’ve got no symptoms, and if he’d passed it on to you, your tests would have picked it up, right?
Right?

Not necessarily. Welcome, brother, to the window period.

What is a window period?

For an explanation, we spoke to Dr Vincent Cornelisse, Sexual Health Physician at the Melbourne Sexual Health Centre (MSHC), who is also completing a PhD on the prevention of STIs.

“The window period is the time after an exposure to an STI, during which it may not show up on a test. The window period for every STI is different, mainly because we use different tests to detect them,” says Cornelisse.

“For example, the tests we currently use for gonorrhea and chlamydia — from urine samples and swabs — test for the DNA of those organisms themselves, and have quite short window periods,” he explains (see below for a list of STI window periods). “But the syphilis test is a blood test. There is no good way of directly looking for syphilis, so the test we use looks for your immune response to the infection, which takes a bit longer to show up. It also varies, because some people’s immune systems will react more quickly or more slowly, so the window period is longer to account for those individual differences.”

It’s important to note that this doesn’t make testing useless within the window period. “The window period only refers to the accuracy of a negative result,” says Cornelisse. “A positive result is still possible within the window period, and it would still be an accurate positive result.”

So, if I have no symptoms after the window period, do I still need to get tested?

Yes, it’s a good idea if you think you’ve been exposed. The window period refers to testing, not to the time it takes for symptoms to show.

“Just like your Scruff pics, your test results are an intimate glimpse of the recent past.”

“There are a lot of people with STIs who have no symptoms,” says Cornelisse. “Having no symptoms after a possible exposure doesn’t put you in the clear, even when you’ve passed the window period. We recommend that men who have sex with men (MSM) get tested every three months if they have more than one partner. In addition, get tested if you’ve think you’ve been exposed, or if you’ve attended a ‘sex event’ — like group sex or sex parties — that you think might have put you in contact with STIs.”

How do window periods affect my test results?

Just like your Scruff pics, your test results are an intimate glimpse of the recent past.

“Say for example that you come in and get a test done for all STIs, and all your results are negative. What that means is that one week ago you didn’t have chlamydia and gonorrhea, six weeks ago you didn’t have syphilis, and so on. If you’ve acquired any of these infections since then, they may not show up yet,” says Cornelisse. “That’s one of the reasons it’s so important to get tested regularly.”

So, to return to our example, a guy gets a call that he’s been exposed to syphilis, which has a window period of six weeks. He was exposed two weeks ago and had a negative test result since then. What should he do?

“He should go and get a syphilis test,” says Cornelisse. “He will usually have two options. Option one is to get treated at the same time as the test, on the presumption that he might have syphilis, and because the syphilis may not show up on the blood test. Option two is to test today, abstain from sex for six weeks and then come back and re-test when he is outside of the window period. Most guys choose option one.”

No surprises there. Cornelisse says this would be different for other STIs, though. “For gonorrhea, the test is a lot more sensitive, has a much shorter window period, and the result is available in one or two days, so we often just recommend the test and not necessarily the treatment straight away,” he says.

There are currently two ways to test for HIV: the HIV antibody test method, and the HIV RNA test. What is the difference, and does this affect the HIV window period?

“In Australia, we use the fourth-generation antigen antibody combination test for HIV. Without getting too technical, this test is designed to be able to detect HIV at various stages of infection.”

“…it’s important to get tested regularly, get treated if necessary, and come back for retesting if your doctor recommends it.”

The RNA test (which you may have seen headlining the opening seconds of your favourite bareback porn) isn’t used routinely as part of a screening test in Australia. “We would use it in specific situations, which are quite rare, and it’s not part of the STI testing you’d normally get. It would make possibly a few days’ difference to the HIV testing window period.”

What can you do if you’re not on PrEP, you’ve been exposed to HIV, and you’re still within the window period?

“It depends on the timing,” says Cornelisse. “If you’ve been exposed in the last 72 hours, make an urgent appointment with a health professional to start Post-Exposure Prophylaxis (PEP). PEP does need to be started within 72 hours, and preferably within 24 hours.”

If you’re outside the 72-hour period, then PEP is not a very effective option. “But it’s still worth getting an HIV test done,” explains Cornelisse. “Even though you’re within the window period, it doesn’t mean the test will be useless. A positive result is still possible, and if that’s the case you can get started on your treatment quickly. And if you’ve had a high risk of exposure and you’ve missed the boat with PEP, minimise your risk of passing HIV to your sexual partners until you have a definitive result, either by abstaining or by using condoms.”

What, specifically, are the window periods for different STIs?

While there are researched-based guidelines, STIs don’t necessarily stick to a schedule, and new research and technology can change how testing works. That’s why it’s important to get tested regularly, get treated if necessary, and come back for retesting if your doctor recommends it. With that in mind, the current STI window periods are:

STI Window period
Chlamydia 1-5 days (most accurate after 7 days)
Gonorrhea 2-4 days (most accurate after 7 days)
Syphilis 6 weeks
HIV 6 weeks
Hepatitis A 4 weeks
Hepatitis B 30-60 days
Hepatitis C 6-10 weeks

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24 Comments

  1. So the window period for hiv is 6 weeks??? Is that only Melbourne because everywhere else says 12weeks. Is the 4 th gen test the same everywhere in Australia??

    1. Hi John,
      Thanks for your question. A six week window period applies for anywhere using a 4th generation combined antigen/antibody HIV test, which is performed in a laboratory based on serology testing of a blood sample.

      In fact, 4th generation antigen/antibody tests provide detection for 95% of HIV infections within a four week window period. However, modern health promotion recommendations reinforce this as six weeks to provide an even greater window of confidence.

      A 12 week window period still applies for many rapid HIV testing kits used in Australia, which typically detect the presence of HIV antibodies rather than a combined antigen/antibody test.

      Discussing window period considerations with the test facilitator is the best way to be sure.

      Cheers — The Emen8 Team

    1. Hi Ross,
      Thanks for your question.

      Syphilis seroconversion typically occurs around 3 weeks, but can take up to 6 weeks.

      While a six week window period provides robust coverage in most cases, it’s still recommended for sexually active people to go for comprehensive sexual health testing at least once every three months.

      Cheers — the Emen8 team

  2. Hi

    I am having a huge issue right now to deal with..
    I recently had a fever, severe chills, muscle aches and headache. Next day extreme sore throat.
    3rd day hard to swallow and a spotty rash on the palms of my hands and feet that got worse every hour.

    I found out my bf was also with someone a month ago..
    My test was negative for syphilis but they still treated me for it..
    They also said possible hand foot mouth disease but I am not 5 yrs old.
    I got the chills the next day I got back from Hawaii

    I made him get a test.
    He and her both tested negative for syphilis as well.

    I 1st went to the hospital and they told me to follow up at a STD clinic..
    The STD clinic saw the photos I took and said I had classic syphilis rash!
    I have only been with him and I get tested yearly.

    He will NOT get a shot of penicillin coz he tested negative.
    He will not listen to me that he should get one to be safe and also coz his Dr said he is negative and he doesn’t need it if negative.

    Can it be syphilis even though I am negative and him too?

    Can someone be a carrier and be negative as well?

    I have only been with him for the past 7 months.

    After I got the shot my rash got bigger but now is getting better and the skin falls off like a flake where the rash spots were.
    My skin is peeling where the rash was.

    Should he get the shot?
    Should he get re tested?

    All 3 of us are negative.

    This is such a tricky situation ..

    I think he should get the shot and retested in a month personally

    I also had a pedicure and that’s when I noticed the rash afterwards. Should she be worried as well?

    Right now I feel like I’m just a disease.

    He regrets being with her and sees how hurt I am and the drama this has caused. He said he wants us to work.
    I need to build trust again.
    I said NO SHOT = NO ME

    Could I of had this for years? Even though my result Is negative..

    But all I can think of is even if those 2 are negative.. and a month later I got this and I am negative..
    What in hell do I have then??

    Thankyou!

    1. Hello Confused,
      Thanks for getting in touch.

      It sounds like you’ve done the right thing by going to sexual health centre and getting tested. It’s best to check in with them regarding your healthcare. Only they are able to offer a diagnosis based on laboratory tests. It is not possible to confirm any kind of diagnosis from your description alone.

      To answer your questions, we can advise that syphilis can have a window period of at least six weeks. This means that it’s possible for someone to come into contact with and acquire syphilis without it being detected by a test until up to around six weeks later. So in this particular scenario, someone could have recently acquired syphilis even when a test result does not yet show it. That’s why it’s important for all sexually active people to go for regular testing — at least once every three months is recommended.

      Considering the sensitivity of blood tests for syphilis, it is highly unlikely someone could have syphilis for years and get a negative test result. Although it is possible for someone to have syphilis for years without knowing.

      We’d recommend continuing to consult with the medical professionals at your sexual health centre for advice and guidelines for further testing.

      Best wishes – the Emen8 team

  3. Good day
    Im a bit confused if my test for syphilis that I have done should retest again after 12th week post exposure. Please help.
    My blood test for syphilis are as follows.
    4th week post exposure ( nonreactive result)
    7th week post exposure ( nonreactive result)

    1. Hi there, and thanks for your comment.

      In Australia, tests for syphilis are most accurate from six weeks after exposure. It’s best to discuss your testing needs and follow the recommendations from your doctor or sexual health centre specialist. Testing from 12 weeks after a possible exposure is a good way to increase confidence for a non-reactive result, and the recommended recurring testing frequency for all sexually active people.

      Going for regular sexual health tests is important for anyone having sex. For anyone having one sexual partner in the last six months, it’s still recommended to test at least twice a year as standard. For anyone with 10 or more sexual partners in the last six months, testing at least four times a year is recommended.

      Cheers — the Emen8 team

  4. Hi could you explain why most sti clinics suggest testing after two weeks after to sex for chlamydia and gonorrhea. I did a test 1 week after which is what you suggest, I was negative but was advised to do the test at a 2 week window? Just adding more to worry, A bit confused to be honest. Thank you for the website btw.

    Sam

    1. Hi Sam,
      Thanks for your comment and great to hear you’ve been for sexual health tests.

      In Australia, tests for chlamydia and gonnorhea will be most accurate from seven days after exposure. It’s best to discuss and follow the recommendations from the specialists at your sexual health centre. Leaving two weeks may be a precautionary measure to have even greater confidence in the results.

      Going for regular sexual health tests is important for anyone having sex. For anyone having one sexual partner in the last six months, it’s still recommended to test at least twice a year as standard. For anyone with 10 or more sexual partners in the last six months, testing at least four times a year is recommended.

      Cheers — the Emen8 team

      1. Thank you for clarifying. Just wondering if its necessary to nor pass urine for 1 hour before a urine test for Chlamydia? I got a negative result but took the test just 40 minutes after previously passing urine. Could this result in a false negative? Are false negatives common?

        1. Hi Roger,
          False results from tests are uncommon, though not impossible. Not all tests for chlamydia are the same, so it’s best to check in with your healthcare professional if you have concerns over your results.

          Cheers — the Emen8 team

  5. Hi, so I got tested for Chlamydia after possible exposure about 6 days after. The test came back negative, but should I be worried about the accuracy of the test?? Just confused and looking for answers, Thankyou!

    1. Hi there and thanks for your comment.

      In Australia, tests for chlamydia will be most accurate from seven days after exposure. It’s best to discuss and follow the recommendations from your healthcare provider for your circumstances.

      Going for regular sexual health tests is important for anyone having sex. To increase your confidence in test results, going for comprehensive sexual health tests at least once every three months is good practice.

      Cheers — the Emen8 team

  6. Hi I had a RPR Syphilis test at 3 months post exposure & a TPPA test at 7 months post exposure both negative/ non reactive are these 2 test conclusive or should other test be taken.

    1. Hi Ted.

      Thanks for your comment. In Australia, tests for Syphilis will identify the majority of cases from at least 6 weeks after exposure. It’s best to discuss your results and follow the recommendations from your healthcare provider for your circumstances.

      If you’ve continued having sex (with or without using condoms), it’s still best to go for comprehensive sexual health tests at least once every three months as standard.

      Cheers — the Emen8 team

  7. Question. About 4-5 years ago I had sex either this lady. It was said she had something. HIV..
    My girl and I been together for a year and a half. She got pregnant last year in July. She had blood work done. But the doctor said the blood work came bk fine. I just want to know if we been together to hat long, wouldn’t it have pop up that I or her had something

    1. Hi Carlos,
      Thanks for your question. It’s possible for STIs to remain undiagnosed for many years in people as symptoms aren’t always guaranteed. The only way to be sure if you have or haven’t acquired any is to go for comprehensive sexual health testing, which includes testing for HIV and STIs such as syphilis, chlamydia and gonorrhea.

      If you live in Australia, you can find nearby sexual health testing services using our interactive map.

      Cheers — the Emen8 team

  8. Hi I had unprotected sex over 5 months ago have tested negative at 6 12 and 13 weeks to hiv and full sti screen . I have had costed yellow tongue for 4 months. Treatments from Oral specialist etc not working.

    Do I need to test at 6 months ???

    1. Hi John and thanks for your comment.

      Going for regular sexual health tests is important for anyone having sex. For anyone having at least one sexual partner in the last six months, it’s still recommended to test at least twice a year as standard. For anyone with 10 or more sexual partners in the last six months, testing at least four times a year is recommended.

      If you have concerns about previous test results or current symptoms, it’s best to discuss these with your healthcare professional.

      Cheers — the Emen8 team

  9. I got tested for chlamydia 5 days after exposure then two weeks after exposure both came back negative now a month later I’m having bleeding between periods was it a false neg

    1. Hi there and thanks for your comment.

      In Australia, tests for chlamydia will be most accurate from seven days after exposure. For anyone having at least one sexual partner in the last six months, it’s still recommended to test at least twice a year as standard. For anyone with 10 or more sexual partners in the last six months, testing at least four times a year is recommended.

      If you have concerns about previous test results or current symptoms, it’s best to discuss these with your healthcare professional.

      Cheers — the Emen8 team

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