<s>[INST] Hello doctor, Unfortunate is that I am a bicurious male who encountered a possible exposure to blood (environmental exposure). Being my first male to male exposure, I was not very sure to engage in anal sex and I just tried inserting and I am sure even I was not too hard enough to penetrate when I tried to. So, I removed the condom and just ejaculated. Before that, I had unprotected oral sex. Once I was about to leave the place, I found a tinge of blood on the top of the used condom. It happened over three months ago. I tested the partner on the same day for HIV fourth generation Ab/Ag test and he tested negative. From then, I am panicked about being contracted with HCV and HIV. In the due course, I got a small sore on my penis which was examined by a dermatologist and he was very sure that it was not a syphilis sore (I explained all that happened). Eight weeks later, I wanted the person who had all other STD tests including syphilis, HCV, and HIV. He tested positive for syphilis and only now he is on treatment. My VDRL and TPHA results are negative until the last test 90 days after the exposure. Further, I underwent Anti-HIV Combo ab/ag, Anti HCV, VDRL, TPHA, HIV RNA PCR qualitative several times in the last three months and got the results as non-reactive and non-detected. Now it has been 13 weeks and three days since the possible exposure. All the above tests were taken in a reputed lab. Apart from the above, HIV RNA qualitative and Western blot tests were also done in a different lab twice (eight and 10 weeks post exposure) and were negative. My fear is: If there was any exposure by touching the blood while I pulled off my condom and that had contact with my penile gland when I ejaculated (though I did not have any open cut or sore, did not see any bleeding or blood tinge on my penis when I washed my penis after the mishap), will I be at a greater risk of contracting HIV or HCV (though the partner was tested negative for HIV and HCV two months post this mishap)? With the above tests done now after three months, what is the chance that I had contracted HIV or HCV? With articles on the internet talking about HIV and HCV co-infection which delays HIV seroconversion, make me go mad. With the tests done can I allay my fears of HIV at least? As my partner is positive for syphilis, is my three months negative VDRL conclusive on me? Is there any other test I can do to put my mind at peace? It has been three months since I slept and now I feel that my liver is bulged and my ribs are aching. I know I am paranoid but an assurance from you as a doctor would give me more confidence. Please help. [/INST] Hello. Since the blood was on the outside of the condom, therefore, it was almost certainly not in direct contact with your penis. Your screening tests are negative on multiple occasions and they are conclusive. A negative Combo test (Anti HIV antibody test and P24Ag test) is considered conclusive at six weeks by most HIV (human immunodeficiency virus) specialists. Similarly, anti-HCV (hepatitis C) and HBsAg (hepatitis B) are reliable six weeks onwards in those with possible exposure. VDRL (venereal disease research laboratory) usually becomes positive three weeks after infection but because of the variable incubation period of syphilis of nine to 90 days, it is certainly conclusive if it is negative at three months. So a negative at three months in your case is conclusive. Regards. For more information consult a dermatologist online --> </s>