Aftercare

PEP completion if started

If you initiated post-exposure prophylaxis (PEP) during the trip, the course runs for 28 days from the first dose and requires daily adherence. Missing doses reduces efficacy. If you are returning home mid-course, ensure you have enough medication to complete the 28 days — most antiretrovirals can be carried across international borders with a prescription; check specific country regulations for Japan (which has import controls on some ARVs) and Singapore before travelling. Your home HIV clinic or GP can continue the prescription; bring the paperwork from the initiating clinic.

First STI test if symptomatic

Gonorrhoea and chlamydia symptoms (discharge, burning on urination, pelvic pain) can appear within 1–14 days. Syphilis primary chancre (painless genital ulcer) typically appears 10–90 days post-exposure. Herpes symptoms (painful blisters) typically appear 2–12 days. If any of these symptoms are present within the first week, see a doctor immediately — do not wait for a scheduled STI panel. Symptomatic presentation means the window period is not a barrier; the pathogen is already replicating at detectable levels.

Embassy follow-up if there was an incident

If you were scammed, detained, or subjected to any incident that you reported to local authorities before leaving, file a follow-up report with your home country's foreign ministry as soon as you land. This is primarily for documentation that supports travel-insurance claims, potential repatriation of lost funds in rare cases, and country-level pattern monitoring. It does not require that you believe anything will be recovered.

Mental-health decompression

The first week home can include a disorientation that is not talked about in most travel health contexts: the re-entry adjustment from a context with very different norms, possibly including experiences that felt compartmentalised during the trip. This is normal and does not require clinical intervention on its own. It does, however, sometimes develop into something worth addressing — see the mental-health section below.

Baseline STI panel

At weeks 2–4, request a full STI panel from your GP or a sexual-health clinic:

• HIV 4th-generation (Ag/Ab combo test) — detects both HIV antigen (p24) and antibodies. Can detect infection from as early as 18 days; most infections detectable by day 45. A negative at week 4 is reassuring but not definitive — a repeat at week 12 is needed to confirm.
• Syphilis (TPPA or RPR) — window period is approximately 3–6 weeks. A week-4 test may miss very recent infection; repeat at week 6.
• Gonorrhoea (NAAT/PCR) — detectable within days of symptom onset; window period is very short. If asymptomatic, week-2 testing is adequate.
• Chlamydia (NAAT/PCR) — same window as gonorrhoea; week-2 adequate if asymptomatic.
• Hepatitis C (HCV antibody) — window period 8–11 weeks; week-2 test is too early unless you were exposed via a needle-sharing or blood-exposure event (in which case an RNA PCR test can detect earlier).

Talking to your home doctor

You do not need to characterise your travel as "adult travel" to request a full STI panel. "I travelled to Southeast/East Asia and had unprotected sex" is sufficient clinical information. Most GPs in the UK (via NHS sexual-health clinics), US (Planned Parenthood, local health departments), Australia (Medicare-bulk-billed clinics), and Canada (free provincial STI testing) will order the full panel without further characterisation.

If your GP is unfamiliar with PEP follow-up protocols or the specific STI context of Asian travel, ask for a referral to a specialist sexual-health clinic (GUM clinic in the UK; ID/infectious-disease department elsewhere).

Repeat HIV testing at week 6 and week 12

The 4th-generation HIV test detects virtually all infections by 45 days (week 6). The standard clinical recommendation is a confirmatory negative at week 12 (90 days) to formally close out an exposure event — this covers the small proportion of people in whom antibody response is delayed. If you tested HIV-negative at week 6 and have had no further exposures, a week-12 test is sufficient to provide definitive clearance. If you were on PEP, the week-12 test is counted from the last dose, not from the exposure date.

Hepatitis B and C window-period testing

Hepatitis B (HBsAg) window period is 1–9 weeks; a week-6 test is usually adequate. If you are vaccinated against hepatitis B, testing is lower priority (though not zero). Hepatitis C antibody test at week 12 is the standard; if there was high-risk blood exposure, an HCV RNA PCR at week 4 can confirm or rule out earlier.

HPV consideration

HPV is the most common STI globally and has no diagnostic test for most strains in non-symptomatic individuals. If you have not been vaccinated, discuss this with your GP — vaccination post-exposure is still useful for strains you have not been exposed to. HPV-related complications (warts, cervical, penile, anal pathology) present months to years after exposure; regular cervical screening remains the primary management tool.

Herpes

HSV-2 (genital herpes) serological testing has significant false-positive issues in low-prevalence populations, which is why routine serology is not recommended. If you have had symptoms (painful blisters or ulcers) during or after the trip, a swab of an active lesion during an episode is the most reliable diagnostic method. Discuss serology testing with your GP in context.

Partner notification

If any STI is diagnosed at any point in this timeline, your sexual-health clinic can assist with partner notification — the contact-tracing process of informing people you may have exposed. This can be done anonymously in most health systems. In some jurisdictions (UK, Canada, Australia) there are legal-disclosure obligations in specific circumstances; your doctor will advise.