Worried sick about HIV

Hi Doctor,
On Dec.28 I had sex with a Korean pros.  in the US.  Before sex she washed me with a meshed body scrubber and some liquid soap, then she kissed the side of the tip of my penis (she did not put it in her mouth or kiss the opening), after she put on a condom, gave me some oral and we had normal vaginal sex.  During sex I did but my fingers into her vagina, and it was very lubricated, after sex, with the condom off she masterbated me and then I also masterbated my self (with the same hand that I used to put into her vagina).  A few days after this incident I noticed the tip of my penis burns, (maybe 1-2 weeks after).  After this incident I also did a stupid thing, I donated blood (which I usually do, but not in such circumstances).  Feeling guilty about the blood donation (Jan 27) and worried that I have something I went to the doc (Jan 31). The burning continued, I had slight burning most of the day, but it usually got worse after urination and at night. The doc gave me a full round of STD tests and all were negative except HSV1.  He put me on Cipro 2x 500 MG per day for a week but that did not help.  That same day, I got an oral HIV test that came back negative.  Also I had an HIV PCR (Feb1) test which came back negative, and a finger prick test which also came back negative. I also ordered another HIV PCR test through another lab (1st lab LabCorp, 2nd Quest diagnostics), that also came back negative.  The burning continued so I went back to the doc and he gave me a shot of azithroand 4 pills of azithro to take at the same time(Feb19) that did not clear up the symptoms.  For the past 3-4 weeks I have not been defecating properly, I only defecate very little, and when I do it is loose (not really watery) but not hard and only once a day in small amounts no matter what I eat.  I also feel like Im loosing weight.  I have ordered an HIV 2 pcr , still waiting for the res.  Can this be HIV,  Could it be Chlamydia Does donating blood have an effect on PCR results

[Dr Sean Cummings]

Hi Mike,

Relax! You do not have HIV - I'm certain about that given the number of tests you have had and also the nature of the sex itself. I count four HIV tests to date including the one the blood transfusion service would have run on you at the time of donation. This test would most likely be a NAAT PCR for HIV RNA and is exquisitely sensitive from as early as 5 days post event. So, for me, HIV is not in the picture.

You said that the doctor gave you a full round of STD test - so chlamydia would have been included within that hopefully. Even if it wasn't the azithromycin should have dealt with it.

From your description it sounds as though you have a Non-Specific Urethritis - NSU for short - and this can arise from miscellaneous and usually innocent bugs that get into the tip of your penis or urethra (the hole you pee through). They can cause an inflammation which gives you the discomfort and they can also take some dislodging.

I would suggest you ask your doctor about doxycycline 100mg twice daily for 2 weeks which should resolve the issue for you.

Best wishes, Sean

[scaredMike892]

Thanks doctor, i have since recieved doxy and have been on it now for 2 days ( no effect yet).  I do know that the blood centet where i donated has not contacted me about anything, so i assume all is okay with them.  Just couple more questions:
1. Could donating blood (ie 1pint less blood in my system) have effected the outcome of my pcr tests)
2. I noticed that your institution provides a duo test which i have notheard of here in the U.S., can i find that test here?

[scaredMike892]

Hello, one more follow up question.  My doctor's office just got back to me and said all my tests including the urine culture were normal (these were CBC, urine, and urine culture), can this be the case if I have NSU?

[scaredMike892]

Dr. Cummings,
I realize I am being a pain, but I am really scared and need some calming, and you have not replied to any of my posts from yesterday.  Can you please reply to my previous posts -- I would really appreciate your input.

[Dr Sean Cummings]

Hello

You asked:-

1. Could donating blood (ie 1pint less blood in my system) have effected the outcome of my pcr tests)

NO - THIS WONT AFFECT ANY RESULTS

2. I noticed that your institution provides a duo test which i have notheard of here in the U.S., can i find that test here?

YES - QUEST DIAGNOSTICS AND LABCORP PROVIDE THESE TESTS IN THE USA.

You also asked about your results and NSU - the answer to your question is that negative results on these particular tests do not mean that you do not have an NSU. A swab taken directly from your urethra looking for NSU will tell you whether you have it or not.

best wishes, Sean

[scaredMike892]

Dr. Sorry to still be a pain, but I am now on doxy 100 mg twice a day for about a week but no real improvement.  Just wondering how (if my encounter was relatively safe) i could have gotten an NSU/NGU?  If i need to pay for this answer i will be more than happy to.  Thanks.

[Dr Sean Cummings]

Hi Mike

Last on this from us ok.

I have answered this question already - I've copied and pasted my original answer beneath.

"From your description it sounds as though you have a Non-Specific Urethritis - NSU for short - and this can arise from miscellaneous and usually innocent bugs that get into the tip of your penis or urethra (the hole you pee through). They can cause an inflammation which gives you the discomfort and they can also take some dislodging"

Best wishes, Sean