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Condom Slippage
Hallo Dr. Your professional input will be of great importance to me. I have already posted my situation here before but I will repeat for the sake of keeping things in one post.
About 5 weeks ago I had protected sexual encounter with two CSW. Both cases condom slipped but was visibly hanging outside vagina. I replaced with new condom both times and continued with sex with one CSW and only hand job with the other.
Anyway 8 days later I discover a clear discharge after I pass urine. I also begun to notice some very slight tingling once in a while at the tip of my penis. Same day I first discovered discharge I started having bad stomach cramps with on and off diarrhea and a very sore neck. The neck was so sore some what painful and my lymph nodes along my jaw and between jaw and neck were swollen (still swollen today) Stomach cramps and the on and off diarrhea persisted for a week but neck is still sore, only not as much as before. Almost two weeks after exposure I also discovered right inguinal lymph node. I visited a doctor who prescribed azythromycin without performing any tests. Around day 22 I had night sweats that went on for about 4 -5 days. My armpits started getting sore with a feeling of dull pain. I have later come to discover small lamps underneath my armpits that I believe are swollen nodes. Initially after convincing myself that all this is due to anxiety I had unprotected sex with my wife. Now I am scared to death I might have infected her. I am a real mess and totally dysfunctional. I have read in various forums, including this one some people who had very sore neck during seroconversion eventually tested positive. Dr. I am mortified especially due to the fact that I may have infected my wife. I am currently on day 35 post exposure. What are your thoughts? Thanks..
About 5 weeks ago I had protected sexual encounter with two CSW. Both cases condom slipped but was visibly hanging outside vagina. I replaced with new condom both times and continued with sex with one CSW and only hand job with the other.
Anyway 8 days later I discover a clear discharge after I pass urine. I also begun to notice some very slight tingling once in a while at the tip of my penis. Same day I first discovered discharge I started having bad stomach cramps with on and off diarrhea and a very sore neck. The neck was so sore some what painful and my lymph nodes along my jaw and between jaw and neck were swollen (still swollen today) Stomach cramps and the on and off diarrhea persisted for a week but neck is still sore, only not as much as before. Almost two weeks after exposure I also discovered right inguinal lymph node. I visited a doctor who prescribed azythromycin without performing any tests. Around day 22 I had night sweats that went on for about 4 -5 days. My armpits started getting sore with a feeling of dull pain. I have later come to discover small lamps underneath my armpits that I believe are swollen nodes. Initially after convincing myself that all this is due to anxiety I had unprotected sex with my wife. Now I am scared to death I might have infected her. I am a real mess and totally dysfunctional. I have read in various forums, including this one some people who had very sore neck during seroconversion eventually tested positive. Dr. I am mortified especially due to the fact that I may have infected my wife. I am currently on day 35 post exposure. What are your thoughts? Thanks..
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your confidence in our services.
I reviewed your discussion on the community forum and agree with the advice you had there. Your CSW partner is statistically unlikely to have HIV, and you had safe sex with her. Withdrawal of the penis while the condom remains in the vagina is not considered a high risk exposure; protection against HIV was complete.
The rest of your story is confusing. The possible urethral discharge and urinary discomfort could mean you acquired a urethral STD like gonorrhea, chlamydia, or NGU -- but it seems you weren't tested for these before being prescribed azithromycin. (BIG mistake!) However, there is no way to tie in any of your other symptoms to that sexual exposure. I agree that many of your symptoms likely were physical manifestations of anxiety.
At this point, I have two main recommendations: 1) First and most important, have an HIV blood test, preferably a 4th generation or "duo" test; enough time has passed for a conclusive result, which you definitely can expect to be negative. (Don't have an oral fluids test, which is the only standard HIV test that doesn't give definitive results until 3 months.) 2) Return to your doctor (or perhaps a new one) for a comprehensive medical and sexual history and careful physical examination. An STD/HIV expert would be ideal, because such a person's reassurance may be most reassuring.
In the meantime, I am very confident you don't have HIV, and it is also unlikely you in fact have any STD. Even if your urinary symptoms reflected NGU, chlamydia, etc, you were treated with azithromycin before having sex with your wife, so it is unlikely you placed her at risk.
I hope this has helped. Best wishes-- HHH, MD
I reviewed your discussion on the community forum and agree with the advice you had there. Your CSW partner is statistically unlikely to have HIV, and you had safe sex with her. Withdrawal of the penis while the condom remains in the vagina is not considered a high risk exposure; protection against HIV was complete.
The rest of your story is confusing. The possible urethral discharge and urinary discomfort could mean you acquired a urethral STD like gonorrhea, chlamydia, or NGU -- but it seems you weren't tested for these before being prescribed azithromycin. (BIG mistake!) However, there is no way to tie in any of your other symptoms to that sexual exposure. I agree that many of your symptoms likely were physical manifestations of anxiety.
At this point, I have two main recommendations: 1) First and most important, have an HIV blood test, preferably a 4th generation or "duo" test; enough time has passed for a conclusive result, which you definitely can expect to be negative. (Don't have an oral fluids test, which is the only standard HIV test that doesn't give definitive results until 3 months.) 2) Return to your doctor (or perhaps a new one) for a comprehensive medical and sexual history and careful physical examination. An STD/HIV expert would be ideal, because such a person's reassurance may be most reassuring.
In the meantime, I am very confident you don't have HIV, and it is also unlikely you in fact have any STD. Even if your urinary symptoms reflected NGU, chlamydia, etc, you were treated with azithromycin before having sex with your wife, so it is unlikely you placed her at risk.
I hope this has helped. Best wishes-- HHH, MD
A related discussion, unprotected Vaginal encounter was started.
MEDICAL PROFESSIONAL
Thanks for clarifying the circumstances of your treatment.
"initially I couldn't detect any axillery lamps/nodes but now I can": Irrelevant. Self assessment of enlarged lymph nodes is notoriously unreliable. And any lymph node inflammation due to ARS would not come on so late -- it would have appeared with 2 weeks of acquiring the virus. And they appear all at once, in several areas of the body, not only the axillae. And almost always with other symptoms like fever, sore throat, skin rash, etc.
"Should I go ahead and test this coming Thursday (day 40)?" Given your anxieties about this, test as soon as you can. There is no signficant difference in test reliability between 40 vs 47 days.
"I strongly believe that I contracted UTI during my incident due to the clear discharge I experienced which stopped after taking azythromycin": Maybe you did, as discussed in my initial reply, paragraph 2. (Although your terminology is wrong. "UTI" means non-sexually acquired urinary tract infection.) If you indeed had NGU or chlamydia, I cannot speculate any better than you can about the exact mechanism of exposure. At this point, I don't see that it matters.
Feel free to report your next HIV test result, but I won't have any further advice until then. Stay relaxed in the meantime; it will be negative. (Perhaps it will help you to know that in the 10+ years since this forum was organized, there hasn't been a single case of a questioner who ended up having caught HIV from a heterosexual exposure. You won't be the first.)
"initially I couldn't detect any axillery lamps/nodes but now I can": Irrelevant. Self assessment of enlarged lymph nodes is notoriously unreliable. And any lymph node inflammation due to ARS would not come on so late -- it would have appeared with 2 weeks of acquiring the virus. And they appear all at once, in several areas of the body, not only the axillae. And almost always with other symptoms like fever, sore throat, skin rash, etc.
"Should I go ahead and test this coming Thursday (day 40)?" Given your anxieties about this, test as soon as you can. There is no signficant difference in test reliability between 40 vs 47 days.
"I strongly believe that I contracted UTI during my incident due to the clear discharge I experienced which stopped after taking azythromycin": Maybe you did, as discussed in my initial reply, paragraph 2. (Although your terminology is wrong. "UTI" means non-sexually acquired urinary tract infection.) If you indeed had NGU or chlamydia, I cannot speculate any better than you can about the exact mechanism of exposure. At this point, I don't see that it matters.
Feel free to report your next HIV test result, but I won't have any further advice until then. Stay relaxed in the meantime; it will be negative. (Perhaps it will help you to know that in the 10+ years since this forum was organized, there hasn't been a single case of a questioner who ended up having caught HIV from a heterosexual exposure. You won't be the first.)
Also, I strongly believe that I contracted UTI during my incident due to the clear discharge I experienced which stopped after taking azythromycin. What are your thoughts on that? My penis head was covered throughout during intercourse. How did I contract this infection? Could it have been during the change of condoms? Could it be from vaginal secretion residue on my shaft that found its way to the urethra after replacing condoms? I am at a loss here?
Thanks again for your time.
Thanks again for your time.
Thank you very much for your reply. I left out certain details because I thought they were irrelevant and also because I have a maximum of 2000 characters to comment at a time. I am living in a foreign country. My visit to the doctor was at night and the labs were closed for testing. He initially wanted me to come back the next day during day time but then decided to go ahead and prescribe azythromycin. He even told me to test for HIV after 3 months without me raising any HIV concerns.
With reference to anxiety, I have gone over my incident a number of times in my head and the thing is I was not really concerned about HIV until about a few days into my sore neck and stomach cramps. This is what scares me the most concerning anxiety. The sore neck and stomach cramps really did start before my anxiety!
initially I couldn't detect any axillery lamps/nodes but now I can and this just fuels my fear. I wanted to know how do lymph nodes manifest in HIV? I know they are generalized but do they appear gradually, or all at once? How soon do they appear? During, before or after seroconversion? How quickly do they grow?
Due to the nature of my work and where I am located, I can only test on Thursdays at the moment. Should I go ahead and test this coming Thursday (day 40) or wait and test next Thursday (between the 6-8 week mark)?
Thanks for your correspondence
With reference to anxiety, I have gone over my incident a number of times in my head and the thing is I was not really concerned about HIV until about a few days into my sore neck and stomach cramps. This is what scares me the most concerning anxiety. The sore neck and stomach cramps really did start before my anxiety!
initially I couldn't detect any axillery lamps/nodes but now I can and this just fuels my fear. I wanted to know how do lymph nodes manifest in HIV? I know they are generalized but do they appear gradually, or all at once? How soon do they appear? During, before or after seroconversion? How quickly do they grow?
Due to the nature of my work and where I am located, I can only test on Thursdays at the moment. Should I go ahead and test this coming Thursday (day 40) or wait and test next Thursday (between the 6-8 week mark)?
Thanks for your correspondence
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