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HIV???
On October 2 I was possibly exposed to the HIV virus. It was a 10 minute sexual encounter (man penetrating woman). He did not ejaculate. As soon as it began I immediately panicked and after a few minutes made him stop. Two days later I was being tested for STDs!!! I actually went to a walk in medical clinic saying "my boyfriend cheated on me and I would like to be treated". I was given 1 GM of zithromax and a GM of rocephin on the spot. A week later the nurse practitioner called saying my test for chlamydia was positive. Two weeks after the initial appointment I went to another clinic to be re-tested for chlamydia and was negative. My dilemma is this... My initial HIV test was done 56 hours post exposure. I had another done today (32 days post exposure), it was a clearview rapid serum antibody test, and it was negative (THANK GOD!). I am scheduled for another appointment next Friday for another rapid test (39 days post exposure). Should I anticipate a change in results? I am also scheduled for a repeat HSV2 test. Is 5 weeks 3 days post exposure too early still for either test? I have recently became a little symptomatic... I feel as if there is something lodged in my throat, this has lasted 5 days. Warm liquids soothe it, but it isn't going away. Also, persistent nausea that gets worse with eating, obviously. No rashes or fever or enlarged lymph nodes that I can tell. Could be some reflux related to the stress of all this or maybe sinus drainage? I am VERY stressed, as I made a terrible decision and cannot seem to erase the effects of it. Please give me any info you have... Waiting for three months then six months then twelve months may be the death of me :( Thanks!
One last thing... If I were to anticipate an HSV2 breakout, since my first tests were too early to be accurate, at what point would it happen? I'm 32 days post possible exposure now... Thanks!
One last thing... If I were to anticipate an HSV2 breakout, since my first tests were too early to be accurate, at what point would it happen? I'm 32 days post possible exposure now... Thanks!
MEDICAL PROFESSIONAL
"What type of vaginal discharge is suggestive of HIV?" None; vaginal discharge rarely if ever suggests HIV.
"Covered in bacteria", without clue cells, is exactly what a normal vaginal wet mount should look like -- although this depends in part on the exact bacterial types. Antibiotics do not wipe out all bacteria. They temporarily suppress the susceptible ones, allowing others to predominate. Even then, usually within days of stopping the antibiotic, normal bacteria begin to repopulate the vagina (or skin, intestines, etc).
The best approach probably is for you to stay off all antibiotics, and not use any vaginal creams or products of any kind, for a month or so. If you have any continuing discharge or other symptoms at that point, see your ObG provider -- or, even better, find one who specializes in infectious diseases.
That will definitely have to end this thread. Good luck.
"Covered in bacteria", without clue cells, is exactly what a normal vaginal wet mount should look like -- although this depends in part on the exact bacterial types. Antibiotics do not wipe out all bacteria. They temporarily suppress the susceptible ones, allowing others to predominate. Even then, usually within days of stopping the antibiotic, normal bacteria begin to repopulate the vagina (or skin, intestines, etc).
The best approach probably is for you to stay off all antibiotics, and not use any vaginal creams or products of any kind, for a month or so. If you have any continuing discharge or other symptoms at that point, see your ObG provider -- or, even better, find one who specializes in infectious diseases.
That will definitely have to end this thread. Good luck.
What type of vaginal discharge is suggestive of HIV? After the multiple rounds of antibiotics, anti-fungal, and anti-fungal vaginal cream medications, well naturally my "normal flora" isn't quite up to par yet... However, being that I work closely with a hospital lab, I got the lab tech to do a wet prep. No yeast, no clue cells, no WBCs. It was covered in bacteria, however. How can this be after all the medications I've been on. Wouldn't all the antibiotics have wipes this out by now? Concerned again...
MEDICAL PROFESSIONAL
Thanks for the clarifications, and thanks for the thanks. I'm glad to have helped.
There is no such thing as chlamydia resistant to azithromycin (Zithromax). Even though you are convinced your chlamydial infection was acquired only 2 and a half days before the positive test, I am not. And even if you are right, chlamydia definitely cannot cause any symptoms that quickly; and the later symptoms could not have been due to chlamydia treated 2 weeks earlier. In other words, something other than chlamydia has caused any symptoms you have had. So I would not have advised the doxycycline. However, it did no harm.
My main advice for you and your chlamydia patients is to have a follow-up chlamydia test in 3-4 months. This is called "rescreening" and is recommended because on average 10-15% of people with chlamydia are positive again after that time. Usually it's because of reinfection after resuming sex with a new partner (or the same one, untreated) -- but some cases may reflect delayed treatment failure, so so rescreening recommended for everyone, regardless of apparent risk.
There is no such thing as chlamydia resistant to azithromycin (Zithromax). Even though you are convinced your chlamydial infection was acquired only 2 and a half days before the positive test, I am not. And even if you are right, chlamydia definitely cannot cause any symptoms that quickly; and the later symptoms could not have been due to chlamydia treated 2 weeks earlier. In other words, something other than chlamydia has caused any symptoms you have had. So I would not have advised the doxycycline. However, it did no harm.
My main advice for you and your chlamydia patients is to have a follow-up chlamydia test in 3-4 months. This is called "rescreening" and is recommended because on average 10-15% of people with chlamydia are positive again after that time. Usually it's because of reinfection after resuming sex with a new partner (or the same one, untreated) -- but some cases may reflect delayed treatment failure, so so rescreening recommended for everyone, regardless of apparent risk.
One quick question before I disappear... What are the chances of zithromax resistant chlamydial infections? Of all the research I did, that seemed to puzzle me the most... My symptoms did not go away with the zithromax, so I took 100 mg of doxycycline bid for seven days. It was then that i noticed a difference and I then tested negative. I am a nurse. And I do from time to time see and treat patients with chlamydial infections. Any advice for both myself or my patients? Thanks again!
Dr. Handsfield,
Thank you greatly for your reply! Sometimes reassurance is the best medication available. Chlamydia was 100% contracted by new sex partner. My long term boyfriend and I were broken up at the time. Still are. But definitely were then. Two days post exposure I began experiencing NGU, a low grade temp, and lower abdominal pain, all conclusive with new onset chlamydial infection. Also, he was somewhat of a risqué guy...a bartender. Terrible mistake! I am 30, college educated, and live a very clean life typically. I knew better, to say the least. Lessons learned the hard way are the ones that are hardest to forget... That being said, I will continue to follow through with the appropriate medical treatment from my primary, but will put some of this testing on hold until much closer to the 12 week mark. Thank you again for you expert advice. It certainly will aid this night shift worker in sleeping a bit tether for the next few weeks! I will let you k ow of further test results. Cheers.
Thank you greatly for your reply! Sometimes reassurance is the best medication available. Chlamydia was 100% contracted by new sex partner. My long term boyfriend and I were broken up at the time. Still are. But definitely were then. Two days post exposure I began experiencing NGU, a low grade temp, and lower abdominal pain, all conclusive with new onset chlamydial infection. Also, he was somewhat of a risqué guy...a bartender. Terrible mistake! I am 30, college educated, and live a very clean life typically. I knew better, to say the least. Lessons learned the hard way are the ones that are hardest to forget... That being said, I will continue to follow through with the appropriate medical treatment from my primary, but will put some of this testing on hold until much closer to the 12 week mark. Thank you again for you expert advice. It certainly will aid this night shift worker in sleeping a bit tether for the next few weeks! I will let you k ow of further test results. Cheers.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
You have been through some unpleasant experiences. I'm a little confused as to whether the brief sexual encounter you described was with your regular partner (who apparently had cheated) or with someone else -- but I don't think it matters in regard to your STD/HIV risks.
First, heterosexually transmitted HIV is less common than you may think. If you or your partner(s) are not at special risk -- male-male sex, injection drug use, commercial sex work, etc -- the chance you were exposed to HIV is very low, despite having caught chlamydia somewhere along the way. (I doubt you were infected only a couple days before you were tested. You should assure that any sex partners in the last 2 months are informed and treated.) The chance of herpes also is low after any single sexual encounter.
Second, your symptoms are not at all suggestive of a new HIV infection or herpes.
But most important in regard to HIV, the tests are extremely accurate, and your negative Clearview test at almost 5 weeks (32 days) is almost 100% reliable. There really no need for yet another test at almost 6 weeks (39 days) -- but if you go ahead with it, you can count on another negative result.
There is nothing in your symptoms, or in your sexual exposure(s) or relationships, that makes me concerned about herpes. If you had acquired HSV-2, any symptoms -- typically, genital area blisters and sores, often very painful, often with fever, swellings in the groin, etc -- would have occurred within a few days, certainly within 3 weeks. So most likely your HSV blood test will be negative.
So try to stop worrying. For sure you don't have HIV, and I see no reason to be concerned about herpes either. Continue to work with your doctor about your symptoms if they persist.
Best wishes-- HHH, MD
You have been through some unpleasant experiences. I'm a little confused as to whether the brief sexual encounter you described was with your regular partner (who apparently had cheated) or with someone else -- but I don't think it matters in regard to your STD/HIV risks.
First, heterosexually transmitted HIV is less common than you may think. If you or your partner(s) are not at special risk -- male-male sex, injection drug use, commercial sex work, etc -- the chance you were exposed to HIV is very low, despite having caught chlamydia somewhere along the way. (I doubt you were infected only a couple days before you were tested. You should assure that any sex partners in the last 2 months are informed and treated.) The chance of herpes also is low after any single sexual encounter.
Second, your symptoms are not at all suggestive of a new HIV infection or herpes.
But most important in regard to HIV, the tests are extremely accurate, and your negative Clearview test at almost 5 weeks (32 days) is almost 100% reliable. There really no need for yet another test at almost 6 weeks (39 days) -- but if you go ahead with it, you can count on another negative result.
There is nothing in your symptoms, or in your sexual exposure(s) or relationships, that makes me concerned about herpes. If you had acquired HSV-2, any symptoms -- typically, genital area blisters and sores, often very painful, often with fever, swellings in the groin, etc -- would have occurred within a few days, certainly within 3 weeks. So most likely your HSV blood test will be negative.
So try to stop worrying. For sure you don't have HIV, and I see no reason to be concerned about herpes either. Continue to work with your doctor about your symptoms if they persist.
Best wishes-- HHH, MD
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