In need of some advice

[ease_my_mind]

I'm a 24 year old bisexual male who, about 30 days ago, had un-protected oral sex (gave and recieved) for a short period of time 2-4 minutes, as well as let my partner put his tongue in my rectum. I employed toe do ask do tell before we engaged in any sexual behavior and since the incident he has informed me  many times that he was tested a month before being with me and that he hadn't been with anyone since 3months before being tested.He has reassured me several times that he is HIV negative as well as negative for all other STD's. I have been expirencing extreme anxiety as a result of this encounter and need to know how much of a risk I am at. I was tested 3 days after exposure for stds and they said that they would call if there was any bad news, they never called back which means everything was negative. I was wondering if my exposure warrants testing for HIV. I have had a sore throat, white tongue, lasting fatigue, and a slight fever. I'm wondering if the fatigue could be connected to the  extreme anxiety from all of this. Also, a few days after being tested for STD's there was white discharge coming from my penis, pain while urinating, a dull pain in my testicles, and blochy red skin on and around the head of my penis. my Doctor perscribed an antibiotic for what she thought might be a UTI and the discharge went away. my questions are as follows
1. Did i get tested too early for stds (3 days)?
2. can i trust that the results were negative?
3. Does my exposure warrant testing for HIV?
4. Can my anxiety be causing my symptoms?

Thanks for your help.

[Edward W Hook, MD]

I am going to provide you with a single answer.  After this, further questions will be deleted. You have heard from me and from the folks on the community forum that you are not at risk yet you are unable to accept this. Saying it repeatedly has made no difference so I will repeat myself no more.  I suspect Lizzie Lou and others are about to get to the same place.

Risk - NONE!!!!
You can get tested at any time because the results for someone with no risk are predictable. They will be negative.  If you had HIV, a test at 5.5 weeks would detect between 90 and 95% of infections.  This is the case no matter which test is used.

This thread is now over.  I hope you can more on soon.  You really need to.  EWH

[ease_my_mind]

I was wondering if you could answer my questions that I posted.

Is 5 and a half weeks too early to be tested?
If i do an oral test at a clinic is this sufficient or should I do a blood test?
once I have this test result can I consider it Conclusive?
in your personal opinion, am i going to be that 1 in 10,000?

Thank you so much for the time and effort you put into this site and all of the other work you do. Thanks again,

J.

[ease_my_mind]

Also, can I trust the advice that was given to me on my posting on  the public forum? Is what they are saying credible?

[ease_my_mind]

Either tomorrow or sometime early next week I think I am going to go to the Doctor for him to examine me. I will also do an HIV test because I'm still expierencing anxiety about some of the lasting symptoms, it has been 33 days since the exposure. I know you said it didn't warrant testing but knowing a negative result will be completly reassuring. My question is, Is this too early to be tested? and can I consider this to be conclusive or should I wait a little longer? I pray that this is anxiety driven and that there is nothing seriously wrong with me other than being a stress case.

[Edward W Hook, MD]

If it comes and goes it is unlikely to be a pathological process and far more likely to be normal varaition.  For someone to be able to make the assessment they really need to be able to see it.  Good luck.  EWH

[ease_my_mind]

No, she didn't do an exam...The redness comes and goes..particularly after masturbation there are red bumps on the head and spots of redness behind the head and on the tip of the penis... I will see what she has to say tomorrow when she calls to let me know if there is anything to worry about.

Thanks for all of your advice. It is greatly appreciated.

[Edward W Hook, MD]

You may be wrong or over reacting.  Certainly sensations such as burning on urination can occur this way, particularly if the urine test showed no signs of inflammation which I assume is the case from what you say.

As for the blotchy redness at the tip of your penis, if you were examined, what did she say?  Did she agree that there was redness?  

If your tests are negative and the doctors see nothing on their examination, then I think counseling may be the way to go.  EWH

[ease_my_mind]

So I went to urgent care today and re-explained my entire situation to the doctor. She said that, discharge happens sometimes in perfectly healthy men. and that the the other symptoms that I am expierencing are all in my head, She suggested that I go to mental health services on my college campus and seek mental help because there is nothing more that she can do for me. She did have me give a urine sample and said that they preliminary results showed that there was no bacteria found, she told me that they would do further tests and would let me know by tomorrow, what, if anything, that they find. She reassured me that it truly is nothing and that this is in my head. How does this explain the buring while urinating, frequent urination, the blochy redness on the the tip and below the head of my penis. Could these be a result of anxiety too? I feel that these symptoms are completely related to this exposure because they only occured after having been with this person? am I wrong to think this?

[ease_my_mind]

Thank you for your advice. I'll probably go to urgent care later today to get this resolved.

Thanks again,

J.

[Edward W Hook, MD]

My advice would be to seek re-treatment with either doxycycline or azithromycin.  Once you have been treated withthat, I suspect there willbe no reasofn for further treatment, even if your symptoms persist.  EWH

[ease_my_mind]

the above post should read "I was prescribed the sulfamethoxazole when i went to my own doctor about a week and a half later.(period) I informed my doctor...." sorry, I need to proof read before posting.

[ease_my_mind]

Sorry for being unclear in my original post. I had visited a clinic at my college and was tested before I started taking the Amoxicillin, so I can still assume the test results were accurate. I was prescribed the sulfamethoxazole when i went to my own doctor about a week and a half later I informed my doctor that I had taken Amoxicillin after my testing but before visiting her office. I also informed her of the discharge which was not present the day i went in for that visit. The test for the UTI was negative but said that it still sounded like it could possibly be a UTI which is why she prescribed the sulfamethoxazole...and my partner was a "he" does this change anything either? sorry for the confusion, the thread wouldn't let me submit and I had to re-write quickly..

Thanks

[Edward W Hook, MD]

I wish you'd told me you were self medicating with your question.  that is importnat information.

1.  Your self medication makes interpeteing the test results difficult.  Self medication is, in general, a bad idea.  Both amoxicillin and sulfamethoxazole have limited acitivity activity against comon STD pathogens maybe you had an STD, maybe you didn't.  Virtually no way to tell at this time  
2.  Regarding the pain in your testicles.  Seeing your docotr so he can assess it is a good idea.  Be sure to tell him that you were taking antibiotics when you were last tested.
3.  Again,. you should tell your partner and suggest she get checked.  The self medication has made assessment difficult and thus it is proper to tell her since you may or may not have been infected.  EWH

[ease_my_mind]

A few more quick questions.

1. I had started taking amoxicillin before going to the doctor(1 a day for about 4 or 5 days, which cleared up the discharge (250mg i think). The doctor then prescribed sulfamethoxazole (1 tablet every 12 hours for 10 days) ..would these antibiotics clear up this infection?
2.If I still have a dull pain in my testicles and redness on the skin near the glans and just behind the head of the penis should I go back to the doctor and ask for a different antibiotic? (doxycycline perhaps?)
3. Lastly, is this infection caused by common bacteria found in the body? Essentially, what I am asking is do I need to inform my partner about getting treatment for himself or is this isolated to just me?

Thanks

[Edward W Hook, MD]

The encounter you describe was low risk. The risk for getting HIV from oral sex is a bit controversial (at least in terms of whether there is any risk at all.  Everyone agrees that it is very low risk). On this site, we have stated repeatedly that the risk from giving or receiving oral sex to an infected person is less than 1 in 10,000 exposures;  some other experts however state that there is no risk from oral sex.  Either way, the risk is tiny even if your partner was infected and from the sounds of things, it is unlikely that he is.

On the other hand, your urethral discharge suggests that you did pick up urethritis (penile infection) from the exposure.  I would believe your STD tests - testing at 3 days is quite accurate. hence I suspect that what you had was what we call non-chlamydial nongonococcal urethritis; this syndrome would not be picked up by routine STD tests and would be expected to be cured with antibiotic therapy.. As for your questions:

1.  As timing of your testing was fine and the results are to be believed.
2.  Yes, test the results. The tests are very good.
3.  No
4.  Anxiety can certianly heighten sensations and lead to persons noticing symptoms they might have otherwise overlooked.  On the other hand, anxiety would not be expected to cause urtheral discharge so there was something going on.  The antibiotics you have taken would be expected to take care of things however leaving you now with residual (and unnecessary) anxiety.

I urge you not to worry.  Hope my comments help you to do that.  EWH