At wits end

Dr

4 months ago I received oral sex three times from a girl.  Each time was protected.  About fourteen days after the last encounter it burned like crazy when I urinated.  I went to the doctor and he had me pee in a cup.  He took some testing tape and dipped it in the urine.  He said I had a uti and gave me antibiotics.  No specific testing was done to determine what infection I had.  About three days latter I had a sore on my shaft.  This time I went to the std clinic.  The doctor looked and said I had a skin infection but not an std.  He said just leave it alone.  The sore went away about a week latter.

I asked the girl to get tested for HIV.  She did and it was negative.  This test was done three months after we hooked up.  I tested with her and it was negative as well.  Since the test I have been sick with neck aches and sinus issues.  I had a cold and it went away and came back.  My DR said I have a bad sinus infection.  This has been a problem all my life.  He gave me three weeks of cefuroxime axetil 500 mg twice a day.  I am on week two.  I went back yesterday because I still don't feel great.  He gave me six days of methyylprednisolone for 6 days.

My questions are

Do I need more testing?

If I decide to test one more time tomm (4+months post exposure) will the antibiotics and steroids I am currently taking affect my results?

Thanks

[H. Hunter Handsfield, M.D.]

Oral sex is safe sex, with little STD risk -- not zero risk, but the low risk event plus the negative STD tests, plus the treatment you had, guarantee you have no STD.  And for sure this was safe with respect to HIV.  You do not need any more testing for HIV or any other STD.  The antibiotics and steroids, in the doses you took, could have had no effect on your test results.

You obviously remain obsessed with HIV risk despite no risk, and despite repeated reassurance that you have not been at risk -- on this forum, the international forum, and the communitfy forum.  By definition, obsessions are irrational.  You obviously have a severe case.  I know you are frightened, and I'm not insensitive to that.  But it's in the nature of obsession that there always are "what if" or "yes but" questions -- i.e. continued discussion that tends to make the emotional/mental problem worse, not better.  Mental health attention is needed here.  I suggest it from compassion, not criticism.  However, this or any other online forum is not a substitute for that kind of care, so there won't be any follow-up discussion.

Also note MedHelp's rule about a maximum of 2 questions every 6 months on the professionally moderated forums -- the purpose of which is to prevent domination of the forum by anxiety driven questions like yours.  Don't risk a future posting fee on a question that would be deleted without reply.

Best wishes--  HHH, MD

[keith965]

I think you misread my initial inquiry.  

After I received the protected oral sex I started to have burning when I urinated.  This was about 6 days post exposure.  I visited a dr who tested my urine just to see if there was an infection.  There was!  He DIDNT do std tests to determine specifically what kind of infection I had.  He gave me antibiotics.  This eliminated the pain.

Two days after sores developed so I went to my std clinic to look at them.  They said it was a skin infection but not an std.

I and the gal were tested at three months after trist.  Both of us were negative.

Ever since that test I have had  neck pain and sinus issues.  I was prescribed antibiotics.  I have been on them for two weeks and I have one more to go.  He also put me on Methylprednisolyn 4 mg for six days.  

I am on both of these medications NOW.  I was not when I tested.  

My question is simple do I need to test again and if I do will the drugs I am on affect the test???????

I am in therapy twice a week.

Thanks !!!!!

[H. Hunter Handsfield, M.D.]

Oral sex sometimes causes NGU, probably often (usually?) caused by entirely normal oral bacteria.  This syndrome probably has no important health consequences either for the infected person or his suex partners.  But it isn't possible to say with certainty whether you had such a problem.  Urinary burning, without discharge, is not typical.  However, with your symptoms clearing on antibiotics, you may have had NGU.

However, the rest of your symptoms don't suggest any STD, and certinaly there are no STDs that would cause "neck pain and sinus issues".

I see no need for any other STD testing at this time.

[keith965]

Thank you Dr.  

If I choose to test one final time for HIV will my results be affected by the two prescriptions I am currently taking?

I wish you a good year.

[H. Hunter Handsfield, M.D.]

No, those medications will have no effect whatsoever.

That will be all for thsi thread.  Try to stay relaxed about all this.  In the nearly 8 years of this forum, nobody has ever reported an exposure that concerned them and turned out to actually catch HIV. You aren't going to be the first!

[keith965]

Thanks I will continue to work with my therapist to work through my anxiety disorder.  I believe I am doing better but still have a long way to go.  I'll print this post and give to my therapist.

[keith965]

I did go yesterday and had one final rapid unigold test.  The result was negative (20 weeks post exposure), as you predicted.  I mentioned to the counselor i recently took Methylprednisolyn 4 Mg for six days.  I told him i had been off of it for 11 days.  

He said that could have messed up my test and i should retest in a couple of weeks.  Do you agree?

Whatever your answer ill follow your advise like its gospel.

Thanks

[H. Hunter Handsfield, M.D.]

No, I do not agree with your counselor (who probably is not a physician).  Potent chemotherapy or high dose immunosuppressive drugs in theory might prevent developement of measurable HIV antibody and thus a false negative antibody test.  However, even these effects are theoretical only, with (to my knowledge) no reported cases in which it apparently happened.  And in any case, the dose of drug you took was far too low to have any effect; the dose would have to be at least 10 times higher, and for a lot longer than 6 days. You should not have any further HIV tests.

Please see my opening reply about excessive anxiety-driven posting.  This thread is now closed to new comments.  Please do not post anything else, and do not start any new threads with the same questions.

[keith965]

Sincere thanks.