Tested at Health Department: Concerns...

I posted a question here awhile back regarding my risks of HIV after having sex with a sex worker.  Basically, I had protected sex but the condom only covered 50% on my penis and 3/4 of the way down the shaft of my penis I had a cut that was exposed to vaginal secreations.  Anyway, I had a 26.5 day HIV test that came back negative and I just went back today after 7.2 weeks for another HIV test.

I went to the Health Department this morning to get tested.  Obiously, I have not recieved HIV results yet but I am praying that I am O.K.  However, they did call me back stating that I do NOT have Gonorria (sp) but i do have extra amounts of bacteria in my penis and that they want to perscribe anti-biotics.  I do not have a burning sensation in my penis or any discarge.  

1.)Should I get on these meds?  

2.)Should this "extra bacteria" concern me for other sexually transmitted diseases such as HIV, Herpes, etc...

3.) Have you heard of such a thing and is it considered a sexually transmitted disease?  

4.) Would you recommend that I get a 3 month HIV test if this comes back negative?


Thank you for your time!  You have truely helped me with your comments.

[H. Hunter Handsfield, M.D.]

This question would have been more appropriate for the STD forum.  In any case, you don't provide enough information.  The term "extra bacteria" doesn't mean anything to me.  If you don't have chlamydia or gonorrhea, and have no symptoms like urethral discharge or uncomfortable urination, then almost certainly there is no STD.  In my clinic, we would not test persons in your situation for "extra bacteria" and would not recommend antibiotic treatment.  And if the exposure you describe above, and in your previous thread, is your only sex in the past few months, then you cannot have any STD.  On the other hand, perhaps they found more definite evidence of an STD, such as nongonococcal urethritis (NGU).

Bottom lines:  1) Probably not, but recheck with the clinic about what they are treating and why.  2) Probably not.  3) Search the STD forum for information about nongonococcal urethritis, or NGU.  4) You didn't need any HIV testing and certainly don't need another test.

HHH, MD

[Perfectmax]

Doc.  Thank you for your advice/response!

I agree that my risk was fairly low but just like everyone else on this forum I have been very nervious about HIV and STD's.    

The reason that I posted this is because the Health Departements findings didn't make any sense to me.  All that they told me is that I needed to come back in so that I could get a prescription.  Gonorhia (sp) negative and Clyamidia results not yet in.  So, why would they have me come back to get a prescription?  

My question is:  I have not had sex in 2+ months (since "the" incident).  Wouldn't I have had noticable symptoms if i had a some funky bacteria in my penis?  I haven't felt anything abnormal.  What gives?

I just want to make sure that this isn't a symptom of HIV...

[H. Hunter Handsfield, M.D.]

Your risk wasn't "fairly low"; it was zero.  I already said that lack of symptoms indeed suggests nothing important is going on.  Since the sexual exposure you described was condom protected, that's not a possible source of urethral infection.  As also said already, you need to check with the clinic provider--but if they cannot provide more specific information about what they found, it seems to me you do not need treatment.

None of this indicates HIV in any way.

I'm not going to be able to help further.  You'll need to deal with the clinic and/or make your own decision about treatment.

HHH, MD

[Perfectmax]

I went back into the Health Clinic and they told me I had NGU and that there is a 50% chance that it was not sexually transmitted.

Do you have any idea how I could have gotten this?  Stress and anxiety from HIV concerns?  I am pretty sure that my fiance doesn't have anything funny and when I made my mistake I wore a condom.  

They gave me 2 pills of Zithromax and 4 pills of Flagyl.  


*On a side note:  I REALLY want to thank you for your efforts on this forum.  Your answers have helped many including myself deal with anxiety issues over HIV.  I tested negative at 26.5 days and am praying that I test negative at 7 weeks.  Life throws some curve balls at you and it is nice to know that there are people out there such as yourself that have the patience to help and advise.  Thank you.

[H. Hunter Handsfield, M.D.]

Follow your provider's advice.  A lot more than 50% of NGU cases are acquired sexually; it's an STD at least 90% of the time.  But sometimes otherwise normal bacteria in a partner may be responsible; for example, normal bacteria in the mouth can cause NGU by oral sex.  Your fiance needs to be examined and, to be safe, treated.  Follow your clinic provider's advice about this.  Standard treatment is azithromycin in the dose you were given.  Metronidazole (Flagyl) covers the possibility of trichomonas, but isn't usually given to men with NGU unless initial treatment fails of if a partner is known to have trich.  But it won't do any harm.  You can find more inforation on NGU on the STD forum.

Thanks for the thanks, but no more questions on this thread, please.

HHH, MD

[Perfectmax]

I'm sorry doc but I have to ask another question.  I just don't understand how I could have gotten this.  I wore a condom with the sex worker THE WHOLE TIME.  I have not had sex since and its been 2.5 months.  Previously I had sex with my fiance who has not slept with anyone else.  The last time I slept with someone else was over 2 years ago.  

I am confused...?  I know NGU isn't a huge deal but I need to tell my fiance about this and its going to stur up the pot EVEN more.  

Can NGU stay dormant for 2 years?  Wouldn't one of us have had symptoms?  


THIS IS MY LAST QUESTION... PROMISE...

[peekawho]

If your fiance has performed oral on you, you can get NGU that way, simply from the normal bacteria present in someones mouth getting in your urethra.

[Perfectmax]

Unfortunately I haven't received a BJ from my fiance since ...?  She isn't a huge fan of dishing those out.  Doesn't bother me though...

[H. Hunter Handsfield, M.D.]

I don't understand it either.  NGU is mysterious.  I said above that sometimes otherwise normal bacteria--including bacteria in your finace's vagina, not just mouth--might cause it.  Also, the diagnosis of NGU is very imprecise, and even with an experienced STD clinic provider, it isn't certain in my mind that you had anything wrong at all.  But to protect your fiance's health, it is important that she be examined and tested for STDs.

I'm holding to your last-question pledge.  Address further questions/concerns to your clinic provider.

HHH, MD