HHH, wanted to clarify on a few things

[globe1]

Hi Dr.,

I received oral from a csw in China 11 weeks ago.  I had an oral swab test done 31 days and 61 days and both were neagitve for HIV.  I was reading some of the forum answers of yours to others and wanted to clarify.

1.  you had said to one person nine weeks was conclusive for a similar exposure to mine but they had finger ***** blood test as opposed to an oral swab any difference?

2. Has anyone you have seen or heard of ever turned out to be positive after two tests at the times I had mine?

3. Do I need to wait until 90 days for final window to close?  Why do they say six months in some cases?  does that have any application to me I am a healthy individual no compromise of immune system due to chemo or anything which sounds like the only reasons someone would need to wait.

4. On an aside I had some urinary pain and burning after the incident whcih is still present 11 weeks later although improved after all std testing only thing they were able to find was HSV1 positive IGG which I had no symptoms
(blisters) or anything from.  Doctor swabbed urethra when the pain was at its height and prescribed valtrex and cream for inside the penis however cultures came back negative.  Now claims prostatitis..... pain still evident but not severe will this subside on its own does it have any possible affect to partners? I have read many times blisters externally would be present if this was from HSV1. I can only assume this might have been a positive from a past exposure  I did not see blisters on her lips or any reason to believe she had an outbreak.  What precautions other than no sex during an outbreak if I ever have one need to be taken?  is it transmitted genital to genitsal often?  have you seen this how about in the reverse genital to oral if i even have it?    I do not want to infect my wife. I had been treated for stds even though tests were negative, with ceft. shot and doxy for one week, as well as I was taking z-pac for bronchitis, I have been told no bacterial would have survived that.  

5.  I am looking for some final reassurance that I am fine, please give me your thoughts.

[Edward W Hook, MD]

I am not a urologist and prostatitis, while a disease I deal with regularly is not one of my areas of expertise.  You will need to look elsewhere for additional information on prostatitis.  

You are correct however, prostatitis can be a disease which can take a substantial amount of time and treatment to cure.  As regards your question about could your prostatitis be dangerous to sexual partners, the answer is no.  EWH

[globe1]

Hi,

Prostatitis if accurately diagnosed would be from me acquiring a bacteria from somewhere sexual or otherwise as I understand it.  The urinalysis was negative and I do not have chl. gon etc.  so that being said sexual relations with a woman would have zero consequences if she was exposed to me? the bacteria or offending agent is not harmful per se?  I hear it is tough to conquer this diagnosis and sometimes can take a very long time.  I feel far from where I was so getting better for sure.  Please give me some info on prostatitis to give me some prospective thanks again for your patience and happy holidays.

[Edward W Hook, MD]

Recommendations for testing depend on the person and there risk.  Please remember that all of this is a numbers game.  That is the reason the most conservative recommendations tell people to take their tests out to 6 months - to cover the rarest events among the highest risk persons.  Both of us on this site think this is excessive, particularly for low risk persons such as yourself.  The risk of acquiring HIV from oral sex is so low that we do not even think everyone who has had such exposures warrants testing.  At the same time, we have learned that our client's anxieties (including yours) are so high that they cannot take that advice.  For you, any result after 6 weeks takes your risk of HIV into the realm where you are far more likely to be hit by lightening than to have your HIV test turn positive.

HSV-1.  Again, you will not get absolutes.  That said, the most common mode of transmission is oral to genital.  All other routes of transmission are very rare.

As far as your rising HSV-1 antibody levels. Indeed this is suggestive that you may be accumulating antibodies but the levels bounce around.  You do not know when or where  you got this infection.   With a pregnant wife, caution (abstinence) is appropriate.

Finally, regarding prostatitis.  STD agents rarely cause this syndrome.  Nearly any bacteria can, i.e. E. coli, etc.  Mycoplasma, ureaplasma and other sexually transmitted bacteria are often worried abut but rarely the offending agents.  EWH  

[globe1]

Dr.  Hook,

Thanks for your infinite patience with people like me in retrospect I guess I was asking the same questions. I addressed these to HHH as he had a reply to someone who had blood test and he said "I test to nine weeks, some test to 3 months I do not and almost no one tests to six months anymore"  I just wanted to be clear on blood vs. oral swab, since I paid the money i thought I would ask a few other questions as well. I will close the window at 86 days and have one more oral swab.

With genital HSV1 if I did indeed get it does it transmit genital to genital?  genital to oral? Am I now facing a condom only sex life?  I certainly have nothing to worry about in giving her oral sex I assume.

My doctor and I thought I got it from this event  because in the week after the event I had the other std testing, had test for Herpes as well, IGG tither was low 2.4 as I recall and it said watch for symptoms.  I had the second test which was >5.0 at six weeks.  The urologist had given me the valtrex and swabbed me which all came back negative....so have no clue whether I had it before or not etc......tricky virus.

I have not given it to her yet, she is negative, in 11 years so if I had it prior and I have no idea how I would know that for sure. Her being pregnant we have abstained since I found out and she has had no symptoms so pretty sure we are good......only had sex twice early on prior to the elevation of this pain and these symptoms.  I think we are doing the right thing abstaining although considering absence of lesions ( I would have seen them at point of contact within 2 weeks or so after for two -three weeks?) and the 11 weeks of irritation not so sure but could not hurt I suppose.

If this prostatitis is the issue in fact and it is non-chlamydial non gonorreal as evidenced by my negative DNA tests which were done more than once. can any of the other bacterial possibilities be passed to her sexually?  ureaplasma?  mycoplasma etc...

I am trying to be vigilant in making sure I do not give her anything and I think I am on the right track Thanks again for your help.  I do not have HIV, or any other STD! I have to convince myself of that and move on, hard lesson learned. G-d bless.

[Edward W Hook, MD]

You are looking for me to repeat myself so that is what you will get.  Asking the same question repeatedly will not get the answer to change.  You were treated so bacterial STDs are a non issue.  You received oral sex which is low risk and have had negative tests since then.  You have been seen by health care professionals who are working with you on the problems.  I am a loss as to why you have posted again.  That said, in reply to your answers:

1.  No, the oral swab is reliable.  
2.  Sure, but those people were at risk. Your risk was minimal from the outset.  You do not have HIV
3.  No, you do not have to wait.  The reason for some sites (not this one) to use a six month window is to be broadly applicable and VERY conservative.  The advice provided on this site by Dr. Handsfield and me is specific to you and your risk
4.  You have HSV1.  Who you got it from, where you got it, or how long you have had it are difficult to answer.  Your urethral pain is not herpes.  The lesions (and pain) of herpes resolve after about two weeks (three max) for persons with initial herpes and far more quickly for recurrences. For you to have irritation at 11 weeks is definitive information that this is not herpes.  I would not worry about having genital HSV 1 or, if you do (which is very unlikely), about transmitting it to you wife.
5.  Consider yourself reassured.  You are not at risk for HIV, herpes, or other STDs from the exposure you describe.  EWH