Fear I may have contracted something

[john989]

Hi Doc,

I recently regrettably had a one night stand on New Year's eve with a woman of unknown status. She turned out later to be a pretty shady character also. I am extremely worried I might have contracted something. I can't even tell if my symptoms are real or anxiety. We used lots of lube and had anal sex, when one minute my condom was on and one minute I noticed it slipped off. It wasn't more than 1 or 2 minutes out of about the 20 minutes we had sex, when I noticed it wasn't on and withdrew immediately. I didn't notice blood or anything. Since then I have been experiencing headaches and some pain in my penis to bladder area, which started probably 3 days after the incident. I get off and on burning sensations also I am terrified I might have contracted something. Everyone I have spoken to so far says the odds are extremely low but not impossible, but I'm still very worried I may have contracted HIV or something else. Thanks for your service it means a lot to the people who read it each day

[H. Hunter Handsfield, M.D.]

All I can do is repeat what you undoubtedly have read if you have reviewed recent threads on this forum.  The risk of acquiring HIV from any single episode of vaginal sex, even without a condom, and even if your partner was infected, is very low--almost too low to worry about.  And the odds are she wasn't infected, regardless of how "shady" she was.  Your symptoms sound more like anxiety than a physical illness, and they certainly do not sound like HIV.  Finally, as I say in almost every situation like yours, when a person suspects his/her own symptoms are due to anxiety, s/he probably is usually right.

In generally, public heath practitioners (like me) do not recommend HIV testing after specific exposures, because the risk almost always is too low.  A better strategy for sexually active people is just annual testing for HIV and other STDs.  But if you remain anxious despite my reassurance and your own assessment of the low risk, get tested for peace of mind.  You can be tested any time for chlamydia and gonorrhea (urine); blood testing for other STDs (HIV, syphilis, herpes, etc) has to be delayed several weeks.  In the meantime, try to stop worrying; your risk really is low.

Best wishes-  HHH, MD

[john989]

How about the burning/nagging pain in the penis/bladder?

Is that a symptom of other STD's such as chlymadia or gonorrhea?

How long should you wait after an encounter to be tested for those.?
Thanks a bunch

[Confused_again]

Doctor,

He specified he had Anal sex with a lady, not vaginal. Would you still not recommend testing after a single anal incident with a lady? Thank you.

[Willl]

I know from my own experience that burning could be an infection from the anal sex. If will get worse too. There is bacteria you can get from anal sex that does not belong inside your penis, which is why I stick to vaginal sex now.

[john989]

Thanks for the insight Will. What was your treatment? Antibiotics? It does feel like it is worsening over time.

[Willl]

I think I was prescribed Doxycycline, it was a long time ago when I got the infection. I remember it feeling like I constantly had to **** but didn't actually need to.
I also remember having a bad burning at the end of urinating. It got to be excruciating.

[aloha37]

If you have a urinary tract infection it will be treated with an antibiotic.  All you have to do is give a urine sample.  This is not a sexually transmitted disease (although obviously if you are exposed to anal bacteria you can get it that way).  So don't be embarrassed or reluctant to see the doctor.  You don't even have to mention the sexual encounter, just say you think you have a UTI because of burning and pain.  They can tell pretty quickly if there are abnormalities in the urine.  If it's not a UTI you can start checking for STDs.  By the way, this (if a UTI) could progress to a kidney infection if left untreated too long.  That is a more serious infection.  If you develop a fever or kidney pain (back/flank area) go to the doctor right away.

[john989]

Thanks everyone so much for your insight. I'll be a member to these boards for life even if I do turn out to be clean to learn more and help how I can on the boards. I'm learning from my mistake.

Will- How long do you think after this did you get the pain/infection? I started to feel something minor within like 2-3 days but it didnt get bad until the end of the week.

Yesterday I went to get tested for everything- UTI's, Chlamydia, STD's

My symptoms look more like a UTI rather than Chlamydia, but I don't know. I don't have sore testicles, and I didn't have any of the other chlamydia symptoms. I just had burning in my penis/bladder. It didn't even hurt when I urinated until yesterday, as Will said, just got worse, which leads me to believe an infection, but only the tests will tell. It got so bad I had to go to the ER to get the testing done and get some antiobiotics. Test results are due in tomorrow.

[Willl]

About a week or so it was really bad. I remember always feeling like I had to urinate but didn't need to. I remember my lower back was aching too.

[H. Hunter Handsfield, M.D.]

The extent of non-condom-protected exposure seems brief.  If you had a urethral or urinnary infection--which could have resulted--the symptoms would not be intermittent; and specifically it is likely you would only have pain or discomfort in the urethra itself during urination, not in the bladder area.  The sense of needing to urinate without result is not generally a sign of any STD.

Can I be certain you don't have NGU or a UTI?  No.  But those things are easy to determine and your pending lab results will tell the story. My original prediction, that there no physical cause of your symptoms will be found and that there was no significant risk of HIV or other STDs, is unchanged.

HHH, MD

[john989]

I went for a follow up today with my primary physician.

He pretty much downplayed everything and told me to stop worrying.

He said even though I have pain, he doesn't think it's sexually transmitted because I'd probably experience discharge. My lab results are not in today but probably will be in the next 1 to 2 days.

[john989]

One last question Doctor,

When I went to the ER the ER doc gave me a paper

Diagnosis: Urethritis

Inflammation of the urethra. 95% of time caused by sexually transmitted disease.

However, When I visited my primary physician today he doesn't think I have one at all and that was an off base statistic.

Do you know if anything else would cause burning pain in the penis/urethra?

No testicular pain or anything else.

[H. Hunter Handsfield, M.D.]

The information on the urethritis information sheet is accurate; the 95% statistic is right.  But did the ER actually diagnose urethritis, or just evaluate you for it (with negative results)?  If you had urethritis, they would have told you; that diagnosis is made on the spot, not by lab tests to return at a later time.

You will need to follow up with your own doctor about what is causing your symptoms and/or what other diagnostic tests to do.  I'm not going to be able to help further, since it is likely you don't have an STD and might only have anxiety, ie no physical problem.

HHH, MD

[john989]

Dr,

Urethritis was put on the "Diagnosis" on my discharge sheet.

I can tell you right now that while I have some anxiety about HIV, I have actual physical pain that has not gone away in only my penis area, of that I am 100% sure. Not testicular pain, or anything else. Just burning 100% of the time in the penis, sometimes worse than others, and I had 1 shot and 4 antiobiotic pills given to me Saturday.

I won't be getting my lab results until Thursday, but my question was if not chlamydia, what else could it be? It's persistent 100% of the time. Like a nagging pain. Any guesses?

Thanks again