Idiot in Asia

[Fool0303]

Was in Hong Kong recently and had un protected oral and vaginal sex with CSW. She swears up and down that she is clean and healthy, which though nice to hear, is not really helping my nerves.  36 hours after exposure I received penacylin and cifixime.  Penacylin 3 times a day for one week and cifixme 2 times per day for one week.  Made a mess of of my stomach.  A week after the incident I returned home and saw a doctor.  Was given tests for STD's and HIV.  Blood was drawn as well as a swab of the penis.  In addition the Dr. proscribed Arithromycin two pills taken at once.  All tests (Thank God) were negative. 12 days after the incident and 10 days after first round of antibiotics and 5 days after the arithromycin I had unprotected sex with my wife but did not ejaculate in her.  At two weeks after the incident I started having some urinary issues.  No pain, no burning, no discharge. This has persisted for a week. Mostly just an increased frequency and urgency.  I visited my PCP today for a follow up.  He drew blood, took a swab of the urethra and a prostrate exam.  His initial conclusion pending test results was Prostitis and he prescribed Cipro 500 MG 2 times a day for 10 days. I know I should just wait for the tests in a couple of days, but I have some questions as I am a mess and the charade of pretending that everything is normal is taking its toll on me.

1) Does increased urgency and frequecy sound like an STD Chlymidia, Gonarhea, NGU etc. etc.?  Could the Prostitis have been caused by this?

2) Could the Antibiotics I was taking have affected the outcome of the first round of SDT tests and make the tests read negative when in fact there were positive?

3) After the regimen of antibiotics and the resulting negatives on all the STD  tests and 5 days after last antibiotic, could I have passed any of this to my wife?

4) How definitive is an HIV test 3 weeks after the possible exposure?

Your counsel would be most welcome as I am a mess.  

[H. Hunter Handsfield, M.D.]

You have been treated (dramatically over treated) for every STD that could possibly cause the symptoms you describe.  You also have been reassured by your doctor (two of them, if I correctly understand the story), which is always more reliable than the advice from a distant online source like this, no matter how expert.

To your specific questions:

1) Prostatitis often is a "wastebasket" diagnosis, a name docs often put on urinary symptoms in men when they can't come up with a clear diagnosis.  It's not an STD.  Your symptoms actually are most consistent with the male chronic pelvic pain syndrome.  If you google "chronic pelvic pain syndrome", you will find a lot of information.  The Wikipedia article is especially good.  As you will see, CPPS used to be considered a form of prostatits, but no infection is involved.  It's often just a manifestation of anxiety.

2) If you had an STD, the antibiotics would have cured it, making the tests negative.  Antibiotics do not make the tests negative except by curing the infection.

3) Clearly you don't have anything from that sexual encounter and probably never did.  If you received the initial treatments before you had sex with your wife, it is not possible that you infected her.

4) About 80% of newly infected people have positive HIV tests at 3 weeks.  But your chance of having HIV is close to zero, given your overall story and the reassurance you were given by your commercial partner.

You're fine.  Let it go.  You absolutely have nothing that can ever harm your health or your wife's.  But of course continue to work with your doctor if your symptoms persist or you remain concerned.

Please no "yes but" or "what if" follow-up questions.  There is no information you can provide that could change my opinion or advice.

Regards--  HHH, MD

[Fool0303]

Thank you Doc no "yes but" or "what if" only a thank you for your consideration and time. This helps to ease my anxiety and I may perhaps get some sleep this PM and maybe just maybe not be an idiot in the future.