HIV/STD

[arianman4u]

Hi Dr. HHH

I have been reading this forum for a few days. I need some help. about 13 days ago I had encounter with a couple of sex workers in canada. It was protected sex for about a couple of minutes with each. No oral was involved. only fingering. This is teh first time I got involved with something in my life. Since then I have lost peace and guilt has given me extreme stress. Please assess my risk. I keep thinking what if the condom was poor quality, what if there holes and rip that I could not see. But after pulling out if it was ripped the fluid would fall out on the bed and on my legs. All these thought keep creeping in. Highly stressed.

1. Do I have risk of HIV and do I need testing.
2. A couple of days ago, I started itching in my foreskin and my glans were red and white skin on the penis head has been peeling off. Is it sign of yeast or sign of herpes/gonorreha/syphillis etc. I dont have any obvious blisters but I am very scared.
I regret all this and dont under stand how I can get into all this mess. I went to see a physician in walk in clinic. I did not tell him about the incident(I was extremely embarassed). he said it is yeast infection.
3. I also went to STI/HIV clinic. They have taken urine samples for chlamydia/gonorreah but said that for HIV testing it is too soon. P24 antigen test not covered by the insurance.
4. Can stress trigger yeast infection.
5. I also take nexium for hyperacidity. Would that cause it?
6. How soon std symptoms appear after exposure.

Please reply.

[Edward W Hook, MD]

No, whether you waited 1 or two hours would make no difference.  Your results will be reliable.  EWH

[Edward W Hook, MD]

My advise woul be not to worry and to move on. EWH

[Edward W Hook, MD]

Testing at 12 days will provide accurate results. In fact at any time 2-3 days after exposure testing would provide accurate results - you're fine.  EWH

[Edward W Hook, MD]

Impossible- no.  Rare, yes.  The risk of catching HIV from a single vaginal sexual encouner is only 1 in 1000 and that is if yoru partner is infected which is also rare. EWH

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.  I'll try to address your questions but having read your earlier communications on the Community forums, it is my sense that your guilt and shame over this exposure are your major problems, not risk for STD or HIV.  I will work to answer your questions but I really think you need to consider talking through this with a counselor or someone who can help to put your mind at ease.

In answer to your questions:
1.  These were no risk exposures. It is unlikely that your partners had HIV or even a STD. most commercial sex workers do not. Even if one did, condom protected sex is safe sex and you can be confident that your condom did not fail.  When condoms fail they break wide open leaving no doubt that they’ve failed.  Similarly, there is no risk from masturbating (fingering) an infected partner or from getting infected genital secretions on your skin.  

2.  This does not sound like and STD and as I've said, your exposure was safe sex.  A trained clinician has suggested this is a yeast infection. They are probably right.  Their estimate, having examined you is better than advice I can give over the internet without the opportunity to examine you.,

3.  I predict your rests will be negative.

4.  Stress, in and of itself does not typically trigger yeast infections.  On the other hand, repeated self examination and manipulation can be irritating.

5.  Sorry, I do not follow your question.  I anticipate that your anxiety can be associated with increased acidity.

6.   Typically within a few days.  Tests however are far more reliable than symptoms.  Believe your test results.

Take care.  Talk this out with someone. EWH

[Edward W Hook, MD]

Your 8 week result is reliable. Believe it. EWH

[sunnyk590]

Dear Dr. HOOK:

My last question although for reassurance purpose. I appreciate your reply.
I had my ELISA test at 8 week exposure. It can back non-reactive. Should I consider this conclusive and move on.

Thank you again.

[Edward W Hook, MD]

This will be your last answer. Further repetitive, anxiety driven questions will be deleted without comment.  You did not need testing to start with.  A 28 day HIV antibody test of the sort you had would detect over 90% of recently acquired HIV infection, if you were at risk (which you are not).

The thread is over.   EWH

[sunny_881]

Dr:

First i would like to thank you and Dr. HHH for the wonderful job you are doing. The expertise you both have is unmatched. Your comments are very comforting and informative.
I had my 3rd generation EIA test(antibody ony) done at 28 day exposure which was negative. Can I rely on it. How reliable is the result. The health nurse said that no DNA test was done. Sometimes DNA test can show false positive.

Please advise. I really appreciate.

Thank you.

[Edward W Hook, MD]

No change in my answer.  Please relax.  Believe your test results.  eWH

[arianman4u]

Thank you Dr. Hook:

That means even if the bladder was voided only1 hr before, it would not make any difference.

[arianman4u]

Dr. Hook:

I really thankful to you for your patience in answering the questions. I dont want to bother you anymore. Just last question and i will end this thread. When I went for the test, the health nurse told me that ideally pee should be held for a couple of hours before the test. I dont remember how long I have been holding it. Does it matter at 12 day exposure if it is 1 hour or 2 hrs. Thank you.

[arianman4u]

Dr. Hook:

Thank you.

[arianman4u]

Dr. Hook:

I really appreciate for all your quick responses. Just one question for information. When I went for the tests, the health nurse said that they dont do test for herpes or syphllis if there is no sore or blister present. Sfter 18 days of exposure, I dont seem to have any obvious sores or blisters(except for the possible yeast infection). Do I need further blood tests to check for these infections later or I should just forget about it.

Thanks again.

[arianman4u]

Dr. Hook:

Thank you very much for your response.

[arianman4u]

Hi Dr. Hook:

I got my chlamydia and gonorreaha test today. they are negative. they were done 12 days after exposure. was it adequate time for testing or was it done too soon. Please reply.

[Edward W Hook, MD]

The contries of origin of your partners in no way changes my assessment or recomendations.  You have nothing to worry about.  EWH

[arianman4u]

Thank you Dr. Hook:

One last question. One of the sex worker was chinese immigrant. Is HIV common in China. The other one was indo canadian born in Canada.

Thank you.

[arianman4u]

Hello Dr. Hook:

Thank you for responding quickly. I read previous comments by yourself and Dr. HHH. Believe me I have been doing this for the last two weeks constanlty. I should listen to the advise. It is the guilt.

In one of the threads, Dr. Hansfiels said that vaginal heterosexual transmission of HIV is almost impossible (If I have not read it  incorrectly). Is this true? I know this is again a question to satisfy myself.

Thanks