Days to wait after treatment

[gnr13]

Hi Doctor-

Two weeks after I had unprotected sex I was treated with a single dose for chlamydia. I did not have any symptoms, and I was not told to wait a specific amount of time before having sex again. So, five days later I had unprotected sex.

After reading that standard medical advice is waiting one week before re-engaging in sex after treatment I am very concerned that I could have infected the new partner. Could you let me know what type of risk there was that I still could have infected five full days after single does treatment? I was asymptomatic.

Thanks.

[Edward W Hook, MD]

Given yoiur low risk to start with for HIV, I would accept the negative viral load (probably a PCR test) as proof that you do not have HIV  You do not need further testing.

Similarly, it is time for you to stop worrying about this encounter with respect to the possiblity of syphilis or other STDs as well.

Finally, it is time for this thread to end.  there will be no further answers.  EWH  

[gnr13]

Doctor Hook - I received a negative "viral load" HIV test - my understanding is that this is actually looking for the virus rather than the antibodies.  The test was done at almost (within 2 days of) 6 weeks after exposure of unprotected vaginal sex. The PA who gave me the results was very unclear about the certainty of the test and whether I should just put the HIV concerns to rest. In fact, the PA said I needed to get tested for antibodies at 3 and then 6 months.

Basically, I just want to know if this "viral load" test at 6 weeks is enough for me to just totally disregard HIV as the cause of my fatigue and muscle pain. Also, I got a syphilis test at the 6 week mark as well. Do i need retesting for either HIV or Syphilis?

Thanks for your help and patience.

[Edward W Hook, MD]

Everyone should be tested for HIV from time to time.  Your risk of HIV however is low.  

Early HIV can manifest itself with joint pains however it is far, far more likely that you have the flu or some other communtiy acquired viral illness than HIV.

I predict that your HIV test will be negative.  When it is, you can be sure that your joint pains are not due to HIV.

At 6 weeks an HIV test would detect over 90% of HIV infections but again, it your joint pains were due to HIV, your test woul be positve at that time.  Try not to worry.  EWH

[gnr13]

I am so sorry to post one last time but I am so concerned. My joint pain has not subsided. I went to get some blood work done and the doctor said I should be tested for HIV. I only had vaginal sex unprotected for maybe 2 minutes tops. I had the flu pretty bad a week after. The doctor said because of the flu and joint pain she would recommend an HIV test. I am just so scared. I am 6 weeks out from exposure and have pretty sore muscles and joints, particularly in the legs....would I have joint pain from HIV so early? Aren't my chances of catching the HIV virus very low? I am just so scared I infected my partner. I have no reason to think that the girl I had unprotected sex with was an intravenies drug user or anything else.....should I be worried?  I'm just so scared.

[Edward W Hook, MD]

Abnormalities on a urinalysis, most typically white blood cells, can be an indication that an STD is present.  There is no way to determine however if urinalysis abnormalities are due to an STD or a UTI without specifc testing for each.  Furthermore, many women can have STDs with perfectly normal urinalysis results.  Botton line, the urinalysis is just not much help.  EWH

[gnr13]

This will be my last question. I do not think I articulated what I meant to ask very well in the previous post.

When one gets a urinalysis, the test can reveal high concentration of white blood cells, nitrates, etc. I assume certain concentrations of one of these indicate that there is an infection of some kind. Thus, if I have had a bacterial STD for over 3 weeks, is it reasonable to assume that there would be some indication of SOME TYPE of infection in the urinalysis, albiet nonspecific? Or would an infection caused by an STD just not effect the indicators in the urinalysis (white blood cells, etc).

thank you for your help and patience.










































Thank you for your help.

[Edward W Hook, MD]

By viral STDs you are really talking only about herpes.  If you had herpes, you would likely have lesions which you would be aware of.

UTIs and STDs are not the same. they occur at different areas of the genitals.  UTIs happen without sex. STDs must be transmitted by sex. Your chlamydia was a STD.  Your urinary frequency is not likely to be so.  Without burning it is similarly unlikely to be a UTI.   EWH

[gnr13]

Thank you for your response. I do have a lot of anxiety, but it does feel like I have a wieght or something in my lower abdomin. I have weak stream and sometimes it takes a little while to start urinating, but i have no burning.

When you say "classical UTI" does that include UTI caused by STD?  Basically I dont know if negative urinalysis is strong evidence that I do not have a bacterial STD.....

Also, could any viral STD's cause the urge to urinate and sore muscles and joint pain around 5-6 weeks out from exposure?

Thank you and sorry for seeming impatient.

[Edward W Hook, MD]

You do not need to pay again but you have to wait until I get to your question.  If the thread runs on too long, I'll tell you (typically around 10 exchanges).  The fact that you ahve a negative urinalysis is stron evidence that you do not have a classical UTI. At the same time some women do get a problem called the acute urethral syndrome in which the bacteria which cause UTIs also cause similar symptoms but result in negative urinalyses.  These typically get better with a short (about 3 days) course of antibiotics.  

On the other hand, anxiety can also cause a sensation of the need to urinate frequently. any chance this could be the problem? EWH

[gnr13]

should I pay again to have my last question answered? Sorry im just not sure how it works.

[gnr13]

Doctor-

Since my last post, I have developed the urge to urinate all the time. I basically feel like not I (along with my partner) have a UTI. Furthermore, I have muscle soreness and joint pain. I am not making these symtoms up in my head. They are very real.  I do not know what to think. Even if waiting five days between single dose treatment for chlamydia and gonnorea was not enough to cure in time before I had sex with my partner, it seems like there is no way I would still be infected. I went to a clinic and got a urinalysis done which came up negative. I also got tested for trichamonas and am waiting on results.

Therefore, I am searching for answers as to what else could do this. Can viral STD's make you feel like you need to urinate all the time? Furthermore, I can only guess that if I had a viral infection that my white blood cell count would have indicated an infection in the urinalysis?

Please just let me know if I need to pay again, I just wanted to put this all on one post. I am very confused by this, and do not really know what else to do.

Thanks

[Edward W Hook, MD]

This could be an STD but it remains unlikely.  My guess is that her UTI is coincidental.  EWH

[gnr13]

Thanks a lot. One reason that I became really concered that I had infected even though i had been treated 5 days earlier is that the new partner says she has a UTI infection now. This infection came about exactly 3 weeks after we had unprotected sex. I am just worried that it really is not a UTI and it is in fact the STD. Would chlamydia cause the type of incessant need to urinate with intense burning sensation? I know STD's can cause burning when urination, but she describes feeling uncomfortable and not well just sitting at her desk.

[Edward W Hook, MD]

Welcome to our Forum.  This is a good question. The recommended 1 week interval has never been studied and I suspect it was originally made to be safe, particularly in situations where multiple doses of medication were given for therapy.  You were treated with azithromycin which is effective as single dose therapy and you can only kill a bacteria once.  The chance that you infected your partner is very, very low and I would not be concerned.  

BTW, just in case you were thinking of getting tested to be "sure" your infection had been eliminated, don't.  The dead chlamydia bacteria can be detected in specimens for up to three weeks following therapy.  For that reason, as well as the high efficacy of the treatment, testing to verify cure is not recommended.

I hope this helps. EWH