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Avatar universal

possible HIV/STD?

I am a guy and about five weeks ago I had unprotected vaginal sex. about ten days later I felt very tired and fatigued, so much so that i didnt go to work for three days. I also got a very sore and inflamed lymphnode in my armpit. A sore throat persisted for a week beyond that (making it 2 weeks). At three weeks I had a painful, milky white yellow penile discharge. I was tested for gonnorea and clyamedia after that (at about three weeks), these both came back negative. I have persisted with low grade fever from time to time and a sore throat. The swollen lymphnodes went away after I took the antibiotics prescribed to me after my testing. However, the sore throat has persisted and from time to time I will feel fatigue. It is true that i am very stressed, but I just cannot think of what this could be if gonorea and clamydia came back negative and some symptoms have persisted. So I am wondering
1) what the odds of this being HIV with my symptoms?
2) what other std could it be?
3) are the swab tests for gonorrea and clamydia to be trusted?
4) How common are other Sexually transmitted baterial infection (beyond the two I was tested for)
5) if the symptoms I discribed were due to HIV, would an HIV anitbody test come up positive after three and half weeks from exposure (mine came back negative).

Thank you
13 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.  I'll try to help.  Don't worry about correct forum or not; your questions are equally pertinent to both this and the HIV forum.  We don't require such questioners to post in both places.

First, your two HIV questions.

1) We can dismiss HIV as a serious concern.  Use the search link in the HIV forum to see innumerable discussions about the low risk of virus transmission during any particular vaginal sex encounter, the low frequency of HIV in most women in the US and other industrialized countries, and the non-importance of symptoms in predicting whether or not someone has HIV.  In any case, your symptoms are not particularly suggestive of a new HIV infection, which generally does not cause single lymph nodes to enlarge; and absence of fever also is against that diagnosis.  Many other medical conditions, most of them minor, cause HIV-like symptoms, as well as the sorts of symptoms you describe.

5) Yes, HIV antibody tests generally are positive within 10 days after onset of HIV symptoms.  And around 80-90% of people with new HIV infections have positive antibody tests at 3 1/2 weeks.  Therefore, your negative test result is reassuring but not definitive.  For peace of mind, you probably should have an HIV test any time 6 or more weeks after the sexual exposure, but you can expect negative results.

2-4)  You have nongonococcal urethritis (NGU).  About 1/3 of NGU cases are caused by chlamydia -- so you are in the majority on that score.  NGU is the most common of all STDs in men, i.e. twice as common as chlamydia and 10 times more common than gonorrhea.  Your negative tests for those infections are highly reliable.  I'm surprised you don't say anything about treatment; most providers would know to prescribe an antibiotic for NGU, usually either azithromycin (a single dose treatment) or doxycycline (twice a day for a week).  Your sex partner also needs treatment.  Fortunately, nonchlamydial NGU is rarely serious and complications are rare; with proper treatment this won't be a serious health issue for you.

I hope this helps.  Best regards--  HHH, MD
Avatar universal
I apoligize that this pertains to HIV, my post was meant to be in an HIV forum, and that is the "interest" that i clicked on at the outset.
Avatar universal
If no comments can be made about HIV here, perhaps you could just respond to the questions you find appropriate for this forum. Sorry for the mix up!
239123 tn?1267651214
MEDICAL PROFESSIONAL
I saw these comments before I replied above.
Avatar universal
Thank you very much for your comments. I was prescribed levoquin, however two weeks after taking that, still have some burning with urination. I have also read that herpes can cause discharge and some of the other symtoms I describe. However, I have had no redness, marks, bumps, or anything else in the groin region. Because I was freaked out, I took a IgM test which came back 1.3 positive, (1.09 being the positive threshold). This really scared me. I know that the IgM test is considered "worthless" but isn't that because it does not differeniate between HSV-1 and HSV-2? I have HSV-1, I tested positive for it in the past on a herpeselect test, however have never tested positive for HSV-2. with all the information out there about herpes not having any symtoms, or mild symtoms, ect, I am concerned about this possibility. My health care provider told me that the IgM test shows i "recently came in contact with the herpes virus." I have never had an outbreak of my HSV-1, so was told that this HSV-1 probably would not make the IGM test positive. I am confused about this, and any information you could give me would be helpful.
Thanks
239123 tn?1267651214
MEDICAL PROFESSIONAL
Levofloxacin (Levaquin) is not a standard treatment for NGU.  It would work if you had chlamydia and probably gonorrhea, but has not been studied against nonchlamydial NGU.  If examination shows you still have evidence of urethritis, which is possible given your symptoms, you should be treated with azithromycin or doxycycline as described above.

Herpes is an unlikely cause of your symptoms.  It does cause a 1-3% of NGU cases, but symptoms would not last this long and probably would have been more severe.  (Some men describe herpes in the urethra as the worst pain they every felt.)  And you are correct about the HSV IgM test.  Your doctor is giving standard information about HgM antibody as a sign of new infection, as all health professions are taught.  But it doesn't work that way for herpes.  Here is a 3 year old but still accurate discussion of IgM testing for HSV:  http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394  You can also use the search link and enter "HSV IgM", "herpes diagnosis", and other similar terms for many other discussions.

Bottom line:  Get reevaluated for your continuing urethral symptoms, preferably by a provider with real STD expertise.  And don't worry about herpes; it's not an issue here.
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