[Question #10991] HIV and STD Risk

18 months ago

Hello Doctors, My question is a two pattern.

Firstly, I had unprotected sex with an Indian girl on the 10th and 11th of February. She happens to be a common friend. Now, 10 days later, I have been having several symptoms. I have a very bad sore throat to a point where I cannot swallow food or water. I have muscle aches, joint aches, headaches, swollen lymph nodes under the neck, diarrhea and fatigue. I haven't gotten a fever yet. She told me her last visa medical was around April of 2023. Here in UAE, they test for HIV during the visa medical. Her test was negative. But she slept with another Indian guy few months later and they had unprotected sex as well. I am uncircumcised. Am I under high risk? Are my symptoms related to HIV? Do I have HIV? I had seen a doctor who tested my CRP levels. It came out high. I am very worried about HIV.

Now, I have few other symptoms. I have a bad lower back and lower abdomen pain especially near my right kidney area. Slight burning while urinating as well. No discharge from the penis. Can these be related to STIs like Chlamydia or Gonorrhoea?

Edward W. Hook M.D.

18 months ago

Welcome back to the Forum. I'll be glad to comment. The encounter you describe was low risk. Your partner was tested for HIV less than a year ago and the likelihood that she acquired HIV in the time since her last test is low. Your flu-like illness, including the sore throat, swollen lymph nodes headache, joint aches, etc. could be caused by a streptococcal infection as well as a large number of viral illnesses including mononucleosis, COVID, influenza and rarely (less than 1% of the time) recently acquired HIV. The likelihood that this is HIV however is low but cannot be totally discounted without an HIV test in you or your partner (as you know, you and Dr. Handsfield discussed this a year ago). If your test is negative, as I am confident that it will be, your symptoms are certainly not due to HIV. If your partner has a negative HIV test, you cannot have gotten HIV. Can you tell me what the doctor you saw said- did he/she take other tests?

Regarding your back and lower abdominal pain as well as slight burning on urination- these symptoms are also non-specific. They could be related to your other symptoms or due to a urinary tract infection, kidney stones or urethritis resulting from the encounter you describe. The timing is a bit long to be due to an STI although this is on the list of possible causes. You should have been tested with at least a urinalysis when you saw the doctor. Again, what tests were done and what did the doctor say.

I may be able to provide further comment when I get more information from you. EWH

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18 months ago

Hi Dr. Hook. Thank you for your response. Firstly I'll have to clarify few things. Apparently, my partner got her visa medical done around June. That came out negative. Her partner who she had unprotected sex with after had his visa medical around December of 2023. That came out negative. She was HIV negative in June and he was negative in December. Secondly, my lower abdomen pain, the slight burning while urinating and pain near the right kidney started 2-3 days back. The other symptoms were there few days before that. It was because of those symptoms I went to the doctor. He ordered a regular CBC test and absolute count test. My total WBC count was very slightly high. The strep test and throat culture test were negative. My CRP however was high. The maximum should have been <5 where as mine was around 12. That's when he suggested that it might be viral. He found my throat congested. I have been having bronchitis for a while now. Maybe that's why. But I have been relating my symptoms to HIV.

Finally, few days back, the other symptoms started. Now I am also worried about Chlamydia, Gonnorrhoea and any Bacterial STIs. I will be seeing the urologist tomorrow since I cannot bear the pain near my right kidney area. Can bacterial STIs show up without having the discharge? I do not see any kidney stones while urinating. Its a hassle to test for bacterial STIs here. Normally they just give out a broad spectrum antibiotic to clear it out. Since these bacterial STIs are proving to be more resistant to these antibiotics, I am quite worried.

Edward W. Hook M.D.

18 months ago

Thank you for the addition information however, it is no way changes my assessment. The encounters you describe are very low risk for HIV. I suspect many of your symptoms are due to something else.

I am pleased to hear that you’re seeing urologist. I trust he will take a careful history. You should make sure that he is aware of your casual sexual encounter. My assessment of the possible infections which may be present is unchanged. STIs, such as gonorrhea, chlamydia, or non-gonococcal urethritis can certainly be present without a discharge, and with the only symptom being mild burning on urination. On the other hand, these STI are unlikely to lead to abdominal or back pain such as you describe. They are also unlikely to cause an elevated CRP or WBC.

Before worrying about therapy and possible resistant bacteria, you need to find out what’s going on. Seeing a urologist is a good step in that direction. I look forward to hearing from you about what the urologist says EWH.

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