[Question #11102] HIV or another STD
17 months ago
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My history with men is NOT good at all! I’m a 41 year old heterosexual female. I have had lots of issues lately. Needless to say I’m very scared. First I went to my GYN 2 weeks ago due to a history of HPV and he did an exam and that was it. I requested all std testing and he didn’t do it. I have had the same partner since 10/2023. When I first met him I requested he get tested for HIV. It was negative. He is very untrustworthy and I am unsure when he has done since we first met. The past 3 days I have had bleeding from the rectum. It’s bright red blood. He did once penetrate my rectum. We have had unprotected sex many times. I was fine today and suddenly my entire body started aching. Ibuprofen has not helped at all ease the aches. I had slight chills and a fever of 101. I’m wondering
1) Could I have HIV and these symptoms be ARS related?
2) with him penetrating my rectum and ejaculating could I have some disease that he gave me from that exposure that could be causing the bleeding?
3) With me having a history of HPV (genital warts) could that have spread to my rectal area?
4) If I had some type of std that I acquired rectally could I have regular tests done for stds and it show accurate results that way or do I need other types of rectal testing done to make sure I’m ok?
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H. Hunter Handsfield, MD
17 months ago
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Welcome back to the forum. Thank you for your continued confidence in our services. I reviewed your two previous discussions. Apparently your current partner is not the same person, right?
First and most important, considering all these symptoms, this could be quite serious: you need urgent medical evaluation, i.e. within the next day or so -- either by your doctor or, if necessary, an urgent care clinic or hospital emergency department.
You don't say how long it has been since the rectal sex event. How long ago? I find it quite amazing that your doctor did not test you for common STDs even after you requested it. For sure you need testing now, and it must include rectal as well as vaginal/cervical testing for gonorrhea and chlamydia. Rectal bleeding can occur from some STDs, but other causes are equally or more common. The bleeding may nor may not be related to your fever, chills, and body aching. What can you say about your partner's sexual history and other risks? Like the partner you described several months ago, does he have a past history of incarceration? If so, when? What do you know or suspect about other sex partners, especially at the current time or in the recent past? Has he been tested for HIV? Regardless of the answers, these problems need immediate in-person health care.
Those comments partly address your numbered questions, but to be explicit:
1) Any number of medical conditions could explain these symptoms. But I have to say acute retroviral syndrome (ARS, i.e. initial HIV infection) HIV does seem a possibility. When you seek care, whether with your doctor or an urgent care setting, make sure they are aware of the entire situation and your concerns about HIV. You need urgent testing for it.
2) Conceivably your rectal bleeding could be from an STD -- but not necessarily, as discussed above. Careful examination, probably including anoscopy (looking inside the rectum) should be part of the examinations to be done, in addition to gonorrhea and chlamydia tests.
3) Conceivably a rectal HPV problem might cause bleeding, but it's not very likely. HPV is definitely not the cause of the other symptoms described.
4) Already discussed: Probably evaluations other than STD testing are going to be needed. Whether it all can be accomplished tomorrow, or whether you might need referral (e.g. to a colon and rectal surgeon) will be determined when you are first seen.
As you will obviously understand, your partner should be evaluated as well. Presumably he knows of your symptoms; if not, you need to tell him. That said, depending on the exact nature of your relationship, perhaps his own medical evaluation can wait until you have been examined and tested. But it might speed your evaluation if he can also be evaluated now.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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17 months ago
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This person is not the same person. He has never been in trouble that I’m aware of with police. He was tested I think in October or November for HIV, Chlamydia, Gonorrhea, Syphillis and they were negative. The anal sex event happened. Probably in December or January. I did get tested only by urine at urgent care early this month for
Chlamydia and Gonorrhea and it was negative. I did test negative for flu and Covid today.
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H. Hunter Handsfield, MD
17 months ago
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Thanks for the additional information. This all suggests that your symptoms are entirely unrelated to your personal relationship and are not due to HIV or any STD. However, the illness you describe is serious, perhaps dangerous. It is urgent that you be medically evaluated very soon.
Forum discussions are closed after two follow-up comments. Let's hold off on further discussion until you have been seen; I would be very interested in hearing the result after further evaluation. Good luck.
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16 months ago
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I’m being sent to colorectal specialist for rectal issues. I’m still concerned about the HIV and the symptoms I was having. The body aches and fever lasted about 1 day. I had a headaches for 3 days. Chills lasted for about 1 day. I only had a slight sore throat on day 3 and when I went to doctor she said my lymph nodes were swollen. My partner was tested but if he had another sexual encounter I know that he’s at risk which I suspect he has. Is the oraquick test at all reliable and since I have already had symptoms when can I take it and have the most accurate results?
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H. Hunter Handsfield, MD
16 months ago
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HIV test results tell two things. First, whether or not someone was infected. For that purpose, negative results are not conclusive until 2-6 weeks, depending on the particular test.
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Second, they tell whether or not symptoms are caused by HIV. For that, the time since exposure doesn't matter. If symptoms are caused by HIV, all tests are positive, no matter how long since exposure. A negative test at this time -- Oraquick or any other test -- will prove your symptoms are not due to HIV. Something else explains your inflamed lymph nodes etc. (In addition, symptoms of a new HIV infection never clear up in a couple of days. They always last at least 1-2 weeks.
Keep working with your doctor(s) about any continuing symptoms. If not yet done, I would advise not just an Oraquick test, but blood tests -- such as an RNA test (conclusive proof any time 12 days or more after exposure) and an antigen-antibody test (i.e. "4th generation test), which probably would confirm at this time that your symptoms are not caused by HIV. Discuss all this with your doctor(s).
I'll keep the thread open so you can let me know your actual test results. Don't post anything else -- only your test results when done. In the meantime, all the evidence is that you do not have HIV.
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16 months ago
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2 negative oraquick tests and just got HIV 1/2 screen 4th generation with reflexes results today and they are negative. Thanks for your assistance in this matter.
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H. Hunter Handsfield, MD
16 months ago
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Thanks for letting me know. Of course I'm not surprised -- but congratulations! And thanks for the thanks; I'm glad to have helped. Best wishes and stay safe.---