[Question #11526] Oraquick accuracy/STI exposure
13 months ago
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Two years ago I had unprotected vaginal sex with a woman, her HIV status is unknown. Immediately after, I developed symptoms consistent with a UTI, and had an additional unpleasant fish smell from my penis head and drip. I tested negative for gonorrhea, chlamydia, and trichomoniasis. I was nevertheless given several rounds of antibiotics and diagnosed with chronic prostatitus. Fast forward two years, I had oral surgery that led to an open wound on my tongue. I performed oral sex on my now wife and shortly after developed oral thrush, along with other symptoms. I have gone through several rounds of treatment (nystatin pill, nystatin mouthwash, and now on the 150 mg fluconazole). The symptoms have persisted and made me think I might have contracted HIV two years ago, since everything I read says a healthy adult should be able to kick oral thrush easily with treatment. (As an aside, the symptoms aren’t severe, more mild and annoying; and I did not seek help until about 1.5 months after the first symptoms).
I took an Oraquick test a few weeks ago and it was negative. So more than two years after exposure. I’ve read all the literature, and done an inordinate amount of research because I’m now in the paranoid state where every symptom I have is HIV.
I am seeking answers on the following:
1. Is oraquick conclusive two years after exposure?
2. Could I have contracted another STI (some bacterial infection), unknowingly gave it to my wife, and then contracted it orally when I had the open cut on my tongue and performed oral sex on her? Could that be contributing to the oral thrush? If so, any ideas what it could be? I also tested negative for syphilis recently.
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Edward W. Hook M.D.
13 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. Your encounter two years ago was very low risk and not something to worry about Your partner was low risk and your recent OraQuick result proves that you were not infected (while not our favorite test, particularly for diagnosis of recent infections, the statistical performance of OraQuick is equivalent to other tests for HIV antibodies. If you had HIV the test would have been positive.
I would not worry about having some other STI which you transmitted to your wife and then required when you performed oral sex on her.
Thrush occurs from time to time and sometimes required several treatment courses to resolve. I would not overthink the significance of your thrush. It is most likely related to your recent oral surgery. EWH
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13 months ago
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Dr. Hook. Thank you very much for your response. It gave me a peace of mind I have not had in over a month. I’ve been stressing daily about this issue, obsessively researching to see if my symptoms were consistent with HIV or some other disease. This stress actually caused my blood pressure to rise from 116/72 (taken a month before the issue arose) to 130/78 (taken in the midst of my constant stress and anxiety). My Mean Arterial Pressure also rose from 87 to 103 in that same time period. I wonder if this constant stress is actually weakening my immune system so that I’m not fighting off the thrush as effectively, and causing a host of other symptoms I am experiencing (cold sweats, blurred vision, irritability, etc).
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Edward W. Hook M.D.
13 months ago
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I'm sorry for the stress you've gone through. The internet is all too often misleading and on the internet connections between "thrush" and HIV are blown totally out of proportion.
I doubt that the stress you're experiencing has weakened your immune system. More likely is that over time, thrush has become a bit more challenging to manage as the fungi causing it have become a bit less susceptible to treatment- requiring longer courses or different meds. I suspect that either your doctor or the dentist/oral surgeon who have been treating you can help get this cleared up.
Once again, this is not related to HIV. I am confident of this. EWH
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13 months ago
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Thank you for your response. Last two questions from me:
1. I looked back and noticed my test for gonorrhea, chlamydia, and tric was 13 days after exposure. The test I took at labcorp was Ct, Ng, Trich vag by NAA. I believe it was a swab, but it might have been urine. It was two years ago so I do not remember. I have seen contradictory information online about the window period for each of those STIs, ranging anywhere from a couple of days to two weeks. Should I get retested to be absolutely certain I am negative?
2. I had my annual physical in May, and given my symptoms my doctor ordered a urinalysis. It looked at everything from PH, to white blood and red blood cells in my urine. It also looked for bacteria. Everything came back negative. I have been unable to find whether an STI like gonorrhea or chlamydia would be detected in that kind of test. Is it? Thanks for your help.
13 months ago
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I meant to add to my last comment that the doctor who ordered the test never told me about a window period or whether I should get a confirmation test. It did not occur to me until I researched the window the other day.
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Edward W. Hook M.D.
13 months ago
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Final Responses
1. I looked back and noticed my test for gonorrhea, chlamydia, and tric was 13 days after exposure. The test I took at labcorp was Ct, Ng, Trich vag by NAA. I believe it was a swab, but it might have been urine. It was two years ago so I do not remember. I have seen contradictory information online about the window period for each of those STIs, ranging anywhere from a couple of days to two weeks. Should I get retested to be absolutely certain I am negative?
The window period for the organisms you tested for- gonorrhea, chlamydia and trich-, whether the specimen was a swab or urine, is 3-5 days. Any source that suggests longer in incorrect. Once again, information found on the internet is misleading.
2. I had my annual physical in May, and given my symptoms my doctor ordered a urinalysis. It looked at everything from PH, to white blood and red blood cells in my urine. It also looked for bacteria. Everything came back negative. I have been unable to find whether an STI like gonorrhea or chlamydia would be detected in that kind of test. Is it? Thanks for your help
Standard urinalyses sometimes hint at the presence of an STI by showing increased numbers of WBCs but to test specifically for STIs requires requesting specific tests for the STIs you are testing for. None of the results of your urinalysis you report suggest an STI.
I worry that you are more concerned about STIs from a distant exposure than you need to be. Even most exposures to infected persons do not result in infection. I encourage you to put any lingering concerns you might have aside and move forward without concern.
This completes this thread. Please don't worry. EWG
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