[Question #13494] STD/HIV question

1 days ago

Hi Doctors

Sorry for coming back but you are my main point of Trust.

On October 4 , I had sex with Vitnamese escort in Dubai (She says that she is resident here but i cannot confirm). She said that she is full clean.

The exposure was the following.

- Deep French Kissing

- Unprotected Deep Blowjob

- Cunninglings

- Protected Sex

On 15th October , I started to feel frequent urine and burining sensation.

The burining sensation is continuing till today i feel the pain only when i pee from the top of the penis and the middle of it. I didn’t see any discharge but always a drop or two urine i believe this happens because of peeing.

I visited the doctor on 18 October he requested Urine analysis and culture and STD urine test.

Urine Analysis showed

WBC 10-25

Bacteria : Rare

Others are normal

Still waiting for the culture and STD which will still take 4-5 days to have the results.

Could this be a symptoms of STDs? What are the risks of hiv in that case and god forbid if positive in STD.

1 days ago

I forgot to mention that 2 days after the exposure on October 6.

I started to have a mild fever and tonsillitis. Dr prescribed Augmentin 1g twice per day for one week and paracetamol. And i became better.

H. Hunter Handsfield, MD

1 days ago

Welcome back to the forum. Thank you for your continued confidence in our services. There's no reason at all to be apologetic about returning to the forum with new concerns.

On one hand, you describe a fairly low risk of any STD from the exposure about two weeks ago. In addition, burning on urination without visible discharge is not typical for the most likely STDs from unprotected oral sex. On the other hand, the timing of your symptoms suggests they are related to that exposure, and 10-25 WBC in urinalysis definitely is abnormal. It is possible you have gonorrhea or chlamydia, but I doubt it; most likely you have none of the most common STDs and I expect your test results to be negative.

However, a viral infection might be good possibility. It's interesting that you initially also had symptoms suggesting an upper respiratory infection. One possibility is adenovirus, which is one of the common cold viruses and also causes 2-5% of nongonococcal urethritis (NGU). If that's what you have, the augmentin and paracetamol (called acetaminophen in North America) had nothing to do with your improved fever and tonsillitis. No viral infection responds to any antibiotic, but such infections of course quickly clear up without treatment.

As implied above, your use of "paracetamol" suggests you might be in the UK or perhaps elsewhere in Western Europe. Are you seeing a GP or maybe a genitourinary medicine (GUM) specialist? Either way, when your test results are available, you should see your doctor again in person for another urinalysis. If there still are elevated WBC (especially in an initial urine specimen, i.e. the first ounce or so), a urine culture for non-STD urinary tract infection would be a good idea. If the WBC are gone and your symptoms clear up, nothing more need be done. I'll be interested in hearing how things are going. In the meantime, you should not be too worried; all in all this doesn't sound serious. For now I hope these comments are helpful; let me know if anything isn't clear.

HHH, MD

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1 days ago

Hi Doctor,

Thank you for your prompt response. I am in UAE. And the tonsillitis happend to me was 2 days after the exposure. Actually i was feeling not well the day of the exposure but the symptoms elevated on the couple of days after.

I already did a urine culture and STD urine test which i am expecting the results on the coming few days.

Also i had a question regarding HIV can you please reply to it?

So god forbid in case of gonhorrea/chlamydia infection. Should i get tested for HIV as well or it has nothing to do with it.

Also the symptoms described are they related to STD or might be UTI or prostate?

Also can i know the risk of capturing STD from unprotected oral sex?

H. Hunter Handsfield, MD

1 days ago

As already discussed, your STD tests (probably gonorrhea and chlamydia) will be negative. There is gonorrhea risk from oral sex, but even this isn't very likely; your overall STD risk was higher from the condom-protected vaginal sex than from oral exposure. Even if exposed to gonorrhea or chlamydia, Augmentin only a couple days later would have prevented them from taking hold. Oral sex risks in general (penis in mouth): gonorrhea is the most important and most common. Chlamydia very rare. Herpes due to HSV1 is possible, and so is nongonococcal urethritis (NGU), often due to normal oral bacteria or adenovirus as discussed above. But all things considered, under 1% of such exposure result in any STD at all. Cunnlingus is even lower risk; it's very rare to catch any STD by oral-vaginal contact.

HIV is rarely if ever acquired from oral sex; any HIV risk was higher from the vaginal sex, even if condom protected. HIV doesn't cause symptoms like yours. Should you have an HIV test? From a medical/risk standpoint, it isn't necessary. However, HIV testing usually is automatic when STD testing is done. Discuss with your doctor.

I have already said your symptoms are not typical for any STD. They could be from UTI, but UTI's are rarely transmitted sexually except by anal sex. Prostatitis also is unlikely and is not sexually acquired.

You have one more follow-up comment coming. I suggest waiting until you have your test results and have seen your doctor for further evaluation, including repeat urinalysis to check for WBCs.

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