[Question #13959] Re 13920 - oral question

1 months ago

Dr Hook. I'd like to add more details to the incident on Mar 9 (10-15 minute unprotected oral and masturbation from CSW in Thailand - unplanned encounter). I also had an encounter on Mar 12 which I did not mention as it seemed more innocuous. This was brief unprotected oral (maybe a couple of minutes), then protected vaginal. I also took Prep on demand for this planned encounter (with CSW in Thailand). From this point I had the following symptoms:

Mild fever, body aches around a week after 1st encounter (the one i'm most concerned about). My penis started to itch around this time, and a couple of days after that I developed inflammation (red, weeping, swollen) in the right side sulcus area of the penis (i'm circumcised) which spread to the left side. This was treated with antifungal/ mild steroid and healed completely after about 12 days. I also got a small canker sore for about a week on the lower inside gum around this time which triggered an HIV panic. Roughly 2 weeks after the first event i developed groin aches (lymph pain?) and a few days later armpit pain which has continued through to today. I also have had fatigue and muscle aches and flushing , particularly in the evening and whooshing sound in my ear.

Currently, I still have the mild aches in the armpits and groin and also a dry mouth with metallic taste and aches in the jaw (saliva glands?) and a reddish eye.

Given the new information what is your perspective of symptoms. Do they align with ARS? Am I needlessly panicking over HIV again? I haven't yet tested, but I intend to do so this week.

Appreciate your analysis and apologise if this seems repetitive.

Edward W. Hook M.D.

1 months ago

six days ago you were warned not to return yet you have with further repetitive, anxiety-driven questions about your earlier NO RISK encounter. , Mild aches in your armpits and groin, dry mouth with metallic tase, and a reddish eye are NOT suggestive of the ARS. Further the ARS would not occur 30 days following an exposure. You are, once again, panicking unnecessarily.

Your test will be negative when you get it. You need to stop thinking that every perceived ache or pain is a manifestation of HIV from NO RISK encounters. You need to move on. Clearly you are having trouble doing this. My recommendations are:

1. Get tested sooner than later.

2. Stay off the internet which has already misled you.

3. Seek professional counseling regarding your unwarranted excessive Fears.

You have two follow-ups remaining. After that the thread will be closed and any further new questions will be closed without a response and without return of your posting fee. This is being done out of concern for you- nothing more. EWH

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1 months ago

Thank you Dr Hook. You are correct about my fear regarding HIV. I’ve been stuck in a cycle for a good part of my life where I have an exposure, some symptoms , panic and make myself miserable. Then I test and after a few months I seem to reset and do it all over again.

Obviously I have to test soon.

If it’s negative, then I can’t go on repeating this cycle. I would consider daily prep even though my sexual exploits are fairly infrequent.

You may have misread my message. The aches and fatigue began around 3 weeks ago. I can’t seem to locate any swollen lymph nodes but there is some mild pain when I press and a mild burning feeling at rest. The timeline looks like this, apologies for the muddled nature of my previous entry :

Mar 9 - insertive bj (10 minutes) and masturbation with csw - no prep no condom

Mar 12. - insertive bj (2 minutes) no condom and insertive vaginal with condom. This was with Prep on demand with completed dose

Mar 16 fever and aches, itchy penis starts

Mar 19 penis “Balanitis” develops and worsens over next few days . Does not improve with canestan but improves with canestan plus steroid

Mar 23-24 the aches , fatigue , flushing and lymph node(?) aches started . I’d been in HIV panic mode several days by this stage due to a small canker sore appearing in my mouth which went away after a week

The penis was fully healed by early April

The lingering fatigue aches etc continue to current time as well as dry mouth etc

Do these symptoms on this timeline make you suspicious about HIV?

Edward W. Hook M.D.

1 months ago

I have no concerns about HIV. You are overreacting.

In my opinion, PrEP is not the answer to your concerns. Your levels of concern are unrealistic and would be best addressed through counseling. EWH

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1 months ago

Dr Hook,

Please see my results from today:

I had an STI panel collected using urine, penis swab, and serum. Serum testing was negative for HIV Ag/Ab Combo 4th gen lab test as you predicted, HBsAg, anti-HCV, and VDRL/RPR. Molecular testing from the genital sample was negative for Candida albicans, Chlamydia trachomatis, HSV-1, HSV-2, Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum, and Haemophilus ducreyi.

Gardnerella vaginalis and Group B Streptococcus were detected.

In your opinion, are these positive findings plausible explanations for the balanitis / foreskin sulcus inflammation I developed, and does the negative HSV swab materially reduce the likelihood that this was primary genital herpes?

And how did I end up with Gardnerella as I haven't had unprotected vaginal sex since about 2021 with an ex-girlfriend.

Thanks once again for your expert analyses.

Edward W. Hook M.D.

1 months ago

Final responses. After the response, the thread will be closed. You should NOT return with further anxiety-driven questions, as you were warned earlier.

Your testing included tests for bacteria and a fungus (Candida) which are normally found in the genital tract. Gardnerella and Group B streptococci are normal in the genital tract and come and go. Molecular testing is overly sensitive and the presence of these organisms, as well as Mycoplasma hominis, and both varieties of ureaplasma is normal. Their presence is detectable in many people off and on.

In the absence of lesions at the time of the swab, failure to detect HSV does not offer useful information.

Please re-read my original reply. You have seriously over-reacted to your virtually no risk encounter. I again suggest that you seek counseling to help you move forward.

End of thread. EWH

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