[Question #1720] Need advice.

43 months ago
I am a returning customer and have a few last questions related to my exposure. 

Just a recap- i had protected sexual intercourse, and was the giver of unprotected oral sex. Although I was already sick before the exposure, 2 days after the incident I got a really bad sore throat (possibly strep throat) because the doctor said he said puss pockets on the back of my tonsils. It sure felt like strep throat. However, after I started amox-clav 875 mg, the sore throat went away after a day & a half to 2 days. After 2 days, I no longer had pain, fever or soreness. However, today i looked at the back of my throat and my tonsils still have white patches on them. I have 2 more days worth of medicine. My main concern is that maybe this was an hsv 2 outbreak in my mouth and not strep or a typical sore throat. I already have hsv 1 orally. I called the doctor today and asked about the white patches, and he said as long as there's no symptoms or pain, the white patches mean nothing. I just dont know how true that is?

Questions:
1. If this was an hsv 2 outbreak, would the pain have gone away after two days on antibiotics?
2. Do the white patches on my tonsils still, seem like hsv 2?
3. I would like to get tested for hiv and was wondering when I could get tested for accurate results and using what testing method? Are the tests over the counter accurate, such as oraquick?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
I'm sorry you felt a need to return after the reasoned, science based reassurance I tried to give you.

Your doctor is exactly right about "white patches" in the throat. To your questions:

1) An initial HSV2 outbreak always lasts at least 10 days, often 2-3 weeks. Almost certainly you had a virus, but conceivably a strep throat. Antibiotics have no effect on viral infectionsis, and if it was a virus, it was going to get better with or without the antibiotic. If you did have a strep throat, the antibiotic might be why the symptoms cleared up rapidly. Either way, herpes is the least likely of all possibilities. 

2) No, see above.

3) As we discussed in your previous thread, the chance of HIV from this sort of exposure is very low, and if I somehow were in your situation, I wouldn't feel a need to be tested for it. But if you decide to do that, the HIV oral fluids home self test is the least reliable of all available tests and takes the longest for conclusive results. At 4 weeks after the exposure, you can be about 90% confident a negative result is valid, but you would need to wait 3 months for a conclusive result. If you go to a doctor, clinic, or lab and have an antigen-antibody HIV test (i.e. a "fourth generation" or "duo" test), you can get a conclusive result 4 weeks after the exposure. 

Really, you need to work to mellow out about all this. Although I'm not a mental health expert, I suspect you are conflating shame, guilt, and/or anxiety about a sexual decision you regret with infection risks from that decision. They aren't the same. Deal with the former as you need to, but herpes and HIV really are not significant risks here.

HHH, MD

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43 months ago
Thank you for your patience and advice, Dr. Handsfield. 

I have one last question. Yesterday afternoon I noticed this bump on my groin area and it's a little tender, just like a pimple. The area around the bump is red, but that might be because i've been examining and messing with it. It appears to be flesh colored, but it looks like there's a white head on the top. It doesn't burn or itch, and it's not real painful. Is this a worrisome bump that I should get checked out? I went to the gyno yesterday, but I forgot to show my doctor it. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
From your description, this sounds like a garden variety pimple and no STD. And the location is atypical for STDs, including herpes (the only STD that can cause pimple-like lesions).

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