[Question #3543] STD/HIV Worry

36 months ago

Doctors, thank you for the service you have provided here as well as previously on MedHelp. I have been in a committed relationship for over 3 years, unfortunately after a series of events on a Saturday in February (over 7 weeks from today) I had a risky sexual encounter with a 20 year old female that was a bar pickup after we had talked for a while after having a cigarette. We went back to her place and began having sex initially with a condom (of which I requested) at one point in time the condom broke. We did stop for a minute but she got back on top of me for a brief amount of time (1-3 minutes) and I ejaculated outside of her. I had severe std worry as well as a primary HIV concern. I do not know the person at all. I had a negative chlamydia and gonorrhea urine test after 23 days from a local Planned Parenthood clinic. I have experienced lack of sleep, about 1/2 dozen occurrences of night sweats, lack of appetite which led to weight loss. I was examined by my PCP at 26 days out, we did a blood draw for HIV, but otherwise he said I appeared to be OK just over anxious/guilty. During this time I discussed the events with my girlfriend in hopes of relieving some stress. At about 4 weeks out, I discovered a red bump on my penile shaft and both my PCP and dermatologist thought it to be an ingrown hair, it was swabbed for herpes which came back negative. Over the past couple weeks (now 54 days out) I have continued being anxious. I have had sensations in the tip of my Penis as well as a feeling of my boxers being wet from time to time, and an increased need to urinate (sometimes even hourly). On Monday, which would have been 51 days out, I took a HIV Antibody test (appears to be 3rd gen it only mentions antibodies) via my PCP, performed at a local hospital lab via blood draw. It came back negative and I thought this would help alleviate my anxiety as well. I still have concerns as well as the sensation at the tip of my penis. Is it time to trust my results and move on?

36 months ago
Sorry for the additional reply, but I meant to add that my PCP has said that this HIV test from Monday is final and I need to put this behind me and learn from this mistake.  He also started me on a small dose of Buspal to try to help move on. I am 27 years old and hope to marry and have children with my girlfriend one day. What are your thoughts?
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome to our Forum.   I happened to be on the site when your questions arrived so you are getting a response somewhat more quickly than is normal.  I'll be glad to comment.  Please remember that most people, even those who have casual, "one-night stand" sex do not have STIs and most single encounters do not lead to infection.  Thus your risk of infection, while no zero is low.  You did the right thing to get checked and your gonorrhea and chlamydia test results are conclusive.  Your risk for HIV, even before testing, were in the range of 1 in 100,000 and the testing you have is at least 98% conclusive.  Thus you really should have confidence that you did not get HIV from the encounter you have describe.  My advice is do do just what you have suggested and to put this behind you and move forward without concern. 

I hope these comments are helpful.  EWH
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36 months ago
Thank you for the reply Dr. Hook and putting the risk into perspective. I am just trying to be cautious as I have never had intercourse outside of my relationship with this girl. I have also experienced great regret and guilt. The last thing I would want to do is put her at risk over my mistake. 

Is there any additional testing/follow-ups you would recommend?

The sensations I feel in the genital region, boxers could those be symptoms of any STI or just anxiety? I have never experienced discharge, fever or pain while urinating, primarily the sensation at the tip of the penis, wet feeling even though the boxers are dry and the need to constantly urinate.
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
I really see no reason for additional testing.  The symptoms you describe are most consistent with a degree of "hyper-awareness" that arise from looking for symptoms.  When people do this, they tend to become aware of normal sensations that just don't normally register as they carry out their activities of daily life.  EWH
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36 months ago
Thank you Dr. Hook. It sounds like you would be in agreement with my PCP and you wouldn't see a medical need to follow up for HIV?
36 months ago
I know I may be out of follow ups, but when I am urinating frequently, I feel like it is much more watery (especially in the last couple days 7+ weeks out) than normal? Is this discharge or just due to going so much? Sorry if over-asking, just really am trying to figure this out after such a dumb mistake and weeks of beating myself up.
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
I do agree with your PCP and see no need for additional follow-up for HIV.

As for your urinary frequency, this has been studied.  Urinary frequency is not a sign of STIs in men but it is a sign of anxiety.  I really would not worry further and urge you to move forward.

As you know, this thread will be closed shortly.  Take care, I wish you the best. EWH
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36 months ago
Thank you for your kindness and words of support and expertise. I will do my best to march forward.