[Question #4590] Last Question- I Forgot to ask.

28 months ago
Dr. Hook

We had a very informative exchange I started last week.  I did print it out and shared it with my psychologist, as I will with this one.

I told you I always use condoms for vaginal sex.  I don't do anal sex.  I don't do drugs.  I also ask my partners if they have been tested.  I also mentioned I have hpv, with usually one or two warts appearing annually, which I have frozen off.

I forgot to mention one fact.

Several  weeks ago i had a bump on the bottom of my testicle sac.  I went to the dermatologist.  I originally thought it was a wart.  He examined and said it was a small cyst.  I asked if it had to be removed, he said no.  He injected me right into the cyst with something I believe was a steroid to reduce swelling.  It did just that, it got smaller.  The cyst is still there but tiny.

My questions

1.  Would the steroid shot into my cyst affect antibody / antigen production or testing results?

(I believe since it's strategically placed it would not)

2.  Does having a cyst increase my risk of hiv infection allowing hiv to enter my blood stream?

(I believe this is not considered an open wound so it's not a problem)

3.  Does hpv increase hiv risk as it is point of entry?

Thanks & Happy Holidays!!!




Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome back to the Forum.  Directly to your questions.  Scrotal cysts are common and unrelated to STIs.  They do not increase risk for HIV or other STIs.  Many patients choose not to treat them unless they become large or troublesome.  In answer to your specific questions:  

1.  Would the steroid shot into my cyst affect antibody / antigen production or testing results?
No it would not.  Local injections of steroid injections are often used for treatment of this sort because very little of the steroid is absorbed into the circulatory system.  A local steroid injection of the sort you describe would not in any way change your test results- either antigen or antibody tests.

2.  Does having a cyst increase my risk of hiv infection allowing hiv to enter my blood stream?
There are no data to suggest this. Cysts are quite common and are not know to increase STI risk, including risk for HIV


3.  Does hpv increase hiv risk as it is point of entry?
The data on this vary however most experts do not believe that HPV acts to biologically increase risk for HIV.

I hope my comments are helpful to you.  Take care. EWH

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28 months ago
Dr. Hook

Thank you for answering my initial questions.  I continue to see my therapist regarding OCD, anxiety, and depression.  I knew to have a happy life I needed help.

My follow-up questions are:

1.  Considering I have HPV, and the warts can sometimes be tiny, If I have sex and they are not covered by a condom am I putting myself at risk for hiv if my partner has the virus?

2.  If a potential partner has herpes and takes acyclovir 800 mgs .  I did not ask if they were genital or around mouth, should I be concerned and avoid sexual contact with her? 

Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
1.  No
2.  If that potential partner takes acyclovir 800 mg daily I presume it is preventative therapy.  If she does not have lesions, even without the acyclovir the risk of your acquiring herpes from her would be substantialy less than one infection in more than 1000 acts of intercourse.  That your potential partner takes acyclovir reduces that risk for infection even less to less than on infection in 2000 acts of intercourse.  

EWH
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27 months ago
Dr. Hook

I am sure you have read my previous posts.  I am providing an update since our  last exchange.  Over last month or so I had  vaginal sex on two separate occasions with a women.  We used a condom.  She also performed oral on me once and I on her.  She had been tested.  We recently broke up.  I since dated a women who only performed oral sex on me twice, no condom.  

A week and a half ago I shaved my chest.  5 days latter I had a chest rash.  I was traveling, so I sent a picture to my dermatologist.  He said it was irritation.  The last three days I had little white sores in my mouth.  If you scrape them they come off.  This afternoon I looked in my mouth and thought I saw a white patch on my cheek.  I put my finger on it and it was no longer there.  Maybe it was the lighting.  I am trying to remain calm and think ratinonaly.

I went and had the hiv antibody insti test this afternoon.  It was negative.

My questions are :

If I truly had ars would my test have been positive?

Did I have risk from what I decribed?

Do I need more testing?

I don't ever want to hurt anyone.  I continue to receive counseling.  I don't want to start a testing cycle if it isn't necessary.

Thanks

Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
There is no meaningful risk for HIV from condom protected sex or from unprotected receipt of oral sex.   As you point out, your previous partner was tested and HIV negative and since you have broken up with her you have only received oral sex.  No one has ever been proven to have gotten HIV from receipt of oral sex.  You are not at risk from the activities you describe.  

Now, Straight to your follow-up questions:
1.  the symptoms you suggest do not suggest the ARS. If you had the ARD you would have a high fever.  Further, and in answer to your question, if you were having the ARS your INSTI combination HIV antigen/antibody test would be positive.

2.  You are not at risk

3.  there is no need for additional testing.  

I hope these answers will be helpful.  As you know, with this, my 3rd response, this thread is now over and will be closed shortly.  Further, I should add that if you return to post additional repetitive, anxiety-driven questions about no-risk situations, your thread may be deleted without a response.  I trust you will understand.  EWH
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27 months ago
Dr. Hook

My hiv test was only an antibody test.  Does that make a difference?
27 months ago
Dr. Hook 

As I said my test today was only an  antibody test.  Would that still have been positive.  ( as it was only an antibody test) if I was suffering from ARS??
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
You were not suffering from the ARS,  You were not at risk for HIV and no testing was needed.  EWH---