[Question #4677] Hiv and herpes risk/symptoms
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80 months ago
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Serious lapse in judgement. Vaginal intercourse with california stripper of unknown std status (she said she tested clean 6 months ago). Pulled out less than 5 seconds after condom break. Then she put on another condom and finished.
27 days later, I noticed a flaky/crusty/partially scabbed linear sore on the upper side of my circumcised penis beneath the glans and tucked along the fold of the coronal sulcus. It was not watery nor did it hurt or itch, and I had not noticed it until then. It healed completely 3 days later and left a faint linear scar along the coronal sulcus under the glans.
I had sex with my girlfriend each of the four days prior to noticing the sore. She was having a bad yeast infection that eventually turned into bv. (She went to the doctor and received antibiotic and antifungal medication and it all cleared up).
I have had these tests:
30 days - 10 panel std test, hiv RNA and trichomoniasis. All negative, except hsv1.
44 days - syphilis, hiv duo, hep, trich, clam, gono, mycoplasma and ureaplasma, all negative.
54 days - hiv duo, negative.
62 days - 10 panel std test, hiv RNA, all negative, except hsv1.
10 weeks - hiv duo, negative.
12 weeks - 10 panel std test, all negative, except hsv1.
Questions:
1) Two days after noticing the sore on my penis, I started having frequent urination and it has remained for over two months. I feel the strong urge to urinate even though very little urine in bladder. Is any std a cause of this symptom? Any suggested causes?
2) Is it possible the penis sore was caused from my girlfriend's yeast infection?
3) Is it possible I contracted a yeast infection and that is the cause of frequent urination?
4) Is the penis sore or frequent urination a symptom of hiv? Is it possible I had false negative hiv tests at 12 weeks and prior?
5) Concerned the penis sore was genital herpes, but tested negative for hsv2 multiple times up to 12 weeks. Is there a chance it was false negative?
6) I am very healthy and rarely get sick. Could it be I am an elite controller and hiv was not picked up on my tests?
The frequent urination is becoming a big problem and am trying to figure out if it is related to this incident. The timing would seem to suggest it is related. I did have a urinalysis and no sign of infection.
Desperately trying to find explanations for frequent urination and information on std test accuracy. Thanks in advance.
27 days later, I noticed a flaky/crusty/partially scabbed linear sore on the upper side of my circumcised penis beneath the glans and tucked along the fold of the coronal sulcus. It was not watery nor did it hurt or itch, and I had not noticed it until then. It healed completely 3 days later and left a faint linear scar along the coronal sulcus under the glans.
I had sex with my girlfriend each of the four days prior to noticing the sore. She was having a bad yeast infection that eventually turned into bv. (She went to the doctor and received antibiotic and antifungal medication and it all cleared up).
I have had these tests:
30 days - 10 panel std test, hiv RNA and trichomoniasis. All negative, except hsv1.
44 days - syphilis, hiv duo, hep, trich, clam, gono, mycoplasma and ureaplasma, all negative.
54 days - hiv duo, negative.
62 days - 10 panel std test, hiv RNA, all negative, except hsv1.
10 weeks - hiv duo, negative.
12 weeks - 10 panel std test, all negative, except hsv1.
Questions:
1) Two days after noticing the sore on my penis, I started having frequent urination and it has remained for over two months. I feel the strong urge to urinate even though very little urine in bladder. Is any std a cause of this symptom? Any suggested causes?
2) Is it possible the penis sore was caused from my girlfriend's yeast infection?
3) Is it possible I contracted a yeast infection and that is the cause of frequent urination?
4) Is the penis sore or frequent urination a symptom of hiv? Is it possible I had false negative hiv tests at 12 weeks and prior?
5) Concerned the penis sore was genital herpes, but tested negative for hsv2 multiple times up to 12 weeks. Is there a chance it was false negative?
6) I am very healthy and rarely get sick. Could it be I am an elite controller and hiv was not picked up on my tests?
The frequent urination is becoming a big problem and am trying to figure out if it is related to this incident. The timing would seem to suggest it is related. I did have a urinalysis and no sign of infection.
Desperately trying to find explanations for frequent urination and information on std test accuracy. Thanks in advance.
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H. Hunter Handsfield, MD
80 months ago
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Welcome to the forum. Thanks for your confidence in our services.
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This was a pretty low risk exposure, since the duration of sex after the condom break was so brief. And your symptoms were not very suspicious for herpes or any other STD. And then your test results: they were conclusive at 30 and/or 44 days; all later tests were superfluous. Your positive HSV1 blood test almost certainly reflects a longstanding infection, unrelated to the sexual exposure with the stripper. To your specific questions:
1) Your tests show for sure you have (or had) no STD to explain these symptoms. Also, frequent urinary urge is really not an STD symptom -- and apparently you have had a normal urinalsysi. Therefore, this is most consistent with genitally focused anxiety. But if it continues, you could have a professional exam to rule out prostatitis. If you do that, I predict negative results.
2,5) Yeast generally doesn't cause such localized symptoms; if you had your partner's yeast, it would have been more diffuse penile redness and irritation. Given your positive HSV1 test, it is possible you have genital herpes due to HSV1, and happened to have a recurrent outbreak at that time. Unless you have had oral herpes symptoms, i.e. cold sores -- which would mean that your HSV1 is oral, not genital, as in most cases of positive HSV1 blood tests. For sure it's not HSV2, and the timing is against herpes acquired during the stripper event. (In case you're not clear on terminology, the numbers -- i.e. HSV1 and HSV2 -- refer to the two different viruses, not to the anatomic site of infection. Genital herpes is usually caused by HSV2, but not infrequently HSV1. Oral herpes is almost 100% caused by HSV1.) Putting it all together, I doubt you have genital herpes. But the only way to know will be if you have another such outbreak in the future, and if within a day or two the sore is tested for HSV by a PCR test.
3) Yeast doesn't cause such symptoms.
4) HIV doesn't cause skin sores, penile or anywhere else.
6) HIV elite controllers have normal (positive) blood test results. Your negative HIV tests prove for sure you do not have HIV.
As noted above, I agree your urinary symptoms are related to the sexual event. However, I believe it is through an emotional/psychological mechanism. As for your "despirately trying" comment, for sure your STD tests are accurate. And as I said above, there are no STDs that cause urinary urgency or frequency.
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD
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80 months ago
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Thanks for the quick response.
1) You mentioned the only way to rule out an hsv2 infection is through a pcr test of a future ulcer. Does this mean the hsv2 blood test isn't conclusive at 12 weeks or 16 weeks?
2) How can the hiv tests pick up elite controllers? By definition, don't elite controllers go undected by tests?
3) Other than outbreaks, are there any long term complications/health issues from hsv1 and hsv2?
4) My tests are all from quest at the same lab. Is it possible they have a flaw with their lab tests, process or operator error? Is it a good idea to get tests from different labs to verify results?
5) Are hiv duo results 100 percent conclusive after 12 weeks? No possibity of another hiv strain?
6) Do you know firsthand of cases where someone had frequent urination for 2 or more months that stemmed purely from emotional/pschological origin, then diminished once anxiety subsided?
7) Are hsv blood tests accurate at distinguishing between hsv1 and hsv2?
Thanks in advance.
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H. Hunter Handsfield, MD
80 months ago
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1) That's how to rule out HSV1 as the casue of your genital sore, not HSV2. For sure you do not have HSV2; that test is conclusive.
2) You misunderstand elite controllers. Such persons do not become immune deficient due to HIV, and the amount of HIV in their blood remains low. But the standard HIV tests are entirely normal (positive) in them.
3) Some people have an immune reaction during outbreaks that shows up as a rash called erythema multiforme. Infected women can transfer infection to their babies during vaginal delivery. A few others as well, but all are uncommon andn othing to worry about.
4) Quest is highly reliable and all these tests are automated and pretty much foolproof.
5) The duo tests are 100% conclusive any time 6 or more weeks after onset of infection, and then remain positive for life.
6) Yes, I've seen many patients like this.
7) Yes, the HSV blood tests are 100% reliable in distinguishing between HSV1 and HSV2.
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80 months ago
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Doctor, thanks for the feedback. You appear very knowledgeable on these subjects.
1) Does hsv1 or hsv2 ever cause neurologic damage that could interfere with bladder function/urgency to urinate/other sexual function? Any other std?
2) Does a recently contracted hsv1 or hsv2 infection cause vaginal yeast infections?
3) Can yeast infections cause vaginal bleeding?
4) Other than hsv, is there another possible cause of the penile sore I described in my initial question?
5) Is 12 weeks or 16 weeks conclusive for hsv testing?
6) When frequent urination is caused by psychological or emotional mechanisms, how long does it generally take for those affected individuals to recover from frequent urination symptoms?
7) Can emotionally derived frequent urination symptoms affect you while you are sleeping, or would those such symptoms only occur during awake hours?
8) During the day, need to urinate with 6 to 8 ounces of urine in the bladder. Really need to urinate with 16 ounces in the bladder. Is that normal?
9) You mention you have never had a forum member with a negative hiv duo or rna result at 6 weeks turn positive for hiv with subsequent testing. Could that be because your forum members were never infected with hiv in the first place, or is that based on actual test data?
10) Is it possible to have hsv1 or hsv2 without ever having symptoms?
11) You mentioned the duo tests are 100% conclusive any time 6 or more weeks after onset of infection, and then remain positive for life. I assume you mean that the tests are 100% conclusive any time 6 or more weeks after potential exposure and remain 100% conclusive anytime thereafter?
12) Is there any bacteria or other obscure sti that I should be concerned about based on my symptoms?
13) Is it a good precaution to take a general antibiotic even if urinalysis shows no infection?
14) Can hsv cause pid?
15) If oxybutynin does not improve frequent urination feelings, is that an indication they are psychologically derived?
Thanks for your service and guidance.
1) Does hsv1 or hsv2 ever cause neurologic damage that could interfere with bladder function/urgency to urinate/other sexual function? Any other std?
2) Does a recently contracted hsv1 or hsv2 infection cause vaginal yeast infections?
3) Can yeast infections cause vaginal bleeding?
4) Other than hsv, is there another possible cause of the penile sore I described in my initial question?
5) Is 12 weeks or 16 weeks conclusive for hsv testing?
6) When frequent urination is caused by psychological or emotional mechanisms, how long does it generally take for those affected individuals to recover from frequent urination symptoms?
7) Can emotionally derived frequent urination symptoms affect you while you are sleeping, or would those such symptoms only occur during awake hours?
8) During the day, need to urinate with 6 to 8 ounces of urine in the bladder. Really need to urinate with 16 ounces in the bladder. Is that normal?
9) You mention you have never had a forum member with a negative hiv duo or rna result at 6 weeks turn positive for hiv with subsequent testing. Could that be because your forum members were never infected with hiv in the first place, or is that based on actual test data?
10) Is it possible to have hsv1 or hsv2 without ever having symptoms?
11) You mentioned the duo tests are 100% conclusive any time 6 or more weeks after onset of infection, and then remain positive for life. I assume you mean that the tests are 100% conclusive any time 6 or more weeks after potential exposure and remain 100% conclusive anytime thereafter?
12) Is there any bacteria or other obscure sti that I should be concerned about based on my symptoms?
13) Is it a good precaution to take a general antibiotic even if urinalysis shows no infection?
14) Can hsv cause pid?
15) If oxybutynin does not improve frequent urination feelings, is that an indication they are psychologically derived?
Thanks for your service and guidance.
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H. Hunter Handsfield, MD
80 months ago
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Sorry, but follow-up questions are intended for clarification of the initial question and replies -- not to ask any STD related question that comes to mind. Answers to most if not all these questions can be found by online searching.
That concludes this thread. I hope the discussion has been helpful.
HHH, MD
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