[Question #6787] HIV Follow Up Question + Confusing Potential STD

65 months ago

Hi, Just briefly following up my previous question (Question #6629) with a few more main questions about potential STDs down below.

I recently resumed protected intercourse with my partner, since following the advice of my last question (Question #6629) I wanted to start unprotected again with my long term partner, I trust them and saw their recent results as negative. I haven’t had any other encounters since the one mentioned in my last question, am I safe to have unprotected intercourse with my partner and not fear giving her hiv? I know this is repetitive, I have moved on, but wanted to get one final reassurance that nothing has changed guideline-wise since my previous question on interference of prednisolone/prednisone and hiv testing. The recent Coronavirus thing keeps making me think about HIV for some reason. I do apologize again, just thought to throw that question in if I'm asking about the other issue that brings me here:

Beyond this, and my main question is regarding some discharge I have noticed from my penis. Back last year, I went to a clinic because I noticed small amount of white discharge from my penis when I don’t urinate for a while. I also have some burning when I finally urinate after holding it in. They treated me with Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1 g orally in a single dose, this was the same day as they took my urine sample for testing.

The testing came back negative for both gonorrhoea and chlamydia. I had not had sex since last June and got tested in November. However, even a month after the treatment (still without any sex) I’m still noticing some discharge, it’s quite a little amount, it’s kind of a weak milk white Colour. I noticed it again twice today, it goes away when I urinate. Keep in mind I still haven’t had any unprotected sex (oral, vaginal or anal) since June.

I have read it could be prostate fluid as well. Im confused as to what else it could be? I can rule out gonorrhoea and chlamydia right? And if you think this is an std and not normal discharge, what other tests should I look for once this coronavirus finally settles down? If you think it could be another STD I will hold back on the decision to resume unprotected intercourse with my partner. Any ideas? Thank you

Edward W. Hook M.D.

65 months ago

On this occasion I will be responding to these questions some of which are repetitive. I agree with Dr. Handsfield’s advice to you. You have overtested and proven that you did not acquire HIV from the very low risk July event that you described. You did not acquire HIV and therefore cannot transmit infection to your partner.

Regarding your discharge, you can have confidence in your November test results and those tests do not need to be repeated. At the same time, persistent urethral discharge may be abnormal and deserve further evaluation. I would suggest you get evaluated and tested by an experienced clinician. The tests I would recommend is a test for white blood cells in the discharge using either a stained swab specimen or in an initial void urinalysis. In addition, you may benefit from a test with a potential emerging pathogen called Mycoplasma genitalium which occasionally causes persistent urethritis. Other potential causes of an abnormal urethral discharge could be a non-STI prostate infection. Whatever this is, you can be confident that it is not related to the acts of oral sex you performed on casual partners in July.

Hope this helps. EWH

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65 months ago

Thank you for the reply.

Yes, I did read about the MG infection. I will get tested for this as well. Do you know if an STI like MG could cause infertility in men if left untreated? I have read that some STI can do this.

I see that you also agree on the conclusion from that previous question that medication like prednisone and prednisolone would not have an affect an std or hiv test. Is that correct Thanks.

Oh, and I’m not sure if you are answering questions about coronavirus, but is it safe to assume sexual contact would be a high risk for transmission due to close proximity to body fluids? And are those coronavirus body fluids only the respiratory fluids, or others as well?

Edward W. Hook M.D.

65 months ago

Unlike for women, STIs rarely cause infertility in men.

correct, steroid medications such as prednisone and prednisolone would not effect the accuracy of your tests.

Little is known about whether or not coronavirus (COVID 19) is present in genital secretions or not however, the close contact which defines direct sexual contact would be expected to place partners of infected persons at high risk for infection. Obviously phone sex and masturbation are not risks for COVID 19.

Hope this helps. EWH

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65 months ago

Thank you.

Good to know that you also agree that taking steroid medication such as prednisolone/prednisone does not affect hiv tests.

Also thank you for answering the coronavirus question, makes sense. Though mutual masturbation would still be risky for covid19 due to close proximity to another person?

Those were all my questions. Thank you for taking the time to answer them.

Edward W. Hook M.D.

65 months ago

Yes, while there is no risk for HIV or other STIs related to mutual masturbation, the very proximity to another person would put you at risk for COVID 19.

Take care. As you point out, this will complete this thread which will be closed shortly. EWH

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