[Question #8571] Steroids, Thrush, Now What?

42 months ago

I am 48-year-old male. Covid vaccinated & boosted. Nov 28 I had a sexual encounter w/ a gal. She was white, divorced, age 44 from Pitts PA. She said her ex cheated & she tested HIV NEG after him. She said she had 2 boyfriends since. She used condoms for vaginal sex w/ them but not for performing oral.

Anyway we had been drinking. We went to hotel. I didn’t have a condom, so I didn’t have vaginal or oral sex. We kissed, I sucked her breasts, we watched each other masturbate and then we masturbated each other. I had nicks / cuts on my fingers from picking and scratching. I purposely put band aids on the cuts, so they should have been covered and I didn’t use those fingers. But you never know.

On Jan 3rd I was given doxy 100 mg 1 cap twice a day for 10 days for a sinus infection. I wasn’t getting better so on Jan 6^th I was given antibiotics ceftinir 300 mg 1 capsule twice a day for 7 days. I was told to finish both antibiotics.

I tested for HIV on Jan 11^th (44 days past exposure) w/ a 4^th gen rapid Alere finger test. It was neg.

On Jan 18^th I had to take 4 caps of amoxicillin 500 mg each for a dental work.

My sinus infection continued, I was given prednisone 20 mg on Jan 13. I took 3 pills day one, 2 pills a day for 1 week and then 1 pill a day for one week. Finished Jan 26.

I tested for HIV on Feb 2 (66 days past exposure) w/ a 4^th gen rapid Alere fingerpick test. It was neg.

End of Jan I had some sores in my mouth. On Feb 8 I felt something in my mouth. I went to dentist & she said it was a THRUSH lesion. She cleaned & said medicine wasn’t required. Now I am scared!

1 Did I need an HIV test and was it conclusive at 44 days for HIV 1&2?

2 Would my prednisone course affect my 66 day test especially the antibody portion for HIV 2?

3. Do I need more hiv tests? or a hep test?

4 Are finger nicks a risk?

5 When can I have unprotected sex with my partner?

42 months ago

Lastly because of my work I frequently have nicks, scratches, wounds how do I know when to cover them or not before masterbating a women?

42 months ago

The incident I described in my initial question also happened with another gal in January. Thats why I am asking: because of my work I frequently have nicks, scratches, wounds how do I know when to cover them or not before masterbating a women?

H. Hunter Handsfield, MD

42 months ago

Welcome back to the forum. However, having reviewed your two previous discussions with Dr. Hook, this seems to be almost exactly the same sort of exposure, the same symptoms, and the same questions covered in those discussions. It should not surprise you when you find my comments and advice are similar. As reminders, here are some of the exchanges I find in your previous threads:

"Can thrush be the only symptom of ARS?" Dr. Hook: "No", and "Thrush, while well described in persons with advanced HIV is a very common problem in persons who do not have HIV as well, particularly after they have taken antibiotics such as you have."

"On day 64 I got another thrush sore." Dr. Hook: "Your oral symptoms sound like aphthous ulcers [not thrush]. And Please remember that most people with thrush do not have HIV. And thrush is a finding associated with advanced HIV, not recently acquired infection."

There also were questions and replies by Dr. Hook that reassured you about the very low risk for HIV of the various kinds of partners you described and the particular sexual practices you had with them; and questions and replies about the time required to conclusive HIV testing.

Now you describe a partner who is exceedingly unlikely to have HIV; and sexual exposures with her that had no chance of transmitting HIV if she were infected. Then a bunch of antibiotics that are exactly the kind that predispose to yeast infections (thrush). To the good side: for both this and the previous sexual exposures described in your two other threads, you have had entirely safe sex -- i.e. no unprotected vaginal or anal sex. Good move: having made that decision, any risk of HIV was far too low to even be a consideration.

To your numbered questions:

1. You didn't need testing at all after such an exposure. But your 44 day HIV test was conclusive; the later test also was unnecessary but further confirms you do not have HIV.

2. There are no medications or medical conditions that affect the reliability or timing of conclusive results for the HIV tests you have had, including prednisone.

3. You should not have any more HIV tests.

4. Fingering has never been known or suspected to transmit HIV, with or without cuts or nicks on fingers. Anyway, since your HIV tests prove you were not infected, the amount of risk at the time of the exposure is irrelevant.

5. You didn't need to stop having sex with your regular partner and certainly can resume it now.

Do your best to accept all this science-based reassurance at face value. You should not be at all worried about HIV! Let me know if anything isn't clear.

HHH, MD

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42 months ago

Dr. Handsfield,

Thank you for your response. My follow-ups are as follows;

1. Do I need hep testing and does hep infection affect antibody / antigen production?

2. Regarding HIV-2 since this is only found with the antibody portion of 4th gen tests;

A. Would it (HIV-2) been found with the antibody portion of the test at 44 days post exposure (prior to me taking the steroids)?

B. Would it (HIV-2) been found with the antibody portion of the test at 66 days post exposure regardless of the steroid intake I described?

3. Considering my job and routinely having little nicks and cuts, on fingers and in cuticle area must these be bandaged and or do I need testing following fingering a women? (like the gal in January whom I fingered but had band-aids over very tiny nicks on my fingers)

Thanks

H. Hunter Handsfield, MD

42 months ago

1. This was a very zero risk exposure in regard to viral hepatitis. And although there has been internet buzz about hepatitis C interfering with HIV testing, it's rare if it happens at all. And in any case, hep C is sexually transmitted ONLY among men having potentially traumatic (i.e. bloody) anal sex practices with other men.

2. Yes and yes to both questions -- which also are repeats of questions answered by Dr. Hook in one (or both?) of your previous threads.

3. I see no need for bandages over your finger nicks. And if there were any risk, bandages probably wouldn't reduce it, in fact in theory could increase the risk by prolonging exposure of your nicks and cuts to moist fluids. Latex gloves would be more effective.

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42 months ago

Dr. Handsfield

Please confirm the takeaway messages and remaining questions.

1. I didn’t need hiv testing after my November finger nick exposure and my tests are conclusive. In addition the steroids wouldn’t affect results for hiv 1 or hiv 2.

2. I don’t need hep testing?

3. My fingering incident in January had a bandaid on my healing nick. This finger was not inserted. This isn’t a true risk or require testing?

In the future don’t use bandaids.

4. My thrush was almost two weeks after my last dose of steroid and a few weeks after all my antibiotics could it still have caused the thrush?

5. Can I sleep with my regular partner unprotected?

I just want to move on but I never want to hurt anyone.

Thank you for your time and the service you provide!

42 months ago

The last thing I’ll say is the thrush spooked me.

42 months ago

Dr.

Last point the gal in Jan is black originally from the Ivory Coast. I am from NJ.

Thanks

42 months ago

Sorry forgot to mention we both reside in nj.

H. Hunter Handsfield, MD

42 months ago

Statements 1 and 2 are correct. 3) Since fingering is no risk, it really doesn't matter much whether any finger nicks are covered with bandaids. 4) Two weeks is a bit long for antibiotic-induced thrush, but it could happen. Whatever the reason, it isn't because you have HIV. 5) Already answered above -- you do not have HIV and therefore cannot infect your regular partner.

As your for your partner's African origin, it makes no difference at this point. As I said above, "since your HIV tests prove you were not infected, the amount of risk at the time of the exposure is irrelevant." If that partner has not been tested for HIV, she might wish to do so, and you might want to ask her to be tested before having sexual contact with her again. But the fact remains that your test results prove you don't have HIV.

That concludes this thread. Thanks for your thanks about our services. However, please note the forum does not permit repeated questions on the same topic or exposure. This being your third, with almost identical replies every time, it will have to be your last one; future new questions about similar exposures, testing, and your fears about HIV will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

Best wishes and stay safe!

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