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Had Unprotected Oral Sex. Experienced Itching And Slight Burning Sensation In Genitals. Used Nystatin Antifungal Cream. HIV Infection?

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Posted on Fri, 19 Jul 2013
Question: Hello Doctors

I have question regarding HIV reconversion.

I am male and live in united states and in mid February 2012, I received a oral sex without protection, but I did not have sexual intercourse with her or gave oral sex to her.

After 1 week or so, I experienced itching and slight burning sensation in my genitals, however i did not have flu like symtoms, or swelling lymphnode etc or anyother illness, I consulted a doctor, he said it may be yeast infection, I used Nystatin antifungal cream and itching was cured for time being and however still sometime again I felt some burning sensation, so I consulted doctor again.

I was tested negative twice for chlamydia and gonorrhea and all my blood and urine tests were normal including CD4 count, HB was normal etc and also urethral swab was tested negative for any viruses in culture test.

however I wanted to make sure I was HIV negative as I am getting married soon, so I got tested for HIV, 1,2 ELISA in end of XXXXXXX that is, 4 months after I received oral sex and test was negative for HIV. I think the serocoversion is by 3 months for the antibodies to appear against HIV, so please let me know that I dont have to worry about this. I was also tested negative for HBV and HCV, there was no cholesterol or TSH was normal.

After one year now sometimes I have itching or burning sensation and doctor said that I may have chronic prostatitis and I was treated with ciproflaxcin for 60 days. But still at times I have slight discomfort and mild pain in glans of penis.

Also my doctor saw my testosterone level was very low, 220 ng/dl and told that i may have this symtoms because of low testosterone level.

I was tested negative HIV from Labcorp lab in USA 4 months after my act of receptive oral sex, please let me know if I have to take HIV again.

thank you very much!
doctor
Answered by Dr. Sankaranantham Murugan (1 hour later)
Hi,
Welcome to XXXXXXX
Thanks for posting your query.

The risk of HIV transmission through oral sex is very low only. Negative ELISA after 4 months is almost conclusive, you are free from HIV and no need for further test.

You are also negative for Chlamydia, Gonorrhea, HBV, HCV. So there is nothing to worry. I hope that they would have done test for Syphilis and HSV also. You had not mentioned.

Regarding your problem, yeast infection and Herpes(HSV1) are more common with oral sex. As you didn't have any vesicles or ulcers the possibility of Herpes is unlikely. Topical application alone might not have been sufficient for yeast infection. Systemic anti-fungal antibiotics maybe needed to eradicate the yeast infection totally. Your doctor will prescribe oral anti-fungal antibiotic, if revisited him.

Regarding prostatitis your urine examination would reveal the presence of infection. Repeated prostatic massage and culture and sensitivity test from massage fluid will help to attain a total relief.
Your physician will guide you in this regard.
Wish you a speedy recovery.
DR S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sankaranantham Murugan (29 minutes later)
Thank you very much Dr. XXXXXXX and greatly appreciate your inputs.
I think they did not test for Syphilis and HSV.
Though I did not have chancre or server lesions in genitals, did you think i still need to take syphilis test?
another question
also I experience itching in my scrotum at nights , could it be caused by yeast infection or symptoms of low testosterone.
thanks for your time and help.
doctor
Answered by Dr. Sankaranantham Murugan (7 hours later)
Hi XXXXX,
Welcome back.

The chances of getting Syphilis through oral sex is also very much less. But as you had other routine STD tests, I thought test for syphilis also could have been done. Even in the absence of a chancre or any other symptom, one can have Syphilis and it is called as Latent syphilis. It is better to have the test and rule out the remote possibility also.

Scrotal itching may not necessarily be due to yeast. Yeast infection over scrotum due to oral sex is not so common. But it may be due to various other reasons like ordinary dermatophyte (Ring worm) infection, seborrheic dermatitis or even due to irritation due to excessive sweating.
If you consult a Dermatologist they will cure this problem very easily.
DR S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sankaranantham Murugan (38 hours later)
Dear Dr. XXXXXXX
Thanks for your comments.
I will try to get tested for syphilis soon.
I still experience very mild pain/discomfort on one side of penis (glans region) /near the crown area of penis after masturbation.

I also have muscle pain, in hamstring, and slight joint discomfort in the morning.

I had taken ciprofloxacin for 2 months, since then I am having muscle pain, could this be caused by medication.

I have been diagnosed by very low testosterone level (205 ng/dl).

Please let me know if my symptoms are related to any STD or may be due to low testosterone level. I am going to see an endocrinologist soon.

please let me know what treatment I can consider for slight pain in the glans of penis during or after masturbation.

Thank you very much!
doctor
Answered by Dr. Sankaranantham Murugan (17 minutes later)
Hi,
Welcome back.

Low testosterone is not the reason for your problem.
The pain and discomfort over your penis indicates that the possible yeast infection had not yet cleared. You may be likely to need further treatment which can be decided by your treating physician.
No other STD can be thought of following unprotected oral sex.
Your muscle and joint pain had not have any relation to the sexual exposure and may possibly be due to your low testosterone level.
DR S.Murugan
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sankaranantham Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 3110 Questions

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Had Unprotected Oral Sex. Experienced Itching And Slight Burning Sensation In Genitals. Used Nystatin Antifungal Cream. HIV Infection?

Hi,
Welcome to XXXXXXX
Thanks for posting your query.

The risk of HIV transmission through oral sex is very low only. Negative ELISA after 4 months is almost conclusive, you are free from HIV and no need for further test.

You are also negative for Chlamydia, Gonorrhea, HBV, HCV. So there is nothing to worry. I hope that they would have done test for Syphilis and HSV also. You had not mentioned.

Regarding your problem, yeast infection and Herpes(HSV1) are more common with oral sex. As you didn't have any vesicles or ulcers the possibility of Herpes is unlikely. Topical application alone might not have been sufficient for yeast infection. Systemic anti-fungal antibiotics maybe needed to eradicate the yeast infection totally. Your doctor will prescribe oral anti-fungal antibiotic, if revisited him.

Regarding prostatitis your urine examination would reveal the presence of infection. Repeated prostatic massage and culture and sensitivity test from massage fluid will help to attain a total relief.
Your physician will guide you in this regard.
Wish you a speedy recovery.
DR S.Murugan