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Suggest Remedies For Fungal Infection On The Penis

Posted on Tue, 10 Oct 2017

Question: Hi Dr, I am male from XXXXXXX Two weeks before I had oral sex protected which lasted for about a min. I did had some fungal infection on penis which is diagnosed as Balanoposthistis (even before the activity). The condom dint break or slip off. I still fear of catching HIV or other STDs. I did consulted a sexiologist who advised me to take test post 6 months after the exposure. To define the person who gave me oral, she is a transgender who does this for money. I had only me protected oral only (i am the insertive partner) dint have any other sexual activities with her. I do not know about her medical history but I do fear she might have any infection(since she is a sex worker) Since it was dark I do not recognise any blood or any other cuts in her mouth and myself too do not have any other raw cuts on my penis. What is my risk considering my exposure even though it is protected? Should I get testing for HIV and other STDs.. please advise.

Answered by Dr. Dr. Kakkar (22 minutes later)

Brief Answer:
STDs screening not required

Detailed Answer:
hello. thank you for writing to us.

I am Dr. Kakkar(dermatologist and venereologist). I have read your query in detail and I have noted your concern.

Receptive oral sex (fellatio) with barrier protection is absolutely 100% safe and does not pose any risk of passing STDs, to and fro. An intact condom provides effective barrier against transmission of STDs as it prevents direct contact between oral cavity of the partner giving oral sex and genital mucosa of the receptive partner.Therefore there is no need for any STDs screening, whatsoever.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (10 minutes later)

Hello doctor,

Thanks for addressing my queries. Can you pls also clairfy on the below points

1)I do not know the brand of condoms used sure it was not a latex one.

2) since I had a fungal infection, will it drives an increase in risk of transmission particularly HIV.

3) Considering the condom is intact I still fear what if basis of getting an STD like HIV. (Depressed a lot) I am sure I can't justify my act however if I would like to test for an HIV test what should I undergo. It's exactly 30 days from the date of contact.

Answered by Dr. Dr. Kakkar (6 minutes later)

Brief Answer:
4th generation Ag/ Ab HIV screening test

Detailed Answer:
hi.

Most condom these days are latex condoms.
Even if you had candidal balanoposthitis there is still no risk because there was no direct mucosal contact ii.e mouth to genital contact!
However, if you want to get tested anyways I would suggest you to go for a 4th generation Ag/ Ab HIV screening test. This test has a window period of 2-3 weeks therefore at 30 days post that incident the result of this screening test would be conclusive.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (14 minutes later)

Thanks doctor.

I will do the test and will share you the details of the report.

One more question. Even though the condom was intact and no leakage I felt some wetness on my penis do know if it my own pre semen or not. Assuming it is the saliva of the other person will it infect me with HIV ? I am restless and these 30 days I am in hell.

Answered by Dr. Dr. Kakkar (6 minutes later)

Brief Answer:
No risk

Detailed Answer:
hi

Surely it was your own precum. Can't be saliva from the other person. Moreover saliva is not an infectious fluid for HIV.
I suggest you to get yourself screened for HIV and get back your peace of mind.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Kakkar (22 hours later)

Hello doctor,

I have done a HIV p24 and antibody test today after 31 days of my potential exposure and the results were non reactive.

Although the lab technician asked me to do a 6 month test once again as confirmation.

Your thoughts on this pls....

Answered by Dr. Dr. Kakkar (12 minutes later)

Brief Answer:
Retest not required in a very low risk contact such as yours

Detailed Answer:
Hi.

This test result at 4 weeks is conclusive in a low risk contact such as yours. Only in high risk contacts e.g unprotected vaginal or anal sex with a commercial sex worker (csw) does one recommend a repeat screening test at 3 - 6 months.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (3 days later)

Dear doctor,
Thanks for the support and detailed explanations you have provided me and it is very much assuring and making me feel better.
Apologies for troubling you back. However do to fear and anxiety which is worrying me a lot I have shown the test results that I took to a local infectious disease specialist in XXXXXXX Dr K Mahadevan. He advised me to take a combo test at 6 weeks mark after the exposure which I am planning to do.

My questions are,
1) Will my negative test at 4 weeks (31 days) have some reason to change at 6 weeks mark (42 days). Have you seen this happening..
2) if I am taking the test at 6 weeks mark, can the test be repeated at the same lab? Or it should be done at a different place?
3) The doctor also advised that saliva will not transmit HIV. Will a small quantity of blood is enough to cause a transmission?
4)I am sure I should not browse Google for this, however I have read that alcohol will kill enzymes in saliva and there is a risk of HIV transmission.

Thanks again for the extended support

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
You don't need another HIV screening test

Detailed Answer:
hi.

A condom protected oral sex has 0% risk of HIV transmission. On your insistence I suggested you to go test with a 4th generation HIV screening test. At 4 weeks an Ag/ Ab HIV screening test is a highly sensitive and specific screening test. I don't feel that there is a need for another test at 6 weeks but still if you want to take another test for your own satisfaction then you surely can but it won't alter the final result.
You may take it from any reliable lab of good reputation.
Yes, blood mixed saliva has a theoretical risk of HIV transmission but in your case there was a condom barrier, so you were protected. The quantity of blood required for hiv transmission depends on the viral load and hence infectivity of the individual.
Alcohol has no effect on transmission risk.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (31 minutes later)

Thanks doctor for your valuable feedback. Anxiety and fear is killing me like anything which is why I am coming back on this.

The doctor whom I met told 4 weeks test will not be sufficient. As he asked to do a 6 weeks test I am opting in for a test which is 1 week from today. Also the reason for my second question in my last follow up is because I have read in some forums stating two tests needs to be taken in different labs for confirmatory results. The lab I took is very friendly which is why I am opting a test there....

Your opinions pls

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
I agree with you. You may take another test from another lab

Detailed Answer:
hi.

I agree with you on that.
You can definitely take another 4th generation Ag/Ab HIV screening test from a different lab. That would be doubly reassuring.

Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (26 minutes later)

If you are agreeing means that it might be false if I take the test in same lab, is that what you meant to say or for my satisfaction I can take in another lab?

Answered by Dr. Dr. Kakkar (17 minutes later)

Brief Answer:
HIV screening test

Detailed Answer:
hi

Cetainly not because the first test could be a false negative but because testing from a different lab would be doubly reassuring for you.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (19 minutes later)

Thanks doctor. And for my last follow up As from your reply you mean to say that even I take the same test at same lab it will not provide two false negatives and also same test at different lab can give a double peace of mind..

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Regarding HIV screening

Detailed Answer:
Hello

yes, exactly.

Regards

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar