HIV risk from brief unprotected anal, then urethritis symptoms?

[Delgado]

I had sex with an asian man my age (25), we met online. I do not know his HIV status, although he says he is negative and was tested for STDs in January, HIV in March, all negative. He said he had just left a 1-year, monogamous relationship with a white male, and the two typically had unprotected sex. He had sex with this person about 2 weeks before having sex with me.

He had no noticeable sores, marks, ulcers or open wounds of any kind. We are both uncircumcised.

We spent several hours together, there was a good amount of mutual unprotected oral, though he did not ejaculate at all. I ejaculated but never into his mouth.

I performed penetrative anal sex using a condom twice, new condom each time. Condoms did not break. However at the end, we had approximately 2-3 minutes of unprotected anal, he was sort of reluctant about it but we both believed the other was clean (we're both young, well-to-do, educated, and i guess that was enough, stupid i know but it happened).

I noticed there was some scattered bits of fecal matter on the tip of my penis and that's why we stopped. I rushed to the bathtub and spent a good 2-3 minutes washing my penis in warm/hot water with lots of soap.

About 2 weeks later, I began to notice an itching in the tip of my penis, it feels like it's just inside the urethral opening. This was accompanied by a mild burning sensation when I urinate in the morning. The burning only seems to happen during the morning.

Finally about 4 weeks after this encounter, I saw my family doctor and received a full STD screening. I was negative for chlamydia, gonorrhea and syphilis. The family doc gave me a 5-day dose of azithromycin, which I finished a few days ago. No effect so far.

Two days ago I saw a urologist, who said I have some kind of fungal infection most likely from the oral sex. I have never heard of fungal infections from oral sex, but the urologist said the negative STD results made this the likeliest explanation. He prescribed 2 doses of Diflucan in tablet form. I took one 150mg tablet Tuesday, then the final tablet today. No noticeable effect so far, though I am scheduled to see this urologist again next week.

I kept in touch with my partner, who insisted he has had no symptoms of HIV or any STD (including the itching I have). He said he has been asymptomatic throughout the last year and his relationship with his ex. He repeated his claim that he really did get tested, and promised he would test himself again soon. However he has stopped returning my calls.

I am worried for a few reasons:

1. The unprotected anal is dangerous and the fecal matter shows the penis was definitely agitating his mucous membranes, right? How high is the risk of 2 minutes of unprotected anal?
2. My symptoms indicate urethritis, though not caused by the common chlamydia/gonorrhea bacteria. Could my partner somehow have a fungal infection that he gave to me yet show no symptoms himself?
3. What relationship is there between what I have and the 2 minutes of bareback anal? Can the fungal infection make it more likely the anal sex would result in HIV transmission?

Thanks and I will keep this thread updated as I keep seeing doctors.

[Delgado]

One thing that worries me somewhat is the fungal infection's possible relationship to HIV. The medication my urologist gave me, Diflucan, is pretty much designed to fight candida infection, a type of yeast/fungus.

90% of all people with HIV develop candida infection just because they are immunocompromised.

I get the feeling it's unusual for a healthy man to get candida in their mouth, and my urologist says I probably got candida on my penis from RECEIVING oral sex from my partner.

He feels the 2-minute anal exposure and negative STD tests make oral transmission likelier than anal transmission. He also said something about how the presence of the fungus in my partner's mouth may not cause any type of infection in my partner, but when it gets in the penile area, it can cause infection.

Any thoughts? I realize maybe this is more STD-related than HIV-related, but of course I am only really worried about the HIV risk here.

[nursegirl6572]

You may be right about the lack of communication....and that IS a good thing that your baseline was neg...otherwise you may have also had the burden of worrying if you could have infected your partner.  Youch!

Anyway....your risk is probably pretty low all things considered.  You can get tested at 6 weeks post exposure for a VERY good indication of your final results...then again at 12 weeks for your conclusive results.

Hang in there.....don't be googling...you'll drive yourself batty!!!  :0)  Take Care!

[Delgado]

I am sorry, I neglected to mention I did get HIV test (oral) about 3 weeks ago, it was negative.

This was only 2 weeks after the incident, so I know it doesn't clear me, but it confirms I was negative at the time of this incident.

Over the last six months or so I have been with 5 other men, always protected (on 2 occasions, condom used for oral as well). I always was penetrative. The last of these episodes took place around the end of May, so the HIV test at the beginning of July was about 5 weeks after this.

I knew my status was almost certainly negative but I did take the test and advised this most recent partner. I suspect this is why he stopped communicating, he believes he is fine since my result shows he was in zero danger from me.

[nursegirl6572]

The fungal infection has no relation to HIV or lack thereof.

While brief, you did place yourself at risk with the unprotected sex (your partner's risk being even higher...I didn't see you mention any history of you having been tested?)

You need to test at 12 weeks post exposure to be sure.

From now on...PLEASE use protection.  2 min might not be a long time, but it's all it takes....and you may have gotten lucky this time, but if you keep taking chances, you may not be as "lucky" the next.

Oh, and btw, fecal matter is not infectious itself...and the presence or absence of it makes no difference in determining level of risk.  If you inserted your penis inside your partner's anus, it was insertive sex...fecal matter or not.

Best of luck to you....

[Uniquelymen]

Hi there,

If you have unprotected sex, regardless how long the duration...it is always a real risk of HIV infection.  I suggest you do a HIV  test 12 weeks after the incident.  

If you are too stress out by this incident, take a HIV test at 6 weeks.  The 6th result will be a good indication of your conclusive result at 12 weeks.

As this is a HIV Prevention forum, I will not discuss too much on other STDs.  However, your does sound like a fungal infections or perhaps just in your mind.