STD exposure

[ScaredOne10]

3 weeks ago I found a prostitute online.  She was fingering/touching herself, and I was touching her as well.  Then she played herself again, then gave me a handjob to completion.  Immediately afterwards, I freaked out about the possibility of her transferring vaginal fluid onto her hands and then onto my penis (I definitely think some of her vaginal fluids got on my penis).  

My response...not the brightest, but I rubbed a chlorox disinfecting wipe over my penis afterwards.

She emailed me later that night and said that I was really sweet, and that she wanted to let me know that she was HIV positive!

I felt ok physically for the first 3 days.  Then, on the fourth day I developed urethritis.  I didn't go to the doctor, but being in a medical field, I took 2 grams azithromycin and 2 grams of flagyl.  I figured this would cover me for GC/trich.  I also took 5 days of cipro.  The antibiotics had no significant effect on my symptoms.

So, now it's been 3 weeks (2.5 weeks since the symptoms began).  I have no significant discharge (maybe a tiny clear discharge, but I might be over-reading that).  No visible lesions.  

My questions:

1)  If this were a chemical urethritis from the disinfectant wipe, shouldn't that have started immediately (or within a day).  Are symptoms beginning 3-4 days later, and continuing for the past 2.5 weeks typical or atypical for a chemical urethritis?

2)  Is there any point in getting tested (or retreated) for GC considering I've already taken azithromycin + flagyl + cipro.

3)  What is my HIV risk? I am uncircumsized, so I know that increases the risk significantly, and she was definitely positive. I'm afraid the vaginal fluids on her hand were rubbed into my penis during the handjob. Should I get tested?  When? Does HIV cause urethritis?

4)  Could the symptoms be from herpes? I don't have any visible lesions, but it seems like everything else was treated.

5)  Where do I go from here?  What other testing or treatment would you suggest?

[Edward W Hook, MD]

Good questions:

1.  Yes
2.  It would cetainly make voiding more comfortable and would not obscure other diagnostic efforts, should they be needed.
3.  No.

EWH

[ScaredOne10]

Two follow up's since I need to get my money's worth... ;)

1). Knowing nothing is 100%, would you feel comfortable having unprotected sex with a spouse without fear of transmission of any STD?

2). Assuming a chemical urethritis, would you suggest an OTC or Rx urinary analgesic like uriatat or something similar, giving any chemical irritation time to heal?

3). Have you ever personally seen or heard of herpes urethritis without external lesions?

Thank you.

[Edward W Hook, MD]

Welcome to the Forum.  Before I address you specific questions,  Let me start by telling you that STDs, including HIV are NOT transmitted through masturbation.  Thus, your irritation was not due to STD and the antibiotics you took relating to the events you describe were probably not needed.  On the other hand, chemical irritation by the bleach is a possibility. Bleach applied directly to sensitive skin can chemically burn tissues, causing lasting discomfort.  Now, on to your specific questions:

1.  Yes, this would be somewhat unusual for a chemical urethritis.  Typically such symptoms begin within 24 hours of chemical exposure.
2.  No, testing for bacterial STDs will certainly be negative.  No need for testing.
3.  Zero risk.  No one has EVER gotten HIV from masturbation, despite the fact that it is typical for persons engaged in mutual masturbation to get each others' genital secretions on one another.  Never.
4.  No, there is little to suggest HSV here.
5.  Without visible lesions, the services of a dermatologist are unclear but that is where I would probably start.  The entire thing is rather unusual an it may take a bit or trial and error to sort out or, alternatively, may go away on its own, at which time I would not be concerned further.

Hope these comments are helpful.  EWH