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What Do Negative Test Results For STD Post Unprotected Anal Sex Indicate?
Question: Dear doctor, thank you all your wonderful help in this site.
BACKGROUND
I am writing to you because un monday afternoon (7 days ago) i had protected CASUAL anal sex (give and receive), but had unprotected oral sex (give and receive). My sexual partner had 1 round flat red coloured lesion between lip and chin but said it was not herpes, more la acne (i am not 100% percent sure it is true). I also took 100mg viagra pill.
Afterwards i got nervous and since i did not had a shower or bathroom nearby i applied an aromatic hand sanitizer on penis shaft and tip.
SYMPTOMS
Since then, 1-2 days afterwards i have been having this burning sensation in the tip of my penis. I don't feel any pain, fatigue or even fever, but i have this persistent intermittent pain for almost 5 days now and laso feel quiet frequently the need to urinate. No other symptoms and at least for now no pain during urination, at least no noticeable pain.
ABOUT ME
Things you may need to know:
1. I am a frequent marijuana smoker (I smoke 1 regular sized joint every night after work).
2. I am HIV+ currently on successful HAART with undetectable VL and 550 CD4 and 43% CD4%.
3. I was diagnosed with HPV warts on march 2014 and they were surgically removed but site where some of the warts have stayed a bit inflamed afterwards (i went back to urologist for this and he said it was some inflammation response of the skin and i should not worry).
4. Other than that good health and good overall frequent blood lab tests.
5. I masturbate regularly (almost once a day on average).
QUESTIONS REGARDING MY SYMPTOMS:
1. Can this be due to chlamydia/gonorrhea, herpes (prodomal) symptoms?
2. Could it be a simple irritation of the urethra because of the hand sanitizer??? Is it normal for this burning sensation to last this long if it was due to the aromatic hand sanitizer?
3. Could this be prodromal symptoms (pre-outbreak) of herpes virus? I was told it probably was not herpes because an outbrake would have followed 1-3 days after burning sensation. No outbrakes as of yet. Do you think it might be herpes considering my symptoms?
4. Could receptive anal sex might have inflamed the prostate which would cause frequent urges to urinate and probably urethitis?
5. What other STD might give my symptoms?
6. How accurate is Urine PCR test for chlamydia? Will it be accurate 4 days post possible infection date?
7. How accurate is Urine PCR test for gonorrhoea? Will it be accurate 4 days post possible infection date?
8. How accurate is simple Urine test for Herpes? Will it be accurate 4 days post possible infection date?
9. If symptoms continue what type of doctor would you recommend me seeing?
10. Finally, if all tests come back negative should i re-take them again and after how many days? Should i perform anymore tests other than the ones i already did?
TESTS PERFORMED
I had STD test, which i did on last friday for 1. Urine Culture, 2. URINE PCR FOR CHLAMYDIA AND GONORRHEA and 3. URINE TEST (NOT PCR) FOR HSV 1 and 2. Have not seen a doctor yet since im waiting on my test result first.
Urine Culture came back negative for common parasites that the test looks for and i still have to wait but i wanted to get some professional opinions before.
Thank you very much for all your help.
BACKGROUND
I am writing to you because un monday afternoon (7 days ago) i had protected CASUAL anal sex (give and receive), but had unprotected oral sex (give and receive). My sexual partner had 1 round flat red coloured lesion between lip and chin but said it was not herpes, more la acne (i am not 100% percent sure it is true). I also took 100mg viagra pill.
Afterwards i got nervous and since i did not had a shower or bathroom nearby i applied an aromatic hand sanitizer on penis shaft and tip.
SYMPTOMS
Since then, 1-2 days afterwards i have been having this burning sensation in the tip of my penis. I don't feel any pain, fatigue or even fever, but i have this persistent intermittent pain for almost 5 days now and laso feel quiet frequently the need to urinate. No other symptoms and at least for now no pain during urination, at least no noticeable pain.
ABOUT ME
Things you may need to know:
1. I am a frequent marijuana smoker (I smoke 1 regular sized joint every night after work).
2. I am HIV+ currently on successful HAART with undetectable VL and 550 CD4 and 43% CD4%.
3. I was diagnosed with HPV warts on march 2014 and they were surgically removed but site where some of the warts have stayed a bit inflamed afterwards (i went back to urologist for this and he said it was some inflammation response of the skin and i should not worry).
4. Other than that good health and good overall frequent blood lab tests.
5. I masturbate regularly (almost once a day on average).
QUESTIONS REGARDING MY SYMPTOMS:
1. Can this be due to chlamydia/gonorrhea, herpes (prodomal) symptoms?
2. Could it be a simple irritation of the urethra because of the hand sanitizer??? Is it normal for this burning sensation to last this long if it was due to the aromatic hand sanitizer?
3. Could this be prodromal symptoms (pre-outbreak) of herpes virus? I was told it probably was not herpes because an outbrake would have followed 1-3 days after burning sensation. No outbrakes as of yet. Do you think it might be herpes considering my symptoms?
4. Could receptive anal sex might have inflamed the prostate which would cause frequent urges to urinate and probably urethitis?
5. What other STD might give my symptoms?
6. How accurate is Urine PCR test for chlamydia? Will it be accurate 4 days post possible infection date?
7. How accurate is Urine PCR test for gonorrhoea? Will it be accurate 4 days post possible infection date?
8. How accurate is simple Urine test for Herpes? Will it be accurate 4 days post possible infection date?
9. If symptoms continue what type of doctor would you recommend me seeing?
10. Finally, if all tests come back negative should i re-take them again and after how many days? Should i perform anymore tests other than the ones i already did?
TESTS PERFORMED
I had STD test, which i did on last friday for 1. Urine Culture, 2. URINE PCR FOR CHLAMYDIA AND GONORRHEA and 3. URINE TEST (NOT PCR) FOR HSV 1 and 2. Have not seen a doctor yet since im waiting on my test result first.
Urine Culture came back negative for common parasites that the test looks for and i still have to wait but i wanted to get some professional opinions before.
Thank you very much for all your help.
Brief Answer:
Herpes unlikely. Wait and watch.
Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query.
I have gone through the elaborate description and question.
As there are no eruption you need not worry for herpes for now.Also the lesion in partner may be acne.The tests have come negative for STDs.
The smear and urine tests may give negative results.Many diseases mentioned may have incubation period for 2 weeks or more. So you can wait for results. And also keep watch on any symptoms.Then get tested if any symptoms develop after discussion with your treating doctor.
You should take more precautions on prevention of any infection . As it can get complicated or difficult to respond to treatment.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venereologist
Herpes unlikely. Wait and watch.
Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query.
I have gone through the elaborate description and question.
As there are no eruption you need not worry for herpes for now.Also the lesion in partner may be acne.The tests have come negative for STDs.
The smear and urine tests may give negative results.Many diseases mentioned may have incubation period for 2 weeks or more. So you can wait for results. And also keep watch on any symptoms.Then get tested if any symptoms develop after discussion with your treating doctor.
You should take more precautions on prevention of any infection . As it can get complicated or difficult to respond to treatment.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venereologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Bharatesh,
Thank you for your answer. I think you misread, i had 3 tests performed on friday:
1. Urine culture test: NEGATivE RESULT (only looks for limited parasites).
2. Urine PCR Chalmydia and Gonorrhea: STILL WAITING FOR RESULTS
3. Simple urine test for HSV 1 and 2: still waiting
Can you please answer my following questions more specifically?
1. Can this be due to chlamydia/gonorrhea, herpes (prodomal) symptoms?
2. Could it be a simple irritation of the urethra because of the hand sanitizer??? Is it normal for this burning sensation to last this long if it was due to the aromatic hand sanitizer?
3. Could this be prodromal symptoms (pre-outbreak) of herpes virus? I was told it probably was not herpes because an outbrake would have followed 1-3 days after burning sensation. No outbrakes as of yet. Do you think it might be herpes considering my symptoms?
4. Could receptive anal sex might have inflamed the prostate which would cause frequent urges to urinate and probably urethitis?
5. What other STD might give my symptoms?
6. How accurate is Urine PCR test for chlamydia? Will it be accurate 4 days post possible infection date?
7. How accurate is Urine PCR test for gonorrhoea? Will it be accurate 4 days post possible infection date?
8. How accurate is simple Urine test for Herpes? Will it be accurate 4 days post possible infection date?
9. If symptoms continue what type of doctor would you recommend me seeing?
10. Finally, if all tests come back negative should i re-take them again and after how many days? Should i perform anymore tests other than the ones i already did?
Thank you very very much =)!
Thank you for your answer. I think you misread, i had 3 tests performed on friday:
1. Urine culture test: NEGATivE RESULT (only looks for limited parasites).
2. Urine PCR Chalmydia and Gonorrhea: STILL WAITING FOR RESULTS
3. Simple urine test for HSV 1 and 2: still waiting
Can you please answer my following questions more specifically?
1. Can this be due to chlamydia/gonorrhea, herpes (prodomal) symptoms?
2. Could it be a simple irritation of the urethra because of the hand sanitizer??? Is it normal for this burning sensation to last this long if it was due to the aromatic hand sanitizer?
3. Could this be prodromal symptoms (pre-outbreak) of herpes virus? I was told it probably was not herpes because an outbrake would have followed 1-3 days after burning sensation. No outbrakes as of yet. Do you think it might be herpes considering my symptoms?
4. Could receptive anal sex might have inflamed the prostate which would cause frequent urges to urinate and probably urethitis?
5. What other STD might give my symptoms?
6. How accurate is Urine PCR test for chlamydia? Will it be accurate 4 days post possible infection date?
7. How accurate is Urine PCR test for gonorrhoea? Will it be accurate 4 days post possible infection date?
8. How accurate is simple Urine test for Herpes? Will it be accurate 4 days post possible infection date?
9. If symptoms continue what type of doctor would you recommend me seeing?
10. Finally, if all tests come back negative should i re-take them again and after how many days? Should i perform anymore tests other than the ones i already did?
Thank you very very much =)!
Brief Answer:
Can be due to irritation or sanitizer.
Detailed Answer:
Hi
Thank you for follow up query.
I know that many of the tests results are expected and i have mentioned about it.
Whatever tests have come negative is a good sign.
Coming to your questions
These burning can be due to herpes and cannot be ruled out totally .It can be due to irritation to sanitizer or chemicals or repeated washing with soaps or friction.
Some irritation can be there for 2-5 days or due to repeated washing .
It can be herpes as incubation period of herpes varies 2days to 2 weeks.We can wait for 2 weeks to see if any lesions develop.Some may be asymptomatic here unlikely .
Anal sex can lead to symptoms of frequent urination.Though may not directly lead to prostatitis.
If the organisms are not present in the urine the PCR is highly specific i.e you do not have the disease(Gonorrhea and chlamydia) on the day of test.But it depends on incubation period .Gonorrhea incubation period may be until 2 weeks.Chlamydia may remain asymptomatic and varies until weeks.
Herpes urine test may not be accurate.False negatives are possible.You can go for IGM and IGG antibodies testing for HSV1 and 2.
You can consult STD specialist or venereologist for discussion and management if symptoms persists.
If you develop any symptoms you can go for retesting of selected STDs after discussion with your treating doctor .
As earlier said precaution ans prevention are better.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh Basti
Can be due to irritation or sanitizer.
Detailed Answer:
Hi
Thank you for follow up query.
I know that many of the tests results are expected and i have mentioned about it.
Whatever tests have come negative is a good sign.
Coming to your questions
These burning can be due to herpes and cannot be ruled out totally .It can be due to irritation to sanitizer or chemicals or repeated washing with soaps or friction.
Some irritation can be there for 2-5 days or due to repeated washing .
It can be herpes as incubation period of herpes varies 2days to 2 weeks.We can wait for 2 weeks to see if any lesions develop.Some may be asymptomatic here unlikely .
Anal sex can lead to symptoms of frequent urination.Though may not directly lead to prostatitis.
If the organisms are not present in the urine the PCR is highly specific i.e you do not have the disease(Gonorrhea and chlamydia) on the day of test.But it depends on incubation period .Gonorrhea incubation period may be until 2 weeks.Chlamydia may remain asymptomatic and varies until weeks.
Herpes urine test may not be accurate.False negatives are possible.You can go for IGM and IGG antibodies testing for HSV1 and 2.
You can consult STD specialist or venereologist for discussion and management if symptoms persists.
If you develop any symptoms you can go for retesting of selected STDs after discussion with your treating doctor .
As earlier said precaution ans prevention are better.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh Basti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr,
Thank you for your quick reply.
In conclusion please confirm if i understood the following clearly:
1. If ONLY SYMPTOMS are sensation to want to urinate and irritated penis opening (urethra), it probably is due to applying hand sanitizer while under effects of viagra to penis tip. How long can irritation from hand sanitizer last? Can it last more than 7 days?
2. If burning sensation started about 7 days ago but still no lesions have appeared nor have any other symptoms appeared, can it be safe to say que there is a low probability it might be herpes? I read somewhere that burning sensation from herpes infection is called a prodromal symptom of herpes and lesions/sores usually appear 2-3 days after prodromal symptoms, therefore i would conclude there is a low chance this might be herpes since this irritation has lasted for almost 6-7 days with any sores.
3. Whenever i smoke marijuana i feel burning sensation stronger. I read somewhere that marijuana (THC) increases blood flow (even to penis area). Can this irritation lasting mora than 6 days could have been exacerbated (elongated) by smoking marijuana?
4. In your professional opinion, taking account my medical history (HIV+ on successful ARVs and was diagnosed with HPV in past), and my possible exposure and symptoms, what would be your best GUESS as to what it causing this burning sensation?
5. Finally, before I go to see a Dr. here I want to get all my lab tests done first so that can see him with results ready. What other test would you recommend me doing (don't worry about me spending on tests) to test what might be causing this symptoms?
*By the way, i don't know if it matters, but my possible exposure was from a male-to-male sexual experience.
Again, thank you very very much. Im kinda scared of what it might be specially since i always use condoms and this time i only didn't use them for oral sex.
Have a great day!
Thank you for your quick reply.
In conclusion please confirm if i understood the following clearly:
1. If ONLY SYMPTOMS are sensation to want to urinate and irritated penis opening (urethra), it probably is due to applying hand sanitizer while under effects of viagra to penis tip. How long can irritation from hand sanitizer last? Can it last more than 7 days?
2. If burning sensation started about 7 days ago but still no lesions have appeared nor have any other symptoms appeared, can it be safe to say que there is a low probability it might be herpes? I read somewhere that burning sensation from herpes infection is called a prodromal symptom of herpes and lesions/sores usually appear 2-3 days after prodromal symptoms, therefore i would conclude there is a low chance this might be herpes since this irritation has lasted for almost 6-7 days with any sores.
3. Whenever i smoke marijuana i feel burning sensation stronger. I read somewhere that marijuana (THC) increases blood flow (even to penis area). Can this irritation lasting mora than 6 days could have been exacerbated (elongated) by smoking marijuana?
4. In your professional opinion, taking account my medical history (HIV+ on successful ARVs and was diagnosed with HPV in past), and my possible exposure and symptoms, what would be your best GUESS as to what it causing this burning sensation?
5. Finally, before I go to see a Dr. here I want to get all my lab tests done first so that can see him with results ready. What other test would you recommend me doing (don't worry about me spending on tests) to test what might be causing this symptoms?
*By the way, i don't know if it matters, but my possible exposure was from a male-to-male sexual experience.
Again, thank you very very much. Im kinda scared of what it might be specially since i always use condoms and this time i only didn't use them for oral sex.
Have a great day!
Brief Answer:
May be due to irritation .
Detailed Answer:
Hi
Thank you for follow up query.
I have gone through the detailed description.
I think you are getting anxious.
For the burning related questions I would still think of irritation or frequent washing .It should come down by 2-3 days.May persist if irritatant still exists.
Marijuana may not be the reason for symptoms. But is better to avoid now at least as it may have side effects due to HIV status.
Though Herpes is unlikely ,Herpes can have symptoms for 1-2 week specially first episode.
Just clean area with warm water twice daily and observe for any rash or symptoms.
Other possibilties are being investigated you need to wait for results.Fungal infection can also be kept in mind.
I do not see any requirements for further investigation until symptoms develop.
You can get back for any clarification.
Thank you
Dr Bharatesh Basti
May be due to irritation .
Detailed Answer:
Hi
Thank you for follow up query.
I have gone through the detailed description.
I think you are getting anxious.
For the burning related questions I would still think of irritation or frequent washing .It should come down by 2-3 days.May persist if irritatant still exists.
Marijuana may not be the reason for symptoms. But is better to avoid now at least as it may have side effects due to HIV status.
Though Herpes is unlikely ,Herpes can have symptoms for 1-2 week specially first episode.
Just clean area with warm water twice daily and observe for any rash or symptoms.
Other possibilties are being investigated you need to wait for results.Fungal infection can also be kept in mind.
I do not see any requirements for further investigation until symptoms develop.
You can get back for any clarification.
Thank you
Dr Bharatesh Basti
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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