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What causes urinary symptoms post sex if HIV is negative?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I had sex with my girlfriend two months ago. She had two sex partners before me who were both HIV (Human Immunodeficiency Virus) negative, including her. After exposure, I had a burning sensation while urinating and pain in the scrotum. I got a urine culture test the next day result (no pathogens present) but doctor prescribed Azithromycin 500, Ofloxacin 400, Norfloxacin 200, Urispas and Tolpa-D two doses every day for five days before the test result came suspecting it to be STI (Sexually transmitted infection).

Lately, I developed pain in the scrotum with frequent urination and symptoms similar to HIV, so I got myself tested with a 4th-generation test 50 days after exposure. HIV 1 and 2 came back negative, including VDRL - nonreactive, urine routine tests are also normal. Scrotum ultrasound inferred "funiculitis". But my symptoms include mild fever, irritation in the eye, pain in the scrotum (right testicle), sore throat, and mild headache. No major weight loss, rashes, diarrhea, and white discharge. I am confused.

Please help.

Answered by Dr. Kakkar

Hello,

Welcome to icliniq.com.

I have noted your concern.

Your 4th-generation HIV screening test is conclusive at 50 days. Therefore, it rules out HIV. Perhaps you had urethritis which ascended to complicate as funiculitis. I would suggest empirical treatment for the most common sexually transmitted causes of urethritis - gonorrhea and chlamydia, with injection Ceftriaxone 250 mg IM single dose. In addition, I suggest oral Doxycycline 100 mg, twice daily for seven days.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

After I got pain in the scrotum for the second time, I also included Doxycycline 100 mg for three days twice each day, including the drugs from the previous course, for a total of 3000 mg/day, combining all for three days. That gave me oral thrush and ulcers inside the mouth (out of stress, and overthinking), and I stopped drugging myself.

As of now, nothing has changed. I still have symptoms. Should I wait for my culture test, which I am going to pick up tomorrow, or should I start these new drugs?

Please advise.

Answered by Dr. Kakkar

Hello,

Welcome back to icliniq.com.

I understand your concern.

Wait for the culture. If it suggests something, treatment may be started accordingly. Otherwise, I suggest taking Doxycycline twice daily for a week. In addition, I suggest you also take an injection of Ceftriaxone 250 mg IM (intramuscular) single dose.

Consult your specialist doctor, discuss with him or her, and start taking the medicines with their consent. I do not think there is any need to take Norfloxacin and Ofloxacin.

I hope this helps you.

Thank you.

Answered byDr. Kakkar

Medically reviewed byiCliniq medical review team

Published At February 16, 2018
Reviewed AtMarch 31, 2026

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