Hi, I am a male age 33 and had bright red blood in my urine several months ago and the doctor thought it was some type of hernia in the lower groin. Over the past two days, the bright red blood in my urine has returned and is again following sexual activity where I was performing anal sex (giver) in a somewhat aggressive manner. The only other condition I am being treated for besides HIV is Toxoplasmosis. Pharmaceutical wise, I am taking Zithromax for 60 days to treat the toxoplasmosis and it's affect on the liver and my HIV regimen consists of Invirase, Norvir, Prezista & Truvada.

1) How do I know when this would require an ER visit vs a call to my doctor? 2) I had used (smoked) crystal methamphetamine during the time that this occurred. Could this be a contributing or causing factor? 3) Do any of the medications listed above interact to cause harm to the kidneys?

Thanks very much for any guidance and information you may provide.

Unlikely to be due to any of your current HIV meds though renal function evaluation including urinalysis is recommended.. Some mechanical injury to urethra or a problem with vas deferens, bladder, kidneys seems more likely. Discussing with your HIV physician and possibly getting a referral to a urologist is recommended. If the hematuria occurs only after sex then the problem most likely is in the urethra or prostate/vas deferens system.