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Frottage and Semen Exposure & Testing Window
Drs. Hook and HHH,
I'm a 26 year old male, and about 4 months ago (May 13th, 2010) I engaged in frottage with a man of unknown status in his hotel room. He rubbed his penis between my buttcheeks and on my anus, and he had visible pre-cum. I then reached behind me and gave him a handjob to completion, until he ejaculated a substantial amount of semen on my exposed buttocks. I was afraid some of his semen could have slid down my crack and into my anus. He told me he was "clean" in his words, but I have no way to confirm this other than his word.
I had shaved the night before, so I also fear I may have had nicks/cuts on my taint or rear end. People talk so much about how HIV is "inactive" once outside its living host, and I'm told frottage isn't a transmission concern, but I want to present this scenario to you and get your expert opinion on my risk and need for further testing.
I'm married, and so I was sure that my HIV anxiety was due to guilt. I told my wife about the incident, and she forgave me, though even after that I still have a great deal of HIV anxiety. My wife and I would like to resume unprotected sex, and are planning on starting a family at the end of this year, but I can't let go of the fact that I might have been infected. I'm hoping either of you could alleviate my fears.
My exposure was May 13th, 2010.
I was tested May 14th, I recieved a full physical from my primary physician and had an HIV antibody test to establish baseline status. I tested negative on a blood draw.
Tested negative again at 7 weeks 5 days from exposure (July 6, 2010), and negative again at 13 weeks and 4 days post exposure (August 16, 2010), both blood draws and antibody tests.
Tested again at 15 weeks and 6 days on a full STD panel (blood and urine tests) and all was negative except for Herpes simplex II.
Is there any reason not to trust my negative HIV tests at this point? Is there ANY need for me to test to 6 months, just to be sure?
Thank you for your time.
I'm a 26 year old male, and about 4 months ago (May 13th, 2010) I engaged in frottage with a man of unknown status in his hotel room. He rubbed his penis between my buttcheeks and on my anus, and he had visible pre-cum. I then reached behind me and gave him a handjob to completion, until he ejaculated a substantial amount of semen on my exposed buttocks. I was afraid some of his semen could have slid down my crack and into my anus. He told me he was "clean" in his words, but I have no way to confirm this other than his word.
I had shaved the night before, so I also fear I may have had nicks/cuts on my taint or rear end. People talk so much about how HIV is "inactive" once outside its living host, and I'm told frottage isn't a transmission concern, but I want to present this scenario to you and get your expert opinion on my risk and need for further testing.
I'm married, and so I was sure that my HIV anxiety was due to guilt. I told my wife about the incident, and she forgave me, though even after that I still have a great deal of HIV anxiety. My wife and I would like to resume unprotected sex, and are planning on starting a family at the end of this year, but I can't let go of the fact that I might have been infected. I'm hoping either of you could alleviate my fears.
My exposure was May 13th, 2010.
I was tested May 14th, I recieved a full physical from my primary physician and had an HIV antibody test to establish baseline status. I tested negative on a blood draw.
Tested negative again at 7 weeks 5 days from exposure (July 6, 2010), and negative again at 13 weeks and 4 days post exposure (August 16, 2010), both blood draws and antibody tests.
Tested again at 15 weeks and 6 days on a full STD panel (blood and urine tests) and all was negative except for Herpes simplex II.
Is there any reason not to trust my negative HIV tests at this point? Is there ANY need for me to test to 6 months, just to be sure?
Thank you for your time.
MEDICAL PROFESSIONAL
Welcome to the forum. Responding first to the title you chose for your question, before reading the question itself: It is probable that nobody ever caught HIV by frottage, regardless of semen exposure during the event. Safe sex doesn't have very much nuance. If a bare penis (no condom) isn't inserted into a partner's vagina, rectum or mouth, for practical purposes there is no risk of HIV transmission.
Now I have read the question. There is nothing in the detailed history that changes my opening comment. No HIV risk, even if your partner was infected. But the important information here has nothing to do with exposure risk. The test results prove you wern't infected. You could have had the highest exposure risk imaginable; even if your partner were known to have HIV and had ejaculated inside your rectum, it would not matter. It is not possible to have HIV and have a negative antibody test 13 weeks later. The other negative STD tests also are reliable.
If the positive result for HSV-2 is valid, you have genital (or anal) herpes. You'll need to be on the lookout for symptoms of outbreaks, and also discuss it with your wife, who likely is at risk (if not already infected). However, many positive HSV-2 blood tests are false. If you would like to give more detail about that test -- the exact name of the test and its numerical value -- I can judge how likely it is that you in fact are infected with HSV-2.
But no worries about HIV and no need for further testing at 6 months or any other time.
Regards-- HHH, MD
Now I have read the question. There is nothing in the detailed history that changes my opening comment. No HIV risk, even if your partner was infected. But the important information here has nothing to do with exposure risk. The test results prove you wern't infected. You could have had the highest exposure risk imaginable; even if your partner were known to have HIV and had ejaculated inside your rectum, it would not matter. It is not possible to have HIV and have a negative antibody test 13 weeks later. The other negative STD tests also are reliable.
If the positive result for HSV-2 is valid, you have genital (or anal) herpes. You'll need to be on the lookout for symptoms of outbreaks, and also discuss it with your wife, who likely is at risk (if not already infected). However, many positive HSV-2 blood tests are false. If you would like to give more detail about that test -- the exact name of the test and its numerical value -- I can judge how likely it is that you in fact are infected with HSV-2.
But no worries about HIV and no need for further testing at 6 months or any other time.
Regards-- HHH, MD
Thank you Dr. Handsfield. I was trying very hard not to be a typical worried well, but I'll admit I just wanted to make 100% sure as my wife and I are going to remove both condoms and birth control from the picture in the next month and start trying for a child.
I hope you'll understand that for her sake and the child's I just wanted to be absolutely sure before we did that. I could live with getting HIV on my own, but I could hardly tolerate my own reflection if I gave it to her and then to my child because I didn't take necessary measures to be 100% certain. Her and I have both been following this thread and doing our own talking with local HIV/AIDS counselors alike leading up to all this. I think I'm finally ready to believe the results and move on.
At this time I just want to express again my infinite gratitude to both you and Dr. Hook for the work you are both doing and have done in this field, and for easing the minds of the overly anxious like myself. That'll be all, I won't bother you again with follow up questions or tests as I know logically that they aren't necessary, and with any luck, my anxiety portion of my mind will realize that too. Thank you again.
I hope you'll understand that for her sake and the child's I just wanted to be absolutely sure before we did that. I could live with getting HIV on my own, but I could hardly tolerate my own reflection if I gave it to her and then to my child because I didn't take necessary measures to be 100% certain. Her and I have both been following this thread and doing our own talking with local HIV/AIDS counselors alike leading up to all this. I think I'm finally ready to believe the results and move on.
At this time I just want to express again my infinite gratitude to both you and Dr. Hook for the work you are both doing and have done in this field, and for easing the minds of the overly anxious like myself. That'll be all, I won't bother you again with follow up questions or tests as I know logically that they aren't necessary, and with any luck, my anxiety portion of my mind will realize that too. Thank you again.
MEDICAL PROFESSIONAL
You have it exactly right, with one correction. The large majority of newly infected people have positive tests by 4 weeks; probably about 5-10% of newly infected persons don't develop measurable antibodies until 6-8 weeks. If the duo test for both HIV antibody and p24 antigen is used, then virtually everybody with HIV is positive by 4 weeks.
As discussed above, you do not need any more testing. You could not have been infected through the exposure you describe and the tests already done prove it didn't happen.
That should be all for this thread. I won't have any additional comments or advice.
As discussed above, you do not need any more testing. You could not have been infected through the exposure you describe and the tests already done prove it didn't happen.
That should be all for this thread. I won't have any additional comments or advice.
So from your statements in that thread and from what I gather from seeing other posts by both you and Dr. Hook on this forum, the 6 month window is far outdated (older tests that have not been in use for quite some time - like over a decade - required the 6 month window, and some people just still haven't caught up to that fact or are being overly cautious and still using that outdated window), and even the current 3 month window is extra padding on what it actually takes people to develop antibodies (6-8 weeks) for HIV especially when they, like myself, are young and in good physical health with no immune or blood disorders? Is this correct?
MEDICAL PROFESSIONAL
See this thread, especially my follow-up comment: http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755
So in regards to the HIV testing, you say it is unnecessary to test out to 6 months. I have seen various sources stating that a 6 month test is needed to be conclusive, yet I see many others saying three months. Why the discrepancy among so many sources? Under what, if any circumstances, would a person need to test out to 6 months? And have there been cases of people taking up to and longer than 6 months to seroconvert? I'm almost sorry to ask these questions as the three month crowd seems to be correct, but I just want to make absolutely sure before my wife and I resume unprotected sex and start trying to have children that everything is ok. Your help is appreciated greatly.
MEDICAL PROFESSIONAL
Your wife doesn't need a "full panel", only an HSV blood test. You need not mention the recent or any other non-marital sexual exposures to her. The only information pertinent to her being tested is your recent new insight into the likelihood that your finger lesion is due to HSV-2.
Thanks for your advice again Doc. I don't recall anything in particular around the time of the first finger lesion, I just know that I have never once noticed anything like it anywhere else on my body since then. I do intend to have it cultured the next time it comes up, as my primary physician and I have been all over the map on what this is the last few years. Again, to my knowledge, I have never had any kind of outbreak in my genital/anal/oral/throat area anything like this.
This whole HIV scare has got me a lot more interested in the nature of STD's and my overall sexual health, something I never thought much of before I strayed from my wife. I guess perhaps this even could even be a blessing in disguise, my wife and I would have never known I had HSV-2 if I hadn't taken these tests. She has never noticed an outbreak either.
I suppose our next steps, and tell me if you agree with this, would be to have her take a full STD panel, and then for me to have my doctor culture the next finger lesion.
This whole HIV scare has got me a lot more interested in the nature of STD's and my overall sexual health, something I never thought much of before I strayed from my wife. I guess perhaps this even could even be a blessing in disguise, my wife and I would have never known I had HSV-2 if I hadn't taken these tests. She has never noticed an outbreak either.
I suppose our next steps, and tell me if you agree with this, would be to have her take a full STD panel, and then for me to have my doctor culture the next finger lesion.
MEDICAL PROFESSIONAL
Your HSV-2 test is strongly positive; you definitely are infected with HSV-2.
Interesting about your recurrent finger lesion, and it sounds likely it is a recurrent herpes whitlow. Individual shingles lesions look pretty much the same as herpes simplex, but recurrent shingles almost never happens. If HSV-2, most likely you were infected not long before the first finger lesion 4-5 years ago. Do you recall genital/anal area or oral/throat symptoms at the time? Or fever, headache, etc? Or any association with a new sexual partnership around that time?
You should speak to your doctor's office and grease the skids so that if and when you develop another finger lesion, you can be seen in the office the same day for an HSV culture or PCR test from the lesion (PCR is best if available). A positive result for HSV-2 would nail the diagnosis. The lesion could also be tested by PCR for VZV, the virus that causes shingles. Also, if it is HSV-2, it is unlikely to be the only infected site; most people with HSV-2 have gental infections. And most people who have no genital symptoms in fact come to recognize mild outbreaks when they know to be on the alert for them. Not always -- the research suggests around 60-70% learn to recognize outbreaks.
Interesting about your recurrent finger lesion, and it sounds likely it is a recurrent herpes whitlow. Individual shingles lesions look pretty much the same as herpes simplex, but recurrent shingles almost never happens. If HSV-2, most likely you were infected not long before the first finger lesion 4-5 years ago. Do you recall genital/anal area or oral/throat symptoms at the time? Or fever, headache, etc? Or any association with a new sexual partnership around that time?
You should speak to your doctor's office and grease the skids so that if and when you develop another finger lesion, you can be seen in the office the same day for an HSV culture or PCR test from the lesion (PCR is best if available). A positive result for HSV-2 would nail the diagnosis. The lesion could also be tested by PCR for VZV, the virus that causes shingles. Also, if it is HSV-2, it is unlikely to be the only infected site; most people with HSV-2 have gental infections. And most people who have no genital symptoms in fact come to recognize mild outbreaks when they know to be on the alert for them. Not always -- the research suggests around 60-70% learn to recognize outbreaks.
Thank you for the response Dr. H. It makes me feel much better to hear an expert opinion like yours, and I think that will go a long way in alleviating any anxiety I still may have over HIV. My wife and I can now get through this and move forward in our marriage knowing that HIV is not an issue.
As far as the herpes test goes, I have never had an outbreak, and don't know how long I could have possibly had it. I was tested through stdexpress.com, who uses LabCorp laboratories for their tests. The test for HSV-2 was Herpes Simplex Virus Type II IgG Test (HerpeSelect) and the value was 5.48. It's the only thing on my full panel that came back positive.
I'd also like to ask you another question regarding the herpes test. As I said, I don't know how long I've had it, as this was my first formal full STD test, but I've never once had an outbreak. I have, however, seen my primary care physician several times in the past about a lesion that breaks out roughly once or twice every year or two on my right ring finger. He has said before that it looks "herpetic in nature", but we have never cultured it to have it tested. The last time I saw him about it, he seemed confident in his diagnosis of it as shingles. It is literally the only thing ever on my body that I've seen even remotely resembling a herpes outbreak, and it's only that one lesion on my right ring finger, same spot every time. I suppose I first noticed it about 4 or 5 years ago.
Do you think that has anything to do with the positive herpes test?
As far as the herpes test goes, I have never had an outbreak, and don't know how long I could have possibly had it. I was tested through stdexpress.com, who uses LabCorp laboratories for their tests. The test for HSV-2 was Herpes Simplex Virus Type II IgG Test (HerpeSelect) and the value was 5.48. It's the only thing on my full panel that came back positive.
I'd also like to ask you another question regarding the herpes test. As I said, I don't know how long I've had it, as this was my first formal full STD test, but I've never once had an outbreak. I have, however, seen my primary care physician several times in the past about a lesion that breaks out roughly once or twice every year or two on my right ring finger. He has said before that it looks "herpetic in nature", but we have never cultured it to have it tested. The last time I saw him about it, he seemed confident in his diagnosis of it as shingles. It is literally the only thing ever on my body that I've seen even remotely resembling a herpes outbreak, and it's only that one lesion on my right ring finger, same spot every time. I suppose I first noticed it about 4 or 5 years ago.
Do you think that has anything to do with the positive herpes test?
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