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Hiv - condom broken, proctitis, 2 nodes
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Hiv - condom broken, proctitis, 2 nodes

Dear Doctors, I am Italian 29 yo etero guy (never went with men or had any drugs). I had only 1 unvoluntary risk in my life. I was in a regulated brothel in Switzerland (Lugano) with a 23 Romanian csw, 8 months ago. During vaginal intercourse, condom brake. I did not realize it and finished inside her. Total exposure could have been 5/7 minutes. I had no symptoms and went to STD doctor in Milan who told me to move on and did not suggest me to get tested. I forgot about what happened and never had 1 symptom. At end Nov 2012 I found blood in feces. Following sigmoidoscopy exam made by GE specialist, specialist found a proctitis and gave me local Mesazaline for 1 month. On 9 January 2013, following new sigmoidoscopy, GE found me healthy (problem solved) and suspended me any treatments. I have now 2 swollen nodes on neck (back and latero) since mid December. I went again to my STD doctor to remind and update him my with my story. He told me my nodes are small enough that he would not suggest any exams. He stated that proctitis has nothing to deal with HIV risk or other STD (also because GE found it aspecific and solved with mesalazine). I want to kindly ask you:
1 - You think what my STD doctor told me is reasonable?
2 - Would you suggest any HIV testing to me? I think I am ready to move on if you will not tell me that tested is warranted to me.
3 - You think GE was professional by giving me mesalazine after sigmoidoscopy (when I have been told proctitis I knew nothing about causes)? You think proctitis cannot be related to HIV?
4 - Nodes - Can 2 nodes be related to autoimmune proctitis? Should I get further in analysing my nodes? (my dad is a general doctors and he also told me to move on and don't think of the 2 little nodes).
Thx a lot.
300980_tn?1194933000
Welcome to our forum.  I'll be glad to comment on your exposure 8 months ago and to address your questions.  Before I do however, let me congratulate you on your commitment to safe sex.  While condoms do break from time to time (about 1% of the time), they remain the best way to avoid STDs, including HIV.  Please keep using them.

The exposure that you mention was low risk.  Few commercial sex workers, particularly those who work in licensed brothels have HIV or other STDs. Typically, because STDs and HIV are bad for business, they are regularly checked for STDs as part of their employment.  Further, even if your partner did happen to have HIV, the infections are not frequently transmitted (about 1 infection for every 1000 - 2,000 unprotected encounters with infected partners).  Thus while I might have offered STD testing, I would not have been too concerned about this exposure.  

As for your questions:
1 - You think what my STD doctor told me is reasonable?
Yes, I agree.  There is little reason to worry.  I might have tested you but I would not worry.  

2 - Would you suggest any HIV testing to me? I think I am ready to move on if you will not tell me that tested is warranted to me.
Here in the U.S. it is recommended that every American have an HIV test and if they have regular exposures, that they get tested from time to time but other than this sort of routine testing, there is nothing in your history that makes me recommend testing for you.

3 - You think GE was professional by giving me mesalazine after sigmoidoscopy (when I have been told proctitis I knew nothing about causes)? You think proctitis cannot be related to HIV?
The doctor was correct in telling you that proctitis was not a manifestation of HIV.  Further, there is no reason related to your unprotected sexual exposure to worry that your proctitis might be an STD. STD proctitis occurs only in persons with direct rectal sexual contact.

4 - Nodes - Can 2 nodes be related to autoimmune proctitis?
There are many other illnesses which can cause lymph node swelling.  Swollen lymph nodes are a non-specific response to any number of stimuli including infections due to bacteria and viruses, allergic reactions and autoimmune disease.  Of all persons with swollen lymph nodes only a tiny proportion of them have HIV.  I would not be worried about the presence of the two small lymph nodes you have noticed in your neck.

Thus, in summary, I urge you not to worry that you have HIV or that the proctitis you experienced was related to your unprotected sexual encounter.  If you wish to get tested for reassurance there is no reason not to do so, once.  When your results are negative, as I am confident they will be however, please believe them and stop worrying.  EWH
12 Comments
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Avatar_m_tn
Dear Doctor EWH,

Just one simple follow up. I am 100% monogamous and I had only 1 HIV risk in my life.

Would you suggest me to get tested at the moment? Unfortunately in Italy it is not simple to get tested and I could do it only at hospital by blood exam.
Do you think it is worth in my case?

I am not worried, I want to know from medical perspective. In these 8 months I never had 1 day of fever of anything else.


Thank you very much for your work and your help.
Matteo
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300980_tn?1194933000
Your risk of being infected at this time is less than 1 in 100,000.  The only reason for you to seek testing is for the peace of mind it would give you.  Blood testing however is more easily done than you suggest so if you are worried (and you seem to be) why not go and get tested so you can put your worries to rest.  If you test, I am confident that your test will be negative.  EWH
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Avatar_m_tn
I am grateful to you. Best.
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300980_tn?1194933000
Glad to help. EWh
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Avatar_m_tn
I hope I am not disturbing (sorry if that).

I have last last doubt about proctitis - Doctor EWH wrote me "STD proctitis occurs only in persons with direct rectal sexual contact."

No one touched my rectus or anus.

Am I at risk if I licked anus of a girl? (some week before proctitis occured).
Now all is good, proctitis went ..but it is for knowledge.

Kind kind regards,
Matteo.

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300980_tn?1194933000
No, you are not at risk if a partner licked your anus.  EWH
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Avatar_m_tn
I licked anus of a girl, not the girl to me.

But I did not lick deeply or something strange.. Thank you very much.

All the best.
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Avatar_m_tn
Sorry if I write again but I promise it is my last post, I did not get Mr EWH point.

I have last last doubt about proctitis - Doctor EWH wrote me "STD proctitis occurs only in persons with direct rectal sexual contact."

Is it possible I took STD proctitis by licking anus of a girl some weeks before proctitis occured?


Finally I want to tell you I am planning HIV test. I want to be free of thinking forever.
Thanks for helping in very difficult times.
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300980_tn?1194933000
Already answeered-

"Is it possible I took STD proctitis by licking anus of a girl some weeks before proctitis occured? "
No.

EWH
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Avatar_m_tn
Dear doctor I found again blood in feces.

Of course I will go to make all tests (including HIV) and analyses as soon as possible.

Could you only confirm me that my unprotected vaginal intercourse did not cause proctitis?


All the best.
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Avatar_m_tn
I Made forte generati on bloombe hiv test. Negative!!

Thanx for support.
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