too many what if thoughts making me crazy ???

[Please Help Me - Really Depressed]

Hi Doc, I’ll go straight to the details.

25 years old, born and raised in Canada. I am a heterosexual male. I have NEVER had sex WITHOUT a condom. Had 30 sexual encounters over last 5 years all at clean massage parlors. Never thought about STDs or HIV due to the fact that I have always had safe sex and used a condom. There were 2 incidents where I might have been exposed to STDs or HIV. Most of these encounters were single episodes.

1.Condom broke(I pulled out as soon as I heard it, even she heard it max 5 secs of condomless sex) she freaked out and said she was clean, asked if I was and said yes, we continued with a new condom.

2.Same situation but noticed blood on condom after we were changing positions; she said it was her period. As a turn off, my penis instantly went flaccid. We removed the condom and put on a new one she finished me off with oral sex.

Last year I was diagnosed with anal warts, and it has been a year now since I last had them. I was shocked since I’ve never had anal sex, but my good doctor told me a finger during foreplay could have spread it even vaginal secretions, as the condom only covers the penis. He said anal warts are fairly common in straight men, which same as to what you’ve mentioned in some posts.  

My questions are.
1.If I can get anal warts from these SINGLE episodes (whether thru a finger that touched me during foreplay or vaginal secretions during sex, what else could’ve I gotten?

2.Does the fact that I had an anal fissure at the time of the anal warts mean anything, or is that just a coincidence, the fissure healed shortly after all the warts went away? Does this suggest any thing else, like could it been due to HIV or syphilis. I did see a Colon-Rectal Surgeon twice, once during my first visit of the anal warts and during the second follow up visit. Both times he didn’t mention anything about the fissure being off the midline which is common in other underlying conditions such as HIV/AIDS, syphilis, or crohn's. All he said was I have a skin tag associated with it and to cut some foods from my diet.

3.I once had mono like symptoms - very severe was bed ridden for almost 2 weeks, but this was 10 weeks after any kind of sexual exposure, does that mean anything?

4.If i was your patient, based on my risks, sexual exposures and above 2 questions (if they even matter) that I need to be tested for HIV or any other STDS apart from my obvious anxiety reasons; I don’t have any other symptoms. (My doctor or proctologist have never mentioned anything about an STD/HIV test of any sort)

I keep thinking I have HIV after what I read on the internet, and other posts on medhelp, which I never wish I had read cause to be honest with you I never had any doubts about this until I browsed the internet so much after having anal warts. Any time anything happens to my wife or me I can’t help to think I might have HIV or other serious STDS, despite being symptom free.

Thanks so much doc.

[H. Hunter Handsfield, M.D.]

Indeed anal warts are seen fairly frequently in heterosexual men with no rectal sexual exposure.  I don't know why you assume they came from only a single exposure.  They could have originated with any number of your various sexual encounters, not necessarily the one with the broken condom.

1) HPV probably is more easily transmitted than other STD.  Never once have I seen a heterosexual man with a rectal STD other than HPV.  Forget it.

2) The fissure and warts probably are just coincidental.  If the surgeon said you had a skin tag, it was a skin tag.

3 and 4)  Your mononucleosis or probably was just that, due to either the classical cause (Epstein Barr virus, EBV) or other viruses that mimic it (e.g., cytomegalovirus, CMV).  If the exact cause isn't known by now, probalby it never will be.  If you're concerned about HIV, get tested for it, to ease your mind.  (Or check with the provider who diagnosed it.  You might have already been tested for HIV at that time.)  But based on your sexual lifestyle and practices, your risks for HIV clearly are zero or close to it--and EBV, CMV, and other viruses (perhaps including some not even identified) are far more likely causes of that illness than HIV.

Good luck--  HHH, MD

[Please Help Me - Really Depressed]

So in conclusion, based on my exposures and risks, I was at 0 risk from HIV or any other STDs apart from the anal warts I got, and I should just forget about all of this and don't need any HIV/STD testing. DO YOU AGREE?

Thanks again so much doc, you really do a wonderful job here helping worried people like me and others.

[sparkeler]

I would suggest you have an hiv test to ease your fears.  You were entirely safe in your sexcapades, but there were a couple of times when the condom slipped.  Getting tested is really only the scariest part.  If you don't, I have a feeling that every symptom that you experience in the future, you will have it somewhere in the back of your mind that its due to hiv.  I don't think you should ask the doctor whether or not he agrees that you should not be tested.  It should be a personal choice.  It seems like your looking for reassurance that you don't have it.  He can tell you don't.  But to actually see it in the test results is a different thing.  That's the ultimate relief.  And believe it or not, you will be glad you did when it's all over.  Again, it's only a suggestion.  I have a feeling it will help put your mind at ease in the long run.

[Please Help Me - Really Depressed]

Thanks so much sparkeler, i will muster up the courage to get it done. what do i say when i go to the doctors. do i just say i want an HIV test and STD test? can i go to a walk in clinic to demand this kind of test? is there certain ones i should be tested for.

Thanks again.

[sparkeler]

Thanks for the thanks.  I only suggest this to you b/c I had a long battle with irrational fears of hiv.  It began when I was 16.  It got so bad that I wouldn't get out of bed b/c I thought I was dying of hiv.  I even asked people I barely knew if they thought I had it, (now if that won't send somebody running in the opposite direction, lol.) Everything I experienced was hiv.  I was scared before I even had actual sex.  I had everyone in the world tell me I was crazy. My friends/family would tell me I didn't have hiv but I couldn't convince myself.  I had to get tested.  Believe me the first couple of times I got tested, even the doctors thought I was nuts b/c of the way that I was handeling this fear.  I  asked them to just have me committed instead of telling me the bad news.  I had no clue how approach the situation or the subjuect.  Through the years of intense therapy, (this by the way wasn't the only thing I obsessed over) I finally learned to accept it as a fear and thats it. But you have to have the courage to look at your fear straight in the face. I don't let it control me or turn me into this crazy girl.  The best way to go about it is to say to your doctor, "I'd like to be screened for std's and hiv."  You don't have to give him a reason, but, if he asks just say "No reason other than I feel like it's the responsible thing for me to do."  That's it.  Because it is responsible and rewarding in the end.  And so you don't obsess over your health or your wife's.  Good luck.

[sparkeler]

Just to add they will usually test you for chlamydia, ghonnorea, and syphillis in the std screening. You have to ask for hiv and I believe herpes test.  If you choose to get a herpes test ask for the herpes select type test.  If you don't have any symptoms of herpes, (i.e., visible sores) then you could leave that one out.

[Please Help Me - Really Depressed]

going to be married soon. since i've been with my gf i have not once cheated. all these concerns were in the past, and i always have had safe sex, always used a condom.

[Brian123]

In regards to your anal warts/anal fissure...

I understand your plight. Nontheless, here are some factors to consider based on my past years experience with Dermatologist/CR Specialist:

Anal warts:
(1)More than often they occur in the perianal area (outside of the rectum) and are around the anal area.
(2) Rectal warts, unless they are causing bleeding and/or obstruction of passage of stool, should not be removed. If you are having these symptoms, contact your CR Specialist. Most internal warts go away with time.
(3) Heterosexual males and females may contract anal warts by the usage of insturments (such as sexual toys,etc. ) if the opposing partner has/had them. Plantar warts and warts on the finger(s) are not transmitted to the genital area. HPV caused by genital/anal warts is only transmitted by genital warts. Extensive research has shown that there are over 100 types of HPV....nonthing that cannot be resolved without the use of such creams as Aldara or cryotherapy (freezing).

Anal fissure:
(1) caused by trauma to the anal region (due either to sexual stimulation or poor diet).
(2) Can be relieved by increasing your water intake (AVOID caffeine and caffeinated beverages (sodas, coffee, etc.)  These work as diaretics..they draw water from your stool when passing. MY ADVICE....drink 6-8 glasses of water a day. You need to increase your fiber intake as well. 22-30 grams of fiber a day is plenty.
(3) The skin tag you are referring to is called a "sentinel tag", caused by the healing of your fissure.  This is nothing abnormal. Most individuals with anal fissures have a sentinel tag.
(4) Do NOT force yourself to go to the bathroom. Use the facilities when needed and do not force the stool....this will only cause more trauma to the area.
(5) Products like Metamucil/Citrucil are helpful....but you need to see what works best for you.
(6) Since you have had an anal fissure, you are more prone to get them in the future if you do not wath your dietary habits.  

Good Luck.

[Please Help Me - Really Depressed]

Thanks to all your guys support, really appreciate it.

[H. Hunter Handsfield, M.D.]

"So in conclusion, based on my exposures and risks, I was at 0 risk from HIV or any other STDs apart from the anal warts I got, and I should just forget about all of this and don't need any HIV/STD testing. DO YOU AGREE?"

Your risk is low enough that you do not need HIV or STD testing from a strictly medical or risk analysis perspective.  But sparkeler suggested, intellectual understanding of zero risk doesn't always translate into psychological acceptance.  If that applies to you, get tested for peace of mind.

HHH, MD

[shygirl1981]

thank you for your honesty and sharing such personal things. I have felt the exact same way as you before, regarding hiv risks and testing. completely terrified. I understand why you got freaked out when you gave blood a few weeks ago but I'm sure everything will be just fine!

[sparkeler]

Thank you.  Testing is never easy.  Even giving blood for the sake of saving a life terrifies me b/C it drudges up that old monster.  But learning to differentiate logic and fear can be easier said then done.  Especially when your giving advice.  I still have to tell myself to be rational.  I actually was taught exercises to ease my fears.  But coming on these forums actually helps me realize how irrational I can be.  It is very gratifying.

[Please Help Me - Really Depressed]

Thanks again for the post doc. I will try my best to put this behind me, however if I have troubles I will go get tested.

Just curious after reading certain websites. I read numerous times, and im sure you're fully aware of this and would have mentioned this.

I've read that if you have one STD, you should get tested for HIV as they can increase your transmission risk, is this true same for anal warts/HPV?

Also what about the other STDs, that sometimes don't produce any symptoms in men or women (especially in men such as Herpes, or syphilis) is that a concern? You have mentioned before that if you don't get any symptoms within a month, especially men you can conclude your home free?

Lastly with this added information, and my previous post on my risks/exposure, does this change your opinion in your previous replies to my post. I highly doubt it will, but as you can see any kind of reassurance is greatly appreciated for a person in my shoes.

Thanks, and GOD Bless.

[shygirl1981]

are you married guy?? why are you having such risky encounters, are you not being monogamous?

[H. Hunter Handsfield, M.D.]

Your username tells the story.  It's time to stop.  Good bye.

HHH, MD