Very concerned about Herpes Acquisition

[extremelyworried109]

Dear Doctors, thank you for this service.  I've ready many of the posts and they have been very helpful.  I’m concerned that I acquired an STD, principally Herpes.  

I’m a male and had two encounters with CSWs at an upscale strip club in South America.  The first encounter on 8/16/10 included unprotected oral sex followed by protected vaginal intercourse.  A second round of sex began with a brief moment of unprotected vaginal intercourse (I inserted my penis briefly, pulled out and put a new condom on and continued with vaginal intercourse).  This was followed by unprotected oral sex performed on me.  The second encounter was on 9/3/10 and included protected vaginal sex.  I don't recall receiving oral sex, but may have briefly. I’v had a great deal of anxiety but have noticed several physical symptoms.  On 9/13 I developed a rash in my groin folds that persist to this day. On 9/17 my GP said it looked like jock itch and prescribed an anti-fungal cream.  My GP ran Herpes I & II igg, HIV Antibody and syphilis test all came back negative.  I know tests were early, but should I be encouraged by these results?

I also had tiny pimples appear on both inner thighs.  Some close to my groin fold.  None are clustered together on a red rash; most appear individually set on a small pink/red area of skin.  I also have a few scattered lower on my inner mid-thighs. A first group of bumps developed in my inner thigh and went away immediately.  A week later a second group of bumps developed in about the same area and immediately went away. I also noticed a few similar bumps on my right hip.  Most of them have a long hair coming out of them.  Makes me believe that it may be infected follicles, but location and timing concerns me. Would herpes present on a hair follicle or with hair through it.  Would they come and go that fast (same day).  I also have persistent soreness in both thighs and upset stomach since mid-September.

Does this sound like herpes or other STD?    

[Terri Warren, RN, Adult Nurse Practitioner]

STOP CHECKING YOUR GENITALS.  You can really irritate your genitals if you are inspecting too carefully, and confuse the picture.

LabCorp doesn't use the brand HerpeSelect, but their test is fine and as accurate.  It is a good sign, yes.  
I think it is safe to rule out Hepatitis B and C and syphilis, and probably HIV.  The herpes test is likely 80% accurate at 2 months out.  I like 4 months, 16 weeks.  

Its good that you aren't seeing anything, but what matters are test results.

Terri

[veryworried109]

Hi Terri, thank you for your reply.  The pimples in my inner thigh seem to have gone away but the irritation in my groin and inner thighs are still there?  Could be do to my compulsive investigation of the area?  I've been checking the area repeatedly on a daily basis since my last exposure.    I also have a pilonidal cyst.  Can this be creating some of my symptoms?

I tested again on 10/28 (10 weeks post 1st exposure and 8 weeks post 2nd exposure).  All tests came back negative.  I did my tests through LabCorp and the results are as follows:

HIV 1/0/2 Abs-ICMA
HIV 1/0/2 Abs-Index Value <1.0
HIV 1/0/2 Abs, Qual - Non reactive

Chlamydia trachomatis, NAA - Negative
Neisseria gonorrhoeae, NAA - Negative

HSV1 and 2 - Specific Ab, IgG
HSV 1 IgG, Type Spec <0.91 (Negative)
HSV 2 IgG, Type Spec <0.91 (Negative)

RPR - non reactive
Hep C Virus Ab <0.1
HBsAG Screen - Negative

1.  Can I rely on these tests from LabCorp?  
2.  The herpes tests was not herpeselect (they said it was ELISA), but they appear to be type specific and both negative?  Is this a good sign?  Is this reliable?
3.  Are there any STDs that I can rule out at this point?
4.  Are there any tests that I should re-perform at 12 and/or 16 weeks or later?
5.  I've been meticulously checking myself and I have not yet seen any lesions, blisters or pimples on my penis shaft or head?   Is this a good sign this far out from my last exposure?  

    

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, you should feel encouraged by your negative antibody test a month out.  
Most people have tiny pimple on their thighs from time to time, and many people have folliculitis from time to time on their body.  Herpes can show up on hair follicles, yes, but if something is present ONLY on hair follicles, that suggests folliculitis rather than herpes.  I don't believe the persistent soreness in your thighs or upset stomach would have anything to do with having a herpes infection.  And the rash in the groin also sounds like jock itch to me. If you are still worried in 3 months, test again, just to be certain.
Terri