contracting anal herpes from a rim job

[canada123]

I have been HIV positive for almost three years now and have been on ARV therapy with an undetectable viral load and CD4 count of higher than 500 for two of those. While I know that makes my immune system mostly normal, I'm pretty sure I'm still at higher risk of various sorts of nasty viral infections, which is where I am phrasing this question from.

In the past two years, I have had sex with 3 people, two of which were in the past couple of months. All insertive activities were fully protected and there was full disclosure of my status prior to the encounters. The second last person I had sex with was a big fan of rimming, which he performed on me for quite a while before we had anal sex with me as the bottom. It was only afterwards that I found out he periodically gets cold sores around his mouth, with his last outbreak   in the early summer. After some research I learned all about viral shedding which definitely made me uneasy, even though he didn't seem to think it was that big of a deal. The last person I had sex with was um.... well, no other way to say it - he had an extremely girthy penis and I had to stop because the pain was far to severe. The two events were separated by three weeks but ever since having sex with the last guy (two weeks ago) I have been experiencing a sharp, knife like pain every time I have a bowel movement and on two days there was bright red blood both in the toilet and on the toilet paper afterwards. I have done a pretty decent self exam and when I spread the skin in the area I can clearly see what looks like tears, only contrary to what I've read a fissure should be like, there is more than one of them and they have a yellowish/white fluid around them located both at the front and at the back of my anus.

I'm wondering what exactly the risks of contracting anal herpes from a rim job performed by a person who gets periodic cold sores are and if what I'm describing sounds like herpes - given time frame and everything. I haven't seen anything that looks like blisters or pustules, but from what I'm reading herpes usually looks quite different when it presents on the anus.

I've made an appointment with my family doctor, but the given what I've experienced with the canadian medical system thus far, I'm not confident they will be able to tell me much... family doctors offices here can't even request any sort of STD testing or culturing and if it's a fissure the STD clinic won't even see you. Very frustrating.

[gracefromHHP]

Chances are good that most of your partners have had at least hsv1 either orally or genitally and over half of them have had hsv2 if you go by the stats for homosexual males.  It actually amazes me that even in canada you still haven't ever been tested for herpes since there has been some terrific research published over the last several years that shows the importance of controlling hsv2 in hiv+ folks.  I know - I shouldn't be surprised but I am ( and dismayed ).

At this point getting yourself examined is the best idea.  Both lifelabs ( formally mds labs ) and gamma-dynacare labs in canada offer type specific testing. If your doctor seems clueless about ordering it -ask them to call either of those labs and find out how to get a blood test sent off to them.   Chances are good that you've had some internal tearing/fissures going on but following up on this is the best course of action.   They should also test you for bacterial infections anally as well.  

I hope that helps with your questions - if not feel free to ask more :)

grace

[canada123]

oh, and there has been no fever, chills, muscle pain or anything like that