Anal rimming

Doctor,

I wrote a few days ago about a massage parlor experience
and really appreciate your response.  I am a 44 year old male.

Reason I am asking another question is subsequent research
on the site led me to realize the same encouter may have
exposed me to another risk.  Basically, around the time of
encounter, i had some rectal bleeding after defecating.
This happened before, not after.  This happens sporadically
and when I told my doctor about it last year, he said it
was a hemmroid.  However, I am not really certain whether
it was a hemmroid or anal fissure.  In any event, I remember
bleeding a bit after a bowel movement about four or five hours
before the encounter.  I was very well washed down there
and did not feel any blood afterwards.

The girl engaged in pretty extensive licking and fingering
down there.  I know the fingering carries no risk, but
does the licking based on what I have related?  Does
it make a difference whether it was a hemmroid or fissure?

Bottom line question I want to ask -- is my risk of a
STD still in the "hit by lightning" category or would
you recommend being tested at a few intervals. If so, for what
and when?

I'll have my annual physical soon --- blood and urine tests about 3 weeks after the encounter.  If it were you would this be
enough if I was symptom free.

In your other response on anal fissures you recommended not
allowing this due to risk to the female -- I assume the
same is also true for hemmroids?  Either way, I won't do it
again.

Chuck

[H. Hunter Handsfield, M.D.]

The "hit by lightning" risk still sounds about right.  If a person is anally exposed to an STD, I am unaware of any difference in risk based on presence of either a hemorrhoid or an anal fissure; in theory, the risk of acquisition may be a little higher.  But it still remains very low by rimming (oral-anal contact) or by hand-to-anus contact.  When it comes to rimming, the orally exposed person is at far greater risk for significant health problems than the anally exposed one; I hope the massage parlor lady has been immunized against hepatitis A and B, for example.

I wouldn't worry about HIV any more than after your previous thread.  But if you want to be maximally safe about other STDs, tell your provider during your upcoming annual exam and request rectal tests for gonorrhea and chlamydial infection.  But it will be very surprising if the results are positive.

Good luck--  HHH, MD