Could it be Herpes or Anal Warts?

[sleepless_in_san_francisco]

I got a hand job from a woman at a massage parlor about a week ago. She also inserted her finger in my anus during the process. Since then I have had a lot of gas and some minor pain (like an ache)  around my anus and prostate and into my testicles. I've also been a bit constipated this week. When I looked at my anus today I saw what looks like little purple grapes bubbling up around the opening. There are no scabs. Could these be Herpes lesions or Anal Warts? I have had hemorrhoids in the past, but I don't recall there being so many bumps. These do look a little bit like varicose veins. I'm worried that she could have had Herpes Whitlow on her finger and that it was shedding without any visible lesions. Is is possible to Herpes this way? I am very concerned that I could have Herpes or HPV.

[Edward W Hook, MD]

Welcome to our Forum  the exposure that you describe is no risk for acquisition of any STD. Her insertion of her finger into your anus is a form of masturbation. There is no risk of STD from masturbation.  The description o f the lesions at your anus are about as good a description of hemorrhoids as I have heard and your other symptoms are likewise suggestive of a hemorrhoidal flare-up.  I would suggest you treat them with and over the counter hemorrhoid medication.  There is no need for STD (or HIV) testing related to this exposure.

I hope this comment is helpful to you.  Take care.  EWH

[Edward W Hook, MD]

Straiht to your questions:

1. Please stop taking the acyclovir. There is no evidence that you have HSV.  Furhtermore, your symptoms really are not suggestive of HSV.

2.  At this time about 50% of persons with HSV would have a positive HerpeSelect test, then it would take up to 3 months for the remainder of infected persons to develop positve tests.  In your situation, I do not recommend worrying about HSV or further testing,  It will just delay focusing on the problems in a way that will help you to get them resolved.  

It is time for you to work with your docotor to address your symptoms.  Further worrying about HSV or other STDs will be of little benefit. Perhaps it is time for a visit to a proctologist.  EWH

[sleepless_in_san_francisco]

It's a week later, and I still have significant pain in my buttocks, prostate and testicles. I've been treating my hemorrhoids with Preparation H and Metamucil. I saw my primary care physician this week and he did a physical exam of my rectum. He said he could only see hemorrhoids and no lesions. He also thought that my risk is low for acquiring HSV2 in this way. I haven't had any lesions yet.

However, there is a complicating factor that I should mention. I've been taking some Acyclovir (200mg every four hours) that a Dr. prescribed after a previous massage parlor scare I had last year. I think I'm doing this just because I don't want to actually see a lesion (denial). A Herpes-Select test came back negative after the encounter a year ago and again 3 months later.

1. Is it possible I could have HSV2 but the Acyclovir is preventing a breakout?

2. It's only been two weeks since this latest encounter. Would an ig-G (Herpes Select) test have any validity at this point?

[Edward W Hook, MD]

1. theoretically yes. Neither I nor Dr. Handsfield have ever seen a case on over 50 combined years of STD focused practice.  It is not something to worry about.

2.  No this is 100% pure paranoia with no basis in reality.

You really need to stop worrying about the possiblity of having gotten an STD from the expsoure you describe.  EWH

[Referee16]

I have the follow on questions Dr. Hook.  I have seen multiple responses that say mutual masturbation is safe.  Thus,

1)  Is it possible to acquire HVS2 via mutual masturbation?  

2) If the the massage parlor worker touch a different individual infected with HSV2 or she was infected with HSV2 and had "dirty" hands and then masturbated the above individual could he acquire HSV2?