Herpes or HPV- not so casual contact- HELP PLEASE

[idiot grande]

Hello,

Big idiot move. 31 days ago I went and got a massage from a woman.  We both were nude. I rubbed her vagina on the outside only with my hand.  She rubbed my penis with her hand and rubbed my penis between her breasts. I never touched my penis to her vagina or mouth.  

I am freaking out that I may have caught something by touching my penis after touching her clitoris.  I took a urine test from my doc for chlamydia and gonorrhea that came back negative. My penis has been hurting and I have had the urge to urinate frequently. (I  went on Zoloft 1 week ago because I was freaking out so bad). I was pretty confident that this was psychosomatic due to guilt until this morning when I noticed a tiny bump on the underside of the head of my penis. It is not red, but more normal color to a little darker.

What are the chances I got a STD? I am married and racked with guilt, but this would be the end of me if I gave something to my wife.

Thanks. I appreciate your time.

[JohnnyV]

Hi,

Thanks for adding that one detail. That's right. And in addition, it's important to point out that the 7% rate is probably bogus; I included it with the intention of talking about the faulty logic of how they came up with it. Out of 100 people who tested positive, 7 claimed that they had only had oral sex and had no other risk. I believe one or two even claimed that they had only gotten sucked. Anyway, it's likely that they lied because they were embarrassed to say they had gotten topped without condoms; the stigma with anal sex is much greater.

The second study is much more reliable, because it took hundreds of people who only practice oral sex, and who claimed as much when they were still HIV-. Even after thousands of hours of sucking and getting sucked by HIV+ partners, not a single infection occurred.

So of the two studies, 0% risk for all kinds of oral sex (sucking or getting sucked) is probably much much closer to the truth than "7% of infections due to oral sex."

Thanks again, hope that clarifies it a little.

J

[idiot grande]

Thanks. This is def a sign of a larger problem. I disclosed what happened to my doc and I am going to find a therapist. I think I have an unhealthy addiction to sex. I went to a few SA meetings a year ago (on my lunch hour) and felt really great after I left there.

[idiot grande]

I did notice the next day that there was a spot on my penis that had been rubbed a little raw.  I was fine basking in my guilt with irrational worries, until I saw the bump this morning, that I believe is new. Now I am, in my own mind, quasi-legitimately freaked.

[idiot grande]

Thanks.

[SeattleMan]

Dear Doctor:

I know this is crossing-the-line somewhat, since I have my own thread, but I'm not sure that you are able to read my latest question under "WBarry 09/26/2005".

Basically, I've gone to four places, and they have rejected my request for PEP.  I don't know what else to do now to ward off HIV infection.  I'm desparate now and would do anything.

Idiot Grande:  please forgive me for jumping on your thread.  Sorry!

[H. Hunter Handsfield, M.D.]

IG:  Most apparently traumatic genital lesions ("rubbed raw") are not actually traumatic; many cases are herpes.  Not to alarm you, of course; this depends in part on STD risks during your life--and if it's herpes, you didn't catch it at the encounter you describe.  But you may want to get it checked out by a health care provider familiar with STDs, such as your local health department STD clinic.

WB:  The exposure you described doesn't come close to meeting accepted criteria for PEP; I wouldn't recommend it either.  Anyway, PEP has no value unless started within 72 hours (preferably 24 hours) of exposure.  Heck, you don't even meet criteria for being tested for HIV, except to the extent that the negative result will help calm your fears and anxiety.

HHH, MD

[SeattleMan]

that explains why four places slammed the door in my face.

[idiot grande]

Dear Doctor:

About the rubbed raw comment, this would have been within 24 hours post visit, so I am not too concerned.

At the STD clinic, do you think that they would likely be able to identify the bump I have? Or rule it out, even if it is very small and appeared this morning?  

I am sick over this.

IG

[idiot grande]

That last comment was to the Doc.

[H. Hunter Handsfield, M.D.]

Yes, that's what STD clinics do.  Public health STD clinics typically offer the best expertise in STDs in most communities, even if their clinics usually aren't fancy; the care is highly confidential and sensitive to alternative lifestyles; confidentiality is taken very seriously; and the cost typically is low, often free or they request a small donation.  The occasional downside is that some are funded on a shoestring and some services aren't as routinely available as I would like (e.g., herpes blood testing).  But they almost always are a good place to start when someone has an STD concern and is not confident in his or her own doctor's expertise in STD, privacy standards, etc.  If you need services they can't offer, such clinics usually know which providers in town are knowledgeable about STDs.

I am aware the "raw" spot came on immediately.  I still think you should ask the STD clinic their opinion about that lesion as well as the penile bump.

HHH, MD

[yoy]

I hope all is well- I too have faced the anxiety of a similar bad decision.  I struggle with it, when the urge hits.  ONe day at a time.  Just a warning for those in a similar position.  The advice you recieve here may help calm those fears over your choice now.  However, when the urge hits again you may use the information to rationalize that it is ok to engage in this activity.  YOu may say my risk from the last time is zero and 0 x another visit is still zero.  Will that be enough to keep you anxiety of STD in check for a return trip?  I don't know, but the guilt and anxiety from other issues, loyalty, cheating, losing respect etc, will still be there.  At that point be ready to make a choice and stick to it.  Is this something I want to do, even it the risk of infection is zero or next to zero?  That is a different question than the one you face now.  Be prepared for it.  I'm not making a judgement on whether the activity is right or wrong, that is for the individual to decide.  My advice is to be prepared when you are faced with the choice and now the risks you did not know before.  

[Imdumb]

Pretty much the same story as several other threads.  no one gets STD's of anykind that way.

Your guilt is being focused on STD's because you know the only way your wife will find out is if you bring home an STD.  You can't get an STD that way.  I guess sceinece will say it would be possible if you got some heroes virus on your hand from an open sore and wiped it on your penis, but come on..theory and reality are two different things and I bet in 30+ years the Dr. have NEVER seen it happen.

You need to find a better way to resolve your guilt.  After I had protected vaginal and unproteced oral, I felt the same as you.  I got negative tests at 6 weeks for STDs and 12 weeks for HIV.  I then resolved my guilt through counseling.

[Imdumb]

I hope you take what the Doc said to heart. Not only would he refude you PEP, but he doesn't even think testing is necessary.  I hope hearing the same message over the last 2 days is enough. I suspect it won't be though. Get tested at 6 weeks with oraquick. You will be negative and hopefully can move on. There is a reason you are refused PEP. They only give it to people who had an actual HIV risk. Which yoy did not. Be well my friend and stay away from the hoochie mommas.

[SeattleMan]

Then why do I feel "yucky?"

[Imdumb]

Not because of HIV.  My guess is guilt.

[SeattleMan]

Okay, I know that I'm not going crazy, and I consider myself to be pretty intelligent overall.  But something is not registering in my brain.  Thus, far I have done the following:

**Called California HIV hotline, GMHC in New York, and Minnesotta HIV hotline.  All of them say, ZERO risk...unless woman was bleeding in the mouth (which was not the case).

**Called City Clinic.  They said that I could come into for testing, but that they would not test someone based on that one exposure.

**Went to four ER for PEP, and turned away.

**Call PEP Counselor in San Francisco, and they said "no need for PEP."

I'm prepared to accept the fact that there was no blood in her mouth.   Where is the documentation, however, that saliva (by itself) does not infect?  Am I missing something?

[Imdumb]

So far every expert you have talk to says "no risk"..a bunch of other people who have had similar experiences and have done research say "no risk".  Here are a couple more:


From the SanFancico City Clinc - ground zero for HIV prevention

http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp

Notice HIV is not listed for the "receiving oral" column?

And here:


http://www.aidspartnership.org/faqs.shtml#link11

Notice saliva is not listed as a transmission risk?

Go to www.thebody.com - they also have other links and research.

I know you will still be worried, so get tested.  It is the only thing that will get it out of your mind - even though you have zero chance of HIV infection.

One question though - since we do know people do from time to time get HSV -1, syphilis, gonnerrea from unprotected oral - and I assume if you got that you finance would bolt on you - why aren't you getting tested for for those.  The risk of getting those is very low as well, but at least it has been known and documented to occur - unlike the HIV issue that consumes you.

[SeattleMan]

Good point, I'm going to set up a testing for those STDs as well.

[JohnnyV]

Hi,

I have to start with the usual disclaimer that "I am not a doctor." BUT I have come across some information about your saliva question. I'll share it as long as you promise not to freak out, and be patient enough to read all of it:

There has been a great deal of scientific interest in the mystery about oral sex. It is a "mystery" because oral sex involves multiple possible bodily fluids coming into contact with permeable tissue, yet it rarely results in HIV transmission. There is not only saliva but of course precum, semen, vaginal secretions, possibly blood. The back of the mouth, the gums, the throat, the vulva, and the meatus are all potential sites where, in theory, the microscopic virus should be able to survive and travel from the infected partner to the uninfected partner.

Guess what -- it almost never happens, even to the person sucking on a penis. Scientists have wondered, how can this be possible? They did multiple studies. What they found was that saliva, even though it contains the virus, seems to have agents that can block the reduplication of HIV, so it can't reproduce enough to travel from an infected person's fluids into the vulnerable tissues of the uninfected person.

None of this is scientifically confirmed. It is all speculative. But it seems to make sense. The mouth deals with bacteria and foreign pathogens all the time, unlike the vagina and the anus. Biologically the mouth, and particularly saliva, is designed to block foreign antigens or neutralize them so that they cannot infect us. So it seems that saliva's neutralizing power freezes HIV in a sense, and won't let it move around enough to travel. Even with ejaculation, it is rare for someone to be infected with HIV.

Two studies in San Francisco came up with totally different conclusions about HIV and oral sex. One study found that 7% of gay infections with HIV were the result of oral sex; this was concluded by looking at the risk behaviors that people admitted to engaging in when they tested positive.

Another study identified several hundred gay men who only practiced oral sex, and tracked them for a while to see how many got infected with HIV -- none became infected, even though they engaged in thousands of hours of oral sex, swallowed the *** of known HIV+ partners, had sore throats and open sores, and never used condoms. The conclusion was, cautiously, that all forms of oral sex posed a 0% risk.

But this is highly controversial from both sides. Some scientists believe that self-reported data is misleading because it overreports the risk of oral sex. Here's why: gay men are more likely to claim they only had oral sex and to deny having unprotected anal sex because of the stigma attached to the latter. So the 7% oral-infection rate looks suspicious; many of those people probably had anal sex and didn't want to confess it to the testing center.

Other people say that the 0% rate could be much higher, because so few people only engage in oral sex. If someone has been having many kinds of sex, how do you know they caught it orally or vaginally, for instance? That's one reason that the "zero risk" for receiving fellatio remains a claim that no scientist will support without reservation. There could be a handful of cases where people caught HIV from getting sucked, but because they had other kinds of sex, health officials failed to attribute it to that practice.

Dr. Jeff Klausner has also pointed out that there is no evidence that cuts, sores, sore throats, or bleeding gums increase the risk of HIV in any direction during oral sex. People may believe so, based on theoretical models, but no data can support that claim.

This explains the difficulty with the data. As you can see, it's impossible to know exactly what invisible mollecules do in the heat of sexual acts that we can't monitor with microscopes. But everything the scientists have found points to two safe, though not perfect, assumptions:

1) Oral sex of all kinds poses a low risk, possibly as low as zero.

2) A male who gets sucked is theoretically AND documentedly at the lowest risk of getting HIV, probably zero.

3) Since there is no other explanation for the mystery of low risk during oral sex, the clearest conclusion is that the blocking power of saliva checks the infectious power of the virus, even though saliva itself contains small titres of the virus.

J

[SeattleMan]

Sick of freaking out.  I'm jsut going to get tested at the appropriate time.  Cannot allow this to interfere with my life in general.

thank you

[Imdumb]

John - I think it is important to point out that the "sucker" is known to be at some risk - but the "suckee" is not known to be at any risk.  The 7% rate that they cite if for recetive oral, not insertive.  As far as what I have read (and I am not a Dr. nor do I play one on T.V.) the insertive oral poses no documented HIV risk.  It is theorectical since if someone bleeds in from the mouth profusly from bad gums, then all the sceientics speculate it can happen.  But is hasn't yet to any measurable and statisical degree where your average dude is going to get HIV from your avergae girl (prostitute or not).

Bottom line - if you have a lot of unproteced oral from anyone -and continue to do so get tested once a year.  If you had it just a few times - forget about HIV.  If after unprotected oral you have discharge, blisters or sores show in in a few days - get tested and treated.  If not - forget about it.  If you have oral with a rubber - forget about it.

[anonymous9999]

Hi JohnnyV,

I appreciate your response the other day...if u remember me....the can't afford 10 dollar guy....I am really sorry for posting my problem in somebody else's thread....is there any other way I can reach u....a chat id or email id.....I really appreciate it.....

Thanks a lot...
anonymous9999

[H. Hunter Handsfield, M.D.]

You cannot get herpes, HPV, HIV, or any other STD from hand-to-genital contact or breast-to-gential contact.  I cannot comment on the penile bump, however.  Genital wart sounds possible, but if you have a wart, you can be confident you didn't get it from the encounter you describe.  If it persists, you should see a health care provider to check it out.

Good luck---  HHH, MD