Increased STD risk due to jock itch and razor cuts

[stillworried2012]

Dr. Hook and/or Dr. HHH,

First things first, THANK YOU very much for this forum, it is such a valuable resource!
Here is my case: In November of 2011 I met with two different CSWs; earlier this year (summer 2012) I met again with one of them. In all cases I had protected vaginal intercourse, but in one instance (back in November) I also received unprotected oral sex. At the time of these encounters (all three of them) I used to have a case of jock itch on my inner thigh/groin (now resolved). I have never noticed any serious irritation (or bleeding) due to this fungal infection, but I was wondering if the presence of an irritated skin may have put me at a higher risk of contracting any STDs in case some of the vaginal fluids or saliva came in contact with my groin area. I also may have had a few razor cuts at the base of my penis.
I am particularly concerned about HEP B (mainly because I am not vaccinated against it), mouth HPV (deep French kissing was performed in all cases) and genital HPV……and yes, why not, any other STDs you can possibly think of ; ) For all of this time I have not had any STD symptoms and I am still asymptomatic. I have spent hours reading your posts and based on what I learnt on this site I am quite sure that I already know what your recommendation will be. But anxiety is a strange beast and I would truly appreciate it if you could provide some reassurance. Many thanks!

[H. Hunter Handsfield, M.D.]

Thanks for the thanks. Take care -- and try to stop worrying so much.  This really isn't a high risk situation.

[stillworried2012]

Thanks for your help (and patience : )....I truly mean it!

All the best,

[H. Hunter Handsfield, M.D.]

I understood everything you posted.  This doesn't change my opinion or advice.  Of course you are free to be tested if you wish, if hte negative results will improve your confidence.

[stillworried2012]

"It is rarely necessary to be tested after any single exposure, and I see no need for you to be tested at this time, especially since the reported exposures were condom-protected"

To be exact during one of these three encounters I also received unprotected oral sex, but based on what I have read from your previous posts this is also considered to be a form of safe sex (with minor risk of contracting clhamydia, gonorrhea, and NGU). Does this change any of your opinions on points 1) through 5) ?

Thanks!

[H. Hunter Handsfield, M.D.]

1) It is rarely necessary to be tested after any single exposure, and I see no need for you to be tested at this time, especially since the reported exposures were condom-protected.  A wiser strategy is for all people who are sexually active and non-monogamous to be routinely tested on a regular basis, like once a year, and to ignore individual exposures unless especially high risk (e.g., a known-infected partner).

2) There is little or no risk of transmitting any STD to your regular partner.

3) Many STDs remain asymptomatic for years.  But that doesn't change my overall opinions or advice.

4) HPV usually clears up on its own, without ever causing important health problems.

5) If I were in your circumstance, I wouldn't be tested and would continue unprotected sex with my wife without worry.

[stillworried2012]

Thanks for replying so quickly Dr. HHH. I truly appreciate your help and do feel relieved. I am in a committed relationship and (despite my repeated escapades) I truly love my partner. For this reason I feel compelled to ask a few more questions:
1) I am not planning to get tested at all. Do you think this is a wise choice and do you support it?
2) Since the time of my last encounter (August 2012) I have remained asymptomatic and have only had sex (unprotected) with my partner. Should I have any fear of transmitting her any STDs?
3) How likely is it that STDs (especially those I may have been exposed to) will remain asymptomatic for a long period of time (e.g. one year or more)?
4) Will HPV (any strains, even those that cause throat and genital cancer) clear on their own after a couple of years (both in me and my partner)?
5) The final million dollar question: if you were in my situation, knowing what you know about STDs, would you be worried at all about any possible infections (or the possibility to get anybody else infected) or you would simply leave these worries behind and move on?

I will not ask you any other questions after these; therefore, thanks again and happy holidays!

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question and for the advance thanks about our service.  And thanks to for reviewing the forum for questions similar to yours.  I'll bet you have indeed predicted my response.

Responding first to the title you chose, "Increased STD risk due to jock itch and razor cuts":  Probably there is no increased risk for HIV, and little or no for other STDs, from such superficial skin lesions.  Exposure of skin cuts, rash, irritation, etc is to blood or infected body fluids is often cited as a risk factor for HIV.  However, this is largely theoretical; in the real world, there are few if any known cases in which such transmission ever happened.  And thats after billions of exposures around the world during the 3 decades of the known HIV/AIDS epidemic.

Now, having read the details, that remains my response with regard to HIV and other blood borne infections, including hepatitis B.  And while I can imagine there might be a slightly increased riks of HPV or HSV, these too must be exceedingly rare.  In my 40+ years in the STD business, I have never seen a patient with either of these infections that appeared to be acquired because of preexisting rash, eczema, razor cuts, etc.

You were wise to use condoms for the vaginal encounters and trust you will do so again if and when similar situations arise.  Keep it up and you can expect to remain free of any STD consequences from such exposures.

Best wishes--  HHH, MD