Dr Hansfield advise please.

[anthonygonzalves]

Hi
26 yr old straight male Mauritian.
Many partners since age of 23.  
13 encounters ranging from models to sex workers and massage parlours and friends – all paid by my mentor who is now dead.  All one time sex only.  
-protected vaginal sex always and condom broke twice and slipped for few seconds once with CSWs in 2009-2010.
- 5 unprotected oral encounters among these in 2009-2011.
-negative all stds  2010.
Herpes test had been type Non specific elisa and it came out negative for IGG (tested same test 5 times) at 3,6, 8 months past exposures in 2010.
Also at 6 and 8month I had a type specific test available here in Mauritius (the only type specific test available – I asked everywher) and it came as :
IGG1= 3.1 and IGG2= 5.2,
Interpretation: POSITIVE > 15
negative for HSV 1,2


-2011 I had sex with only 3 girls
-one a CSW in September (all protected)
- one a friend in December (unprotected oral + protected sex)
- a girl with some body rub and a possible few seconds genital touch- No penetration
–no sores on their mouth or genitals.

3 months (March 2012) past my last exposure I am tested for all STDs (hiv, hep and all) including herpes with the type specific test available here and it came out negative for IGG 1 and IGG 2 (same test as described above  IGG1 =4.5; IGG2 = 5.1,…+ve is over 15).  I also had two non type specific test IGG came out as -ve.
I want to turn this page of my life and settle down forever in monogamy.  I am getting married in 2 weeks with the girl I have met and fallen in love with.  Waiting till marriage to have unprotected sex and build a family.  No sex yet.
I am lived a depressive time waiting to be clear and was on the brink of suicide.

Never had oral / genital sores in all these years and even in childhood.

Considering these results for STDs and herpes that I had and the fact I had no sores oral or genital ever, can I safely have unprotected sex with my to be wife and settle down without fear of infecting her with anything now?

[Edward W Hook, MD]

Actually, I beleive it is an anxiety post.  You keep thinking and remembering small details which are not relevant and need not concern you.  This does not change my opinion or advice.  

If you cannot stop worrying about this, my sincere advice is to speak with a counselor or mental health professional about your concerns as they are out of proportion to your situation and you are having toruble moving forward.  I say this out of concern for you.  To continue to worry is not a productive use of your time

There will be no further answers.  You need to move on, not continue to worry.  EWH

[anthonygonzalves]

Hello doctor

Am sorry i posted here again.  If you cannot answer then i will have to pay again and post.

THIS IS NOT AN ANXIETY POST.  ITS A DETAIL I MISSED ABOVE.

It is just one symptoms I remembered since 2010.  After broken condom incident in 2010 with CSW i took Post Exposure Propylactic drug same day for 5 days before i read it was useless.  I got the CSW and made her get same type non specific herpes test which came as negative.  I was scared at that time.  In the stress and while on the Antiretroviral drug, i got kind of 2 canker sores in my mouth on gums both up and down. It was a big white patch with redness around it and was below and above my teeth.  I made mouth washes with salt water and applied some benzalkolium chloride oral cream and it went away in around 10 days.. there was no blister or anything ever.

I also noticed a small miniscule red bump on my scrotums where hair grow after some 3-4 weeks. I had shaved the day before i saw the bump.  Saw no hair in it.  It was tiny and i popped it and rubbed/scratched it to create a wound which bled a bit.. I was in anxiety.  It healed and went away in 5 days maximum.  I didnt care much about it as i thought it was just a razor bump or something like that as i had shaved one day before i saw it.

These are all and the only symptoms that i can associate with whatever happened in all these years.  As said before, I tested negative for all and herpes also this year with IGG combined negative.  I never had any other symptoms ever.

I will really appreciate a last answer from you.

Its in relation to what I asked above.  If you cannot answer, please direct me how to ask it in a new post.

Im just one and a half week away from settling in family life.

Thanks again.  I will really appreciate if you will reply.  

Does this change anything here?

[Edward W Hook, MD]

Still no change in my assessment or advice. EWH

[anthonygonzalves]

Thank you doctor.

Last comment.

I make a last mention.  The burning urination in 2009, I had it for around five days maximum.  2 days without treatment and then 3 days on urinary alkaliniser and it was gone and forgotten. And I had same frequent urination and a bit of urethral pain (imaginary mostly perhaps) in 2010 also.  Did all tests and when it came back negative, i forgot about it.

I hope this does not change anything and I can get married and settle safely?

I wait for a last comment from you.

Thank you again.  I have no further questions or post.

Bye and take care

[Edward W Hook, MD]

None of this changes my opinions or recommendations.  Please don't worry.  EWH

[anthonygonzalves]

I was worried about herpetic urethritis mainly from above info.  But i confirm I never had any lesions.  

My burning urination lasted two to three days maximum in 2009 and had started around 3-5 weeks (not two months - I really do not remember) after condom slippage.  There was no discharge or anything else.

The frequent urination as from december 2009 lasted quite some time (around 2 months) before i was diagnosed with the debris in bladder which was preventing me from emptying it well.  And as you noted all my Herpes tests have been negative up to here.

Do I have anything to worry from all the information i have given?

[anthonygonzalves]

Thank you doctor Hook.

I should add a little detail here.  In september 2009, i had a condom slippage and penetration for few seconds unprotected.  After around two months i had burning urination which went away by drinking much water and taking citro soda (urine alkaliniser) for two days maximum.  

Then in december i had a little yeast infection (white dry patches)  treated with antifungals ...at same time i had some frequent urination which was treated with antibacterial tabs and an ultrasound had revealed some debris in bladder which cleared by drinking much water again.  In 2011 august I had frequent urination again and urine tests showed a higher WBC count and some epithelial cells.  I was put on Cipro and after some weeks all urine test came back to normal.

I wondered that this could be herpes here in the above details i said.  


Your answers sends me much reassured.  I never had chicken pox or varicella or all that.  Confirmed by my granny as well as my mother!

My tests are all negative (type non specific elisa) and type specific test available here also.  I have already spent a fortune here in these tests.

Just provide me a last insight about these details i given.  I am leaving that old life of debauchery forever now.

A.G

[Edward W Hook, MD]

Welcome to our forum.  As you probably know, Dr. Handsfield and I share the forum.  You got me today.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.  I'll do my best to help.

If I may summarize my understanding of your post, you have had a number of sexual encounters over the past 3 years, most protected but some unprotected, with commercial sex workers.  You are particularly worried about herpes and have been tested with the tests available in Mauritius and want to be sure that you do not have an STD that you might pass on to the woman you plan to marry.  Further, you have noted that you have not had typical STD symptoms including sores.

Assuming that my summary is correct, I have several comments.  As you probably know, we do not recommend testing for HSV using non-specific tests for HSV antibodies.  The reason that we recommend against these tests is that they can often be positive in persons who do not have herpes due to cross-reactions with antibodies to other sorts of infections (like chicken pox).   On the other hand, in your case your tests are negative.  A negative test is strong evidence that you do not have herpes. When this is considered along with the fact that you have not experienced symptoms of HSV I can comfortably say that it is most unlikely that you have acquired herpes in your previous sexual encounters and that you should not worry that you might give your wife to be a herpes infection due to your prior sexual activities.

I see no reason for further testing and urge you not to worry.

I hope my comment is helpful.  EWH

[anthonygonzalves]

No possibility for other herpes test for me.  That is the best test available in my country.  Impossible to get another test apart from type non specific test;(.

IGG in Type non specific test has always been negative.  Type specific test also always negative.  No sores oral or genital EVER.  Used condoms all times for vaginal sex. (apart from slippage few seconds in 2010 and breakage of 5 seconds in 2010.)