Protected sex; lower back pain, sores, genital discomfort

I have had a few indiscretions with high-risk women.  Two very quick protected vaginal penetrations (lasting less than a minute each, if that), and a few protected oral sex incidents performed on me.  The last penetration occurred 3 weeks ago, and the condom slipped a tiny bit (as I pulled out I believe), and I am fairly certain all of the penis shaft that was inserted remained covered and I had no noticeable open sores on my penis shaft. The last instance (oral sex) occurred 2 weeks ago.  All instances, as I've said, were with protection.  No rips or major slippage of condoms.  At one point, probably two months ago (after the first protected oral), I got what felt like a flu. At of the end of last week, I started getting lower back pain and some lower abdominal discomfort.  I also had some testicular discomfort.  Just a general soreness, mainly in the right testicle. I don't believe I've had any discharge.  None that I can notice.  There was a slight bit of discomfort/ichyness at the tip around/in the hole for a day or so a week and a half ago, but that seems to have gone away.  I also must admit that I doused my genitals and penis with hand sanitizer after each encounter.  Possibly that caused the irritation? The urine is yellow, not discolored.  No fever, but general achyness, muscle soreness, tiredness.  I also do have IBS, and I have had some bowel irregularity and discomfort this past week too.

I did develop a lesion on my leg about a week and a half ago, which has mostly healed now, but I think that was a mosquito bite.  I also have a little lesion on my gums where the tooth meets the gum, but that may be from over brushing and holding listerine in there too long.

Do I have anything to worry about?  About HIV?  Syphilis?  Chlamydia?  Gonorrhea?  Should I get a full STD panel?  Or am I worrying for nothing since I used protection that did not fail.  I don't want to ruin my life, or the life of my wife or child.  I don't want to give my wife anything.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

It sounds like all your sexual exposures have been low risk for all STDs, given consistent condom use.  A liitle slippage is normal and doesn't significantly reduce protection.  It's even considered protected if the penis slips out of the condom during withdrawal, leaving the condom behind in the partner's vagina.

As for your symptoms, they are not suggestive of any STD.  Skin irritation or a little discomfort at the tip of the penis are not common STD symptoms, but indeed alcohol and other disinfectants very commonly cause exactly this sort of thing -- so that's by far the most likely cause of your genital symptoms.

As for the systemic symptoms (low back pain, abdominal pain, testicular discomfort), they also are not typical for any STD.  It is more likely that you just happened to pick up a garden viral infection; or are just having symptoms of your IBS.  If there is any relationship to your sexual exposure, I would suggest the possibility of genitally focused anxiety, which often causes the chronic pelvic pain syndrome with low abdominal pain that often radiates into the testicles.  (For more information, google CPPS -- spell it out -- and start your reading with the excellent Wikipedia article and/or the information provided by the Stanford University dept of urology.)

So based on your description of both the exposure and your symptoms, I see no need for testing.  Of course you are still free to do that if the negative results would reinforce my reassurance.  And if you have otherwise been sexually active and non-monogamous over the past year, testing once a year makes sense -- but not because of this particular event.  If you would like testing, I recommend you find a provider who understands STDs (e.g. your local health department or a Planned Parenthood clinic); don't do it through an online service that doesn't offer examination and clinical perspective.

In the meantime, you really needn't worry.  If you are tested at all, I expect all results to be negative.

Best wishes--  HHH, MD

[soveryveryworried]

Thank you so very much, Doctor.  You state "this incident."  It was actually a few different high-risk partners, but all protected as explained above.  But as I understand it, that would not alter your response any.  Correct?

Can I continue my sexual relations with my wife without protection, worry?

[H. Hunter Handsfield, M.D.]

"...as I understand it, that would not alter your response any.  Correct?"  Yes.

"Can I continue my sexual relations with my wife without protection, worry?"  No distant expert can guarantee someone is disease free.  If I were in your circumstance, I would continue unprotected sex with my wife without worry.  But I'm not you; you'll have to make your own decision based on the information I have provided.

[soveryveryworried]

Thank you so, so much Doctor Handsfield.

[soveryveryworried]

Starting on Tuesday morning, I've now had diarrhea/loose, watery stools for the past 3 days.  Could this be an indication of me having contracted HIV from one of these above-described experiences?

[eyeamsam]

Take out the experiences, would you think your symptoms are from HIV?  No, would you think you have cancer?  No.  Why not?  Because the symptoms are so common they could be due to anything - The food you ate, a virus or bacteria.  If you can't put it to rest, then get tested-If you get tested 4 weeks from last exposure(which protected sex both oral and vaginal is not an exposure for HIV)- maybe 50% of the test that will have a positive result will be positive at that time( the doctors can check my numbers)  if you can wait 8 weeks 99.9% of those that will turn positive show up.  You can buy the over the counter oraquick test at CVS for about $40.00 bucks.  Maybe that would put your mind at ease, but I suspect you would question whether you did the test right- so get tested-

[H. Hunter Handsfield, M.D.]

The additional information does not change my opinion or advice; and eyeamsam is exactly right.  

That will end this thread.  Try to move on without worry.