Rectal concerns

[haden]

I am a 24 year old gay male. About 5-6 months ago I briefly engaged in prodected anal sex. I was the reciever. At the time that person stated they were disease free. About 3-4 months ago I was was rimmed by another male who I am still in contact with and swears that he has tested negative for all STDs. I have tested negative for most but not herpes.

I am concerned and almost convinced I have herpes. I have not shown any signs of cold sores or sores/blisters on my genitals but about two weeks ago I found a red bump on my right buttock. a little over a week ago I saw another one right next to it. There does not appear to be any clusters not open sores or scabbing. I have had no other flue like symptoms... etc. I have been applying bacitracin for two days and the spots are seemingly going away and can't be felt but I can still see them. About a day or two ago I have been experiencing some minor to moderate discomfort around my anus and rectum. There is no real itch but a burning sensation and from what i can see on white/skin colored growth. There seemed to be purple skin around the anus but that is gone and it is more red than anything. I have been applying a hemorrhoidal cream for about a day and that helps the irritation but not forever. I am sure this is herpes, but have no insurance and don't ha a gp. I don't know where to get tested.

I would like to get this confirmed soon, but if it isn't herpes than what else would it be? I don't know of a lot of options for me to get multiple tests and don't have a regular dr who can see me.

[H. Hunter Handsfield, M.D.]

Herpes symptoms are highly variable, even more so in the anal area than on the genitals or mouth. Your STD risk from the exposures you describe was low, and as best I can tell from your description, herpes is an unlikely explanation for your symptoms, especially since red bumps (mostly acne or folliculitis) are extremely common on the buttocks.  Anal itching is a very nonspecific symptom, and I do not know what to make of the "white growth" you see.  Most likely you have nothing sexually acquired, but syphilis, chlamydia, gonorrhea, and anal warts are remotely possible.

Bottom line:  You definitely need to see a health care provider.  Most larger towns in the US have one or more providers who have particular experience with gay men's health problems; word of mouth from gay/bi friends might identify a knowledgeable, lifestyle-sensitive provider who would provide excellent, reliable care.  Alternatively, visit your local health department STD clinic, where the care will be confidential, expert, sensitive to lifestyle issues, and likely free or very low cost.  But do it soon.

Best wishes--- HHH, MD

[haden]

I should add that i've never had a herpes test. i don't know where to get one.

[tfe]

I'm not the doctor, but I've been in your boat (gay male here, too). It is possible that getting "rimmed" may transmit oral HSV1 to the area in question, but the symptoms that you describe don't jump out and immediately suggest herpes. You should check out the FAQ and other posts. However, breifly, herpes manifests itself as clusters of open sores that generally start out as raised red bumps (water-type blisters) which could tingle, be sore, or itch and after about a day they become open sores for a few days. Then after they crust up and go away, generally lasting anywhere from 1-2 weeks. (This description has been adapted from the dermatology forum here)

The discomfort you are feeling now, as was mine back when I had a window period after risky behavior, is likely due to hypersensitivity due to your mind conciously worrying and paying attention to the affected reigon.

If you're the receptive partner in anal sex (or have been recently regardless of protection), discomfort in that area wouldn't be uncommon, and you'd probably dismiss it (if you noticed it at *all*) if you weren't this worried.

I'd check with you state's department of health for some low/no cost herpes blood tests if you'd like to put your mind at ease. I'm sure the Dr. can elaborate on the types that you would need.

However, in my *UNOFFICIAL* opinion, what you have doesn't sound like herpes and sounds exactly like my situation -- increased awareness that blows normal occurences "down there" out of proportion. I'd try and relax (stress probably isn't helping you), follow Dr. HHH's advice and enjoy the new year! :)

[haden]

Thanks that's helpful... i will see what the doctor has to say. I have only had anal sex that one time and it was 5-6 months ago that is why i am concerned with this burning sensation now. I never did notice any crusting or blister though. just the red bumps. Thanks again.

[haden]

Thanks that's helpful... i will see what the doctor has to say. I have only had anal sex that one time and it was 5-6 months ago that is why i am concerned with this burning sensation now. I never did notice any crusting or blister though. just the red bumps. Thanks again.

[tfe]

Glad I could provide a bit of insight.

Herpes manifests itself differently (which is why a large majority of people don't identify symptoms are being herpes oftentimes), but given your history it doesn't sound serious.

In the meantime, don't beat yourself up =)