Very Bad Decision

[regret2013]

While on a boys trip and I was fairly intoxicated and made a bad decision.  6 days ago I went to an Asian Massage parlour in Phoenix.   I engaged in protected oral and vaginal sex with her.  The condom was placed on my penis and was fully extended to the base of the shaft before any interaction took place.  She started with oral then moved to vaginal which only last 2-3 mins max.  When finished the condom was fully intact.  Afterwards she grabbed some alcohol swabs and wiped me off as well as herself.    I attempted to touch her vagina and she politely asked me not too.  


This was my first and will without a doubt be my last visit to place like this.  I am happily married with  kids and am distraught at the thought of losing them.   I will get tested for piece of mind however I am looking for some re-assurance

My questions:
1. What are the odds of aquiring HIV and am I at risk?
2. What about other STD's such as gonnahrea, chlamydia, syphiliis, etc
3. I already have genital herpres so i am sure my mind is playing tricks on me as i always have subtle tingling and burning prior to an outbreak.  Currently my left testicle and left lower abdomen hurt. and I always seem to have to pee but it doesnt burn.  Is this cause for alarm?
4. What testing schedule should i be on?  After 6 days what test results can i be confident in?  Will 4 weeks be enough for HIV and syphiliis?

Thanks for your input Dr's.  You guys are doing an amazing job with this forum.

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment.  There is virtually no risk for any STI, including HIV from your misstep.  Most commercial sex workers do not have STIs and even most unprotected exposures do not lead to infection.  In your case, a condom was used and thus there risk, even if she was infected with something falls effectively to close to zero.  I would  not worry and from a medical perspective there is no need for any sort of STI testing.  

I should add that it sounds as though your partner is quite protective of herself and her actions, hence I think this suggests your risk for infection, already effectively zero, if lower still.

As for your specific questions:
1. What are the odds of aquiring HIV and am I at risk?
See above- virtually zero.

2. What about other STD's such as gonnahrea, chlamydia, syphiliis, etc
Same answer.

3. I already have genital herpres so i am sure my mind is playing tricks on me as i always have subtle tingling and burning prior to an outbreak.  Currently my left testicle and left lower abdomen hurt. and I always seem to have to pee but it doesnt burn.  Is this cause for alarm?
No, I suspect your senses are heightened due to your concerns and that you are noticing normal sensations that you normally overlook.

4. What testing schedule should i be on?  After 6 days what test results can i be confident in?  Will 4 weeks be enough for HIV and syphiliis?
See above, from a medical perspective there is no need for testing.  If you need to test, at 6  days tests for gonorrhea and chlamydia are entirely reliable at this time,  Testing for syphilis (rare, not  needed) would be reliable about a month after exposure and HIV testing using a 4th generation, combination HIV p24 antigen/HIV antibody test would be completely reliable but testing with a test which detects antibodies only would not be reliable until 8 weeks following exposure.

Again, please don't worry. From what you tell me there is no need to do so. EWH

[Jetwoe]

relax dude, trust your lab and trust your doc. I have never seen a doc replying the same answer 6 times. 6 free consultations, so consider yourself lucky. it is so obvious that you suffer from a sever anxiety right now, so maybe you need another massage, how about that? :) :) relax...

[regret2013]

Dr.

I wanted to send a note indicating that I had the duo test (p24 antigen and antibody) done after 33 days post exposure and it came back negative.   From everything You have said and all I have read lead me to trust my results are negative and trump any symptoms.  I believe you are 100% in agreement of this?

Thanks for your time

[Edward W Hook, MD]

This will be my final aswer.  

Since you choose not to believe my professional assessment, I suggest you go get tested,  If your symptoms were due to HIV, which I am confident is not the case, your test would be positive.,  Your test wil be negative. When it is negative, believe the result.  Your upset stomach and vomiting is due to something other than HIV.  EWH

[regret2013]

Dr.  

A few questions.  I am still fairly sick.  The chest cold I mentioned earlier is almost gone but now I have had some diarrhea for the last few days and am now unable to keep any food down for the last 2 days.  So I am experiencing vomiting and a sore body (muscle aches).  my tongue is white (thrush)? and the roof of my mouth is sore.  So naturally I am scared about HIV.  It seems I have had a lot of symptoms but my risk to exposure was low to non existent.

i keep reading other forum posts and the consensus is that protected sex runs me no risk for HIV. Other std's yes, but not HIV, assuming the condom is used properly.   How truly accurate is this?

  Since I have run myself down with lack of sleep, stress, anxiety, lack of working out, etc Plus many people i work with have been sick.  i probably shouldn't be surprised that I am sick.  The vomiting/upset stomach has me concerned as its falls on the heels of my other issues.    Is this cause for alarm?

With acute HIV are my symptoms not late since they started to show up around 22-30 days post exposure? (I have read from dr handsfield that the onset is rarely after 20 days)

I don't have a fever and isn't that nearly always present with acute HIV?

Do my symptoms concern you from a medical perspective or I making a lot out of nothing?

[Edward W Hook, MD]

The rash thet you describe is not typical of any STI, including syphilis, herpes or HIV.  If the rash were due to HIV, a HIV blood test taken just a few days after the rash appeared would certainly be positive.  Please donot worry, there is nothing here to suggest that you have an STI. EWH

[regret2013]

One last question Dr.

The rash that I developed on day 15 post exposure taht was present on the tops of my feet.  I described it as rash/sores are a 2-5 mm's in size and when scratched would sometimes scab over and when popped would have pus in them.  In the end they are like blisters.  Do i need to worry about HIV with this type of rash?    I am now fairly sick with a heavy chest cold/cough and I have a small appetite.  i know this can be due to stress, anxiety, lack of sleep, etc.  I know i used and condom and it stayed in one piece  and completely covered my penis, so i shouldnt stress.  

I am now 29 days post exposure and worry about the things i know the least about and can casue the most harm.

1.  Are my rash/blisters indicitive of HIV?  I read a rash from 2-4 works post exposure is normal?  
2. If the rash is HIV would i test positve even after 29 days?

[Edward W Hook, MD]

I suspect your current symptoms are unrelated to the exposure you have mentioned.  The rash on you tops of yor feet does not suggest any STI, including herpes and syphilis.  Same is the case for the sore that is in your mouth. These sound like a possible reaction to a drug, or perhaps some other process, but not an STI.

As for your specific questions:
1. is what i describe above characteristic of secondary syphilis?
No.

2. the timing of the rash is unlikely for secondary syphilis as you stated before.  But should i be concerned?
No, this is too soon for the rash of secondary syphilis.

3. does my taking of valtrex for gentile herpes have any effect on your opinion
No.

4. if i have a rash would i test positive for syphilis if i went now for a blood test?  (i do intend to go again this week)
Yes, if this were syphilis, your syphilis blood test would be positve at this time.  

I repeat- what you describe does not sound like an STI.  You should have a professional, preferrably a dermatologist, take a look.  EWH

[regret2013]

i meant 2-5mm not cm as the size of the sores.  

[regret2013]

Dr.

A agree that some of this could be irrational thought and anxiety.  I would like to update you on my situation and if you can provide any feedback that would be appreciated.  I am now 22 days post exposure

The rash on my feet that appeared 15 days post exposure has not disappeared.  The rash is only on the top and inside of my feet.  there are about 15-20 individual soars on either foot.  The soars are subtly itchy (at best) and about 2-5cm in size red to reddish brown and raised.  i have scratched some them and they have scabbed.  Others that i checked have a clear pus inside them when i popped them.  

The rash did appear 15 days post exposure and i didn't notice any chancre at any point.  As i mentioned in my first post i do have gentile herpes and i do take Valtrex regularly.  Around day 17 I noticed a red irritation on the bottom side of the head of my penis.  it generally went away after a few days but a red irritation is still there.  i am cautious as it may have been there for a few days prior to my rash but because i take valtrex i wonder about a chancre.  I now have a bad cold with a lesion/chancre soar inside my mouth, i am rundown and my appetite is limited (anxiety is very possible).

All of this being said i did use a condom and i was protected on the head and shaft of my penis the entire time.  

1. is what i describe above characteristic of secondary syphilis?
2. the timing of the rash is unlikely for secondary syphilis as you stated before.  But should i be concerned?
3. does my taking of valtrex for gentile herpes have any effect on your opinion
4. if i have a rash would i test positive for syphilis if i went now for a blood test?  (i do intend to go again this week)

Thanks

[Edward W Hook, MD]

The rash on your feet is not syphilis. the timing is wrong and the risk is non-existant.  You are taking a coinicdiental event and letting your guilt of the exposure carry you away.  

1. Is this a common symptom within a few weeks of exposure?
No.

2. are chancre's always present with syphilis?
Not always but typically.  EWH

[regret2013]

Dr.  I was tested and everything came back negative after 9 days post exposure.  Today (15 days post exposure) i developed a rash on the top of my feet.  The rash/sores are a few mm's in size and are pretty itchy.  at first i thought they were bug bites of some kind but now i am worried about syphilis.I have found no chancre of any kind over the last two weeks.

1. Is this a common symptom within a few weeks of exposure?
2. are chancre's always present with syphilis?

[Edward W Hook, MD]

Yes, I believe it would  be safe to have sex with your wife at this time.  Take care. EWH

[regret2013]

Thank Dr.      This has been incredibly helpful.   I will get tested for peace of mind.   Based on all of your comments i presume it is safe practive safe sex with my wife until the final test results come back.