still worried and next steps

[worriedintucson]

I continue to have made mistakes, and I feel quite guilty. I am working on bailing out of my poor lifestyle choices. Pretty stupid for a man my age I know.

But here's the summary of my misadventures. What are my risks and course of action?

(1) Had shallow but penetrative sex with a massage girl (she's 19 I found out). Chlamydia and gonorrhea tests came back negative. No other tests performed.

(2) Had oral sex the next week with another girl and rubbed on here wet vagina but did not penetrate her to my knowledge. Early 20's. No testing yet regarding her.

These first two were asked in a prior question; I accept and value Dr. Hook's advice on these.

(3) With another girl a few weeks later did cunnilingus although she was not especially wet. No testing yet regarding her. She is a 30 something. No testing yet regarding her.

(4) With still another girl about the following week received oral sex. Single mother, age 27. No testing yet regarding her.

Q>> Should I test for HIV, syphilis (as I haven't done this for any exposures yet)? Chlamydia and gonorrhea again? I only have definitive knowledge that I wasn't infected in the first (1) exposure to Chlamydia and gonorrhea.

Q>> Without further testing can I safely resume sex with my wife at this time?

Since this all started there has been no sex at home.

I am symptom free at this time, more than a week past my last error.

I hope I am clear on what I did this time.

Drs., thanks in advance for this wonderful service.

[worriedintucson]

Just a comment on my first few exposure that I asked a question about. They all came back negative. Whew!

For the new exposures I mentioned above I have already done the chlamydia and gonorrhea urine tests. Planned parenthood tells me that if I don't get a call in seven to ten days from yesterday it is negative. But it has been six days since the stupid exposure and no symptoms, probably a good sign based on my reading forum. At four weeks I will repeat the HIV and syphilis test for good measure, maybe repeat the chlamydia and gonorrhea just because I am there.

And yes I feel stupid over my lack of control issues. I am so tired of this, and so ready to move on to a normal life. I hope I can report that soon as I have been at this for too long.  

Thanks again.

[worriedintucson]

Quite right Dr. Hook, I reread the policy and sorry about that.

I think I do know the answers. I have spent hours reading the forum since. One thing I know is that there must be a better way to approach my dilemma. If I continue to act out I must do no more than unprotected oral and protected vaginal sex. Better still I need to resolve this "need". I am also quite tired of the guilt, worrying, testing cycle. You have no idea how tired I am of this.

Since my actions were essentially the same as before I can expect that the same answers. I list them again for my own peace of mind.

"there is no medical reason for HIV testing. As for other STDS, the risk of infection in your case is low- less than 1% I would guess.  If you are worried or concerned., testing might make you feel better.  Personally I would not be worried about these exposures.  EWH "

"I will resume unprotected sex with my wife, should that occur, since the apparent STD risk is less than 1%.

Also based upon reading the forum and your replies, the odds against acquiring HIV are on the order of a million to one, good enough for me.

And I will follow up with the full panel (HIV, syphilis, chlamydia, and gonorrhea) in the near future just bring these lapses to completion (peace of mind), and to allow me to fully move on."

""I agree with your summary and your plans are the same as the course of action I would take.  Take care. EWH

Next Gonorrhea and Chlamydia test is Wednesday and HIV/Syphilis in 4 weeks. I'll be on the lookout for the next two weeks for symptoms as well.

Thank you, yours and Dr. Handsfield's service is extraordinary in this day and age. I appreciate the access, expertise, and blunt honesty.

Worried in Tucson

[Edward W Hook, MD]

This is new question, unrelated to your earlier question.  You probably already also know the answers to your questions.  If you wish to ask these questions, please post as a new question.  

Reminder, we ask clients to ask no more than two questions in any 6 month period.  EWH

[worriedintucson]

You can still call me worriedintucson but also the STUPIDEST man in the world. Yes all the guilt as well. I am still waiting for the PPH total panel but they told me that if they don't call immediately within a week to 10 days the result is negative, so keeping my fingers crossed, as its been 2 1/2 weeks. That will rule out any problems with prior exposures.

However this the stupid part. A day or so after the test I felt an overwhelming urge for some sexual attention and went back to the same massage parlor and had oral sex from the same 27 year old mom and protected vaginal sex another time with the 19 yo. (1) what are my risks with herpes or syphilis on protected vaginal? I understand probably very low risk with oral sex other than gonorrhea. (2) Anything else I should worry about with oral? (3) If nothing in a week to ten days am I home free without testing?

Finally, here's my real concern. I hooked up with another 27 almost 28 year old massage girl friend I hadn't seen for almost 8 months. I used to do unprotected oral and protected vaginal quite often. She was quite faithful with condoms and feared pregnancy as well as STDs, and I tested then about every 6 months to be sure, and always a negative result. She always said she was clean. But I worry about her activities.

Last night we started with unprotected oral  and then unprotected vaginal for no more than 1 to 2 minutes max when I came to my senses. Then we switched to protected vaginal. (4) What are my risks here and course of action? (5) Is unprotected sex with my wife out of the question? I am willing to follow up with the full panel again next week.

Thanks,

worried and stupid in tucson

[Edward W Hook, MD]

You are over reacting. No change to my prior advice.  Your tests will almost certainly be negative.  

There will be no further replies.   You are welcome to post your results (which I remain confident will be negative).  EWH

[worriedintucson]

I got my syphilis and HIV test today and will know the result in 7-10 days.

What are the real odds I got HIV from penetrating that 19 year old Hispanic CSW? She is apparently a wild one.

Are they really 1 out of (2000x100)? I gave 1/2000 for any one event and 1% chance she had something.

I have had sex twice with my wife in the interim. Have I put her at great risk?

I am worried sick still. But I'm trying to do the right things.

Thanks.

[Edward W Hook, MD]

I agree with your summary and your plans are the same as the course of action I would take.  Take care. EWH

[worriedintucson]

You are quite right about me paying a pretty big psychological price for these events.

I will resume unprotected sex with my wife, should that occur, since the apparent STD risk is less than 1%.

Also based upon reading the forum and your replies, the odds against acquiring HIV are on the order of a million to one, good enough for me.

And I will follow up with the full panel (HIV, syphilis, chlamydia, and gonorrhea) in the near future just bring these lapses to completion (peace of mind), and to allow me to fully move on.

So unless I have misunderstood something in the above, it is what I will do.

Thank you again for your help, Dr. Hook.

[Edward W Hook, MD]

Welcome back to the Forum.  You seem to be in a bit of a rut-  seeking sexual contacts outside of your marriage, then regretting it.  It's not my place to lecture and I won't but I'm guessing that you are paying a pretty big psychological price for these events.

As for your questions-
Events 1 and 2.  No change from my earlier assessment and suggestions.

Exposures 3 and 4.  As I read your posts, the only exposures of any consequence are giving and receiving oral sex.  Both are low risk for all STDs.  There has never been a case of HIV reported to have been acquired through performing cunnilingus or receiving oral sex form an infected partner- none.  You will not be the first and have no reason for concern.  There is a low probability that you could get gonorrhea, either or the throat from cunnilingus or the penis from receiving oral sex. Both are rather rare however.  there is also a small chance that you could get NGU from receipt of oral sex although since you have no symptoms , the chances of this occurring are likewise very, very small.  

You have to be the judge about testing. there is no medical reason for HIV testing. As for other STDS, the risk of infection in your case is low- less than 1% I would guess.  If you are worried or concerned., testing might make you feel better.  Personally I would not be worried about these exposures.  EWH