STDs Expert Forum
worries to the point of anxiety attacks!
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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worries to the point of anxiety attacks!

I posted a link on the free forum.

I apologize if I did something wrong by posting here also.

What do you think Doc?  Do I have to worry?  Get tested?  Stop having sex with my wife until I get tested?
Welcome to the forum.  There's no problem asking the same question on a community forum and the corresponding professional forum; it happens a lot.  However, it's often unnecessary, and on quick scan, it appears you had accurate replies on the other forum.  You probably didn't need to spend the posting fee, but I'll be happy to reply.

However, the moderators should not be expected to go back and forth to other threads in order to reply. Next time (and for other users), please copy and re-post the original question.

You describe low risk exposures, because condoms were used for vaginal penetration.  Oral sex is low risk for all STDs (and zero risk for some), and hand-genital contact and minor contact with vaginal secretions, saliva etc while putting on a condom are risk free.  To your specific questions:

1. "Did I just open myself up to STDs and HIV?!?! Does the fact that I already have an STD make it worse since I licked/sucked my finger after it touched the vagina??"  I cannot say the risk is zero, but it is limited to those infections that can be transmitted by skin-to-skin genital contact (herpes, syphilis, HPV) -- and even these are very low risk if any.  You are not at risk for chlamydia, gonorrhea, NGU, trichomonas, HIV, or hepatitis.

2. "It has been 5-6 days since the incident, and I have been feeling pains in my penile area, abdomen pains, burning sensations when I pee (phantom?). This morning, I think I had a clear white discharge in my underwear but it could have been pre-*** from my morning erection? IS this a symptom?  What should I look out for?"  The only symptom of possible concern is the discharge.  If it's truly clear (like saliva or tears), then I suspect you're right about it being pre-ejaculate fluid; STD related discharges are white, creamy, or yellow and leave colored stains.  And as noted above, you aren't at risk for any STD that would cause urethral discahrge.  Of course see a doctor if it continues or turns colored, but I don't think this will happen.

3. "Should I avoid having sex with my wife until I get tested for everything?  Do I need to get tested? When should I get tested? Now?"  From a strict risk standpoint or symptoms, no testing is necessary.  If I somehow found myself in your circumstance, I would continue unprotected sex with my wife without worry.  But I'm not you, and I cannot guarantee you didn't catch anything.  If you decide to be tested for reassurance, you can have an accurate urine test for gonorrhea and chlamydia whenver you want -- any time more than 2-3 days after exposure is enough.  For reliable syphilis and HIV blood tests, you have to wait until 6 weeks after the exposure.  But I stress the chance of these is exceedingly low and testing is optional.  I recommend against testing for anything else.  If you do decide to be tested, I suggest you visit your local health department STD clinic or something like a Planned Parenthood clinic for personal evaluation and testing -- i.e. not an online STD testing service.

4. "When I woke up in the morning, I noticed I had a cut on the finger I rub the girl's vagina with  Dont know if I had it before or after.  Assuming before, does this make my chances worse?!?!  The cut looked fresh. Right now, the finger looks healed and no pus or extreme redness."  Minor cuts of the fingers have never been known to carry risk for any STD.  There must have been billions of fingering events by people with hangnails or other minor breaks in the skin, yet still no known infections.

Bottom line:  This really was a low risk situation.  There is no rational basis for panic.  Don't confuse anxiety about a sexual decision you regret with STD/HIV risk.  They aren't the same.  Deal with the first as you need to, but don't be worried about the second.

I hope this has been helpful.  Best wishes--  HHH, MD
Thank you Dr. H for taking the time to answer my long winded questions and will copy and paste going forward.  I do have a few follow ups if you don't mind.

1. From your answers, it seems that I can still contract herpes.  I am assuming you mean HSV-2 since I already have HSV-1?

2. Since my HSV-1 cold sore was active and an open wound on my mouth, was that a gateway for an STD/HIV to cling to the white cells when I put my fingers to my mouth after I touched her vagina and condom?

3. After the reassurring comments from you and the other commentators yesterday, I was able to relax somewhat and have a decent meal.  Right before I went to bed, I had a terrible itch on my penis.  I thought nothing of it and went to sleep.  When I woke up and went to urinate, I noticed a flat brown oval shape about a 1 cm away from the pee hole.  Don't know if it was there before or not.  Since I wore a condom, can this still be possible? Since they used their mouth to put the condom on, do saliva get in contact with my penis head and caused this?

4. Is it safe for me to change my child's diaper and give them hugs and hold there hands?

5. My armpits have been very itchy today. is that a concern?

Sorry for the additional questions and thank you for all your help!
1)  Sorry, I forgot you already have HSV-1.  Therefore, you could NOT catch herpes from the exposure described.  HSV-2 is rarely if ever transmitted by oral sex, and you are immune to a new HSV-1 infection.

2) Unlike HSV-2, HSV-1 does not increase the risk of HIV.  And in any case, your description of the exposure suggest your mouth was not exposed to your partners.*

3,5) I'm sure these symptoms have nothing to do with the sexual events, except possibly the anxiety they have caused.

4) Entirely safe.  You cannot transmit an infection you don't have.  And anyway no STDs are EVER transmitted to kids in this way.  The ONLY way children get STDs is through sexual abuse.

* If there WAS any contact of your mouth with your partners (kissing, oral sex on them), you must contact them and tell them you exposed them to your active oral herpes outbreak.  Even in a commercial sex context, you are morally obligated to avoid contact that can spread the infection, except with the consent of theperson exposed; and even after the fact, ethically you must let the person know.

That will end this thread.  Do your best to move on without worry, after you have informed your partners of your oral herpes (if indeed your mouth contacted them).
Thank you for answering all my questions.  My mouth never came into contact with them so no worries there.

For reasurrance purposes, I am getting tested tomorrow.  They are performing a 8 panel STD exam since its cheaper than doing individual.  

He also recommended the HIV Rapid Test and RNA test?  Based on your comments, it seems that these tests are too early to detect anything.  However, the doctor stated that around the 2 week mark, the Rapid and RNA are very reliable.

1. Am I just wasting money and time at this point? Should I move forward with the 8 panel STD test and the HIV tests?

2. No burning sensation during urination, or weird out of the ordinary bumps.  I think I have stains in my boxers but could just be urine stains.  How noticable are the discharges?

3. My face has been itchy/burning sensation lately, around the jawline and mouth but could be nothing.

This will be my last comment until I get the test results, if I really need them.
  Thank you.

"That will end this thread.  Do your best to move on without worry..." was an attempt to shut down this thread.  I'll answer these briefly, but that will be all.

1) Yes, any more testing will be a waste of money.  As implied above, any and all testing after such an exposure is primarily for reassurance, not because of any measurable risk.  Had I somehow found myself in your situation, I would not be tested for anything and would continue unprotected sex with my wife.

As for HIV testing, you are wrong about timing.  I would strongly recommend against an RNA test (very expensive and won't add any reassurance); see this thread:

2) You would not miss an abnormal discharge.

3) No STD can cause such a symptom.

Do your best to move on.  If you are tempted to ask any more questions, just re-read my replies above.  This thread is closed.
Hello Dr. H,

Just wanted to give you a follow up to my anxiety. I went in for my annual physical and spoke with my doctor about my extramartial anxiety and he concurred with you that my risk was extremely low.  Since he noticed my anxiety, he recommended running some tests for peace of mind.  I should have the results in about a week or so.  He did however run a Rapid HIV TEST and it came back negative.  I know you said it would be too early since it is only 31 days post exposure, but I think he did it to ease my anxiety, which it has done.  He recommended I do so again in 3 months for complete assurance.  Do you agree or is it not worth it?

The only reason why he is running some additional tests (other than to ease my anxiety) is because I told him that when I urine, I see "stuff" floating in my urine.  No pain or lesions or sores, just the "stuff" floating, in additiona to my leg pains and sore throat, temp was 99.2 and blood pressure was 146/90 (He was a little worried about the high BP)..

He didn't feel right giving me any antibotics since he did not know what it could be, if anything.  But reading some of the questions on the forum, it seems that I must have gotten something.  Sound I ask for antibotics, to be safe and start early?

Is it possible that I did get something, even though I was protected both orally and vaginally?
I agree exactly with your doctor on every point.  From a strict risk assessment standpoint, you don't need another HIV test -- and if I were in your situation, I wouldn't do it.  But I think you should do it; most people as anxious as you have been will continue to worry about it until a final test is done at an officially recommended interval after the last exposure.  He also was correct to not prescribe an antibiotic -- if you had asked me, I also would have refused a prescription.

"Is it possible that I did get something, even though I was protected both orally and vaginally?"  Nope.

That will end this thread.  I won't have any further comments or advice.  Continue to work with your doctor if you have any further concenrs; it's clear he is on top of this situation.  
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