Do I have reason to worry?

[Jake05]

I received oral sex from a prostitute (in Europe) on April 22nd. A latex condom was used. I did not kiss or touch her.  She did not touch my penis without the condom. To my knowledge, her mouth was only on the condom. I removed the condom after the act and flushed it down the toilet. She then left. Entire thing lasted 5-10 minutes.

On April 28th I got tested for STDs. The test was with sSTD and the lab was LABCORP. The results were as follows:

Hepatitis B-HBsAg Screen-Non-reactive-negative
Hepatitis C-HCV Antibody-non-reactive-negative
HIV-1-HIV-1 Ab-non-reactive-negative
HSV-1 aB IgG-1.13 h-Postive
HSV-2 aB IgG-<.90-NEGATIVE
Chlamydia Trachomatic-DNA, SDA-not detected-Negative
Neisseria Gonorrhoeae-DNA, SDA-Not detected-Negative
Syphillis-RPR, Rfx, Qn/Confirm TP-PA-Non-reactive-Negative

On April 25th I notices a couple of red bumps on my upper thigh-went to the Dermatologist on May 1st and Derm indicates the bumps were pimples and precribed some cream. Derm took a culture of all bumps which were negative.

Questions:

1. Am I at risk of herpes or other STD from this act?

2. I have never had cold sores, is it common to be positive for HSV 1?

3. Is 1.13 really a positive?

4. If a person does not have any signs of herpes 1 how would you know if this was gentital or oral?

5. Would you get tested again in 3 months?

Obviously I am worried and do not know if I am overeacting?

Thank you

[H. Hunter Handsfield, M.D.]

If your description of the exposure is accurate, you were not possibly at risk for any STD.  Had you asked about testing before you did it, my advice would have been to save your money.  The test results show you didn't catch chlamydia or gonorrhea.  The other results are meaningless in relation to that exposure, since it takes a few weeks for any of them to become positive.  "Red bumps" of the upper thighs are not suggestive of any STD and the dermatologist obviously agreed.

To the specific questions:

1) Zero risk for HSV and all other STDs.

2) Half of all adults in the US have HSV-1.  It's up to 90% in some countries, lower in others -- but common everywhere.

3) An EIA ratio of 1.13 is positive for HSV-1.

4) In the absence of symptoms, it is not possible to know for sure whether an HSV-1 infection is oral or genital.  Statistically, oral is much more likely.  If you had a history of oral cold sores/fever blisters, that would make it definite.

5) As I said above, I wouldn't have recommended testing at all.  There is no point in another test.

Yes, you are overreacting. There simply is no risk here.

Regards-- HHH, MD

[Jake05]

thank you very much I will try to relax...

[Jake05]

I now have a rash on my upper thigh. 10-12 red bumps. All bumps appear tp have a hair coming out of it. Does this appear to be a hair folical infection? The area feels raw. Any concerns here?

[H. Hunter Handsfield, M.D.]

No.  You need to get past the fallacy of sequential thinking.  That a health problem appears soon after an paticular sexual exposure doesn't mean they are linked in any way, and it is not a "wierd coincidence".  Look at it this way.  During any few weeks, there are millions of new high risk sexual exposures.  During the next few weeks after such events, millions and millionos of people get sore throats, skin rashes, unexplained fever, night sweats, or other garden variety symptoms.  It stands to reason that the two groups overlap:  that is, the people with sexual exposures include many who develop the other symptoms.  It is purely random, with neither one having nothign whatseover to do with the other.

You're worrying needlessly.  Please just put this whole business behind you.

This thread is over.  I will delete any further comments or questions.