Anal Frottage/Rubbing - PLEASE HELP

[jddkdd]

It;s been several years since I have been on this board and have adhered to a strict safe sex policy including using condoms for intercourse, oral sex and asking my partners their status prior to engaging in any activity.  Three weeks ago I had an encounter with another male which started out with kissing, mutual masturbation, he fingered me and rimmed me for a while as well.  As things became more intense, he started vigorously rubbing his penis against my anus.  There was significant pressure and the head of his penis was on my anus which may have been open at the time and wet from his saliva.  After a minute or two I asked him to stop and he took a condom out and placed it on himself and attempted to enter me.  I was pretty tight and he was only able to get in about half way and only for a few minutes before I asked him to stop altogether.  He took off the condom and we mutually masturbated and ejaculated on each other's chest.  I am most worried about his rubbing his penis on my open anus.  I gave him oral just before and did not detect any precum but I am worried nonetheless.  I have had a sore throat now for a couple of weeks, although no fever or any other symptoms. I asked him several times since our encounter regarding his status and he continues to say that he is negative (although I think he is getting annoyed with my constant questions).  He came to my apartment with a condom which is indicative of someone who engages in safe sex.  I am worrying incessantly about this.  Can you please help me to understand my risk?

[Edward W Hook, MD]

We have limited time and space for follow-up questions.  This will be my final response., Further posts will be deleted without comment.

Further, it appears that you are wasting time looking for "clues" on the internet- this will most often mislead you.

The parotid glands ARE NOT on the tongue.  Further cysts (anywhere) are not a manifestation of HIV.  Finally, had whatever you have found on your tongue been related to HIV, your HIV antibody test would have been positive.

This thread is now over.  EWH

[jddkdd]

Thank you.  The inevitable follow up to your prompt reply.  I indicated earlier that I have a small cyst on my tongue and now it feels like my parotid gland is swelling slightly.  Online sources indicate that these may be early HIV infection symptoms.

So in follow up:  

1.  If the oral issues I am experiencing are related to HIV infection (I know symptoms are never a reliable way to diagnose HIV), would my test at 49 days be positive?

I recognize I may be crossing the line into paranoia, but in order to trust my test results and take your guidance to heart, I did have this lingering questions that I wanted to address.  

[Edward W Hook, MD]

Tests for HIV antibody are completely reliable 8 weeks after an exposure.  At 7 weeks following your low risk exposure, testing such as you performed would detect over 95% of recent infections but not all. That said, the chance that you will now have a future positve test from the exposure you have described is vanishingly low and not something that I would worry about.  EWH

[jddkdd]

My last comment/question on this issue.  So I took an Oraquick In Home HIV Test today at exactly seven (7) weeks from the incident.  I haven't had sex with anyone else since then.  The test result was negative.  Are these results reliable as to the incident seven weeks ago? Thank you!

[Edward W Hook, MD]

Glad to help. EWH

[jddkdd]

Thank you.  I appreciate your time and advice.

[Edward W Hook, MD]

The web sites you are getting your information from are wrong. Oral syphilis is very, very rare.  Further, when syphilis occurs on the tongue or mouth it presents as a firm, painless ulcer, not as a cyst.  I suspect what you describe is a coincidence. EWH

[jddkdd]

One additional comment/concern related to this particular scenario.  Yesterday while I was brushing my tongue I identified a pearly white bump way in the back of my mouth on the right side of my tongue.  It hurst a bit, but not very much.  Now that I know it's there I can certainly tell that there is something on my tongue.  This gave me significant concern so I went to my doctor today.  She took a look and indicated that it was likely a pustule that should resolve in a few days to a week.  She didn't have any concern that it was anything else.  She did give me a prescription for Cephalexin 500mg that she said I should take if it gets bigger or hurts more in the next day or two.  She advised me to come back if it does not resolve after three weeks.  She said it was fairly common and that I shouldn't be concerned.  My obvious fear here is oral syphilis.  There seems to be many web sites that say that oral syphilis is fairly common/easy to catch and highly prevalent among MSM.  Should I be concerned? Thank you again for your assistance.

[Edward W Hook, MD]

Thanks for your comments.  You are right- words and defintions are important and precision is important here as well.  While the distinction between the anus and rectum (for those who are reading this the rectum is deeper, beyound the anus) is important in terms of possible transmission this does not change my assessment (no risk from anal pressure without penetration) or my concern that having a partner push his penis against your anus is inviting penetration.  

I hope this clarification is helpful. EWH

[jddkdd]

Dr.  I was re-reading your initial response and you indicated that his penis on my rectum was a non-risk.  Obviously you''re the M.D. here so maybe my technical clarification is of no consequence or relevance, but he was not on or in my rectum (which I presume is further in beyond my anus).  He was rubbing his penis on my wet anus.  Actually during his vigorous rubbing the head of his penis did not go beyond my sphincter. Is there a difference between your response concerning rectum and anus?  Does it change your analysis of the risk?  Thank you again for your assistance.

[jddkdd]

Thank you for your prompt response.  I appreciate your insight and counsel. Thank you also for your reflection on the particular situation. The application of pressure by penis rubbing on the anus is in a sense mimicking or simulating the act penetration, which is pleasurable (to me).the act penetration, which is pleasurable (to me). However, I agree with your comment in that it invites penetration either deliberate or accidental.  For me, the situation was very much a "heat of the moment" scenario in which I quickly got my wits about me as it appeared that going any further would have resulted in penetration. Maybe the lesson learned (for me) in this is that if I am susceptible to such "heat of the moment" lapses, then perhaps I should forgo that type of anal frottage, particularly if the consequences even if low risk leave me with a high degree of anxiety and despair.

[Edward W Hook, MD]

Welcome back to the Forum.  Your question is one which has caused me to reflect a bit as noted below. Before I do however, let me congratulate you on your ongoing commitment to safe sex.  it sounds like you are doing all the right things- Great job!  None of the exposures, including non-penetrative pressure of his penis on your rectum represents a risk for HIV.  Penetration is the absolute necessity for sexual transmission of HIV.  Let me also comment that now that you have asked your partner several times about his status, it is time to stop, particularly if you value his friendship. The answer will not change and to be asked the same time repeatedly can be irritating and suggests a failure of trust.  

Now for my reflection.  From time to time we do have other clients who report encounters with partners in which the penis is pushed against the rectum or a female partner’s vaginal entrance (the medical term is introitus) without penetration.  For me this raises the question of what is going on and why.  This sort of application of pressure is inviting penetration.  Then if it happens, what do you do?  It would seem to me that, with respect to this practice in the future my counsel to you (and others who may be reading this comment) is that if you don't plan to be penetrated or penetrate your partner, then don't invite it to happen.   This is not to suggest that the friction and rubbing associated with frottage is not pleasurable but this seems to be something different.  Perhaps you have some comments about the pleasure derived from this activity that I am not aware of but for me, it seems like an invitation to penetration.    

I hope this comment is helpful.  I'd be interested in your reaction to my reflection above.  EWH

[whats_the_story]

HIV has never been transmitted by "unprotected frottage" and you're not going to be the first. Main thing is that he wore a condom whilst he penetrated you, thus meaning you both protected yourself from HIV.