Advice needed

[ned2120]

Doctor, I am confused about a particular risk.  I regularly get tested for STDs, but I'm worried about this exposure.  

I engaged in homosexual activities for the first time about 2 weeks ago.  Essentially, we engaged in deep kissing and I was the top in anal sex.  A condom was used during the anal sex.  The reason why I'm worried is because instead of rolling the condom over the penis first while holding the tip, I unrolled it all the way and then proceeded to put it on my penis.  (I was a bit drink).  My partner told me that I was doing it incorrectly  as I was trying to put the unrolled condom on my penis, so then I then held the condom tip in the appropriate manner and adjusted the condom to be on my penis.  To my knowledge, the condom was intact and did not break during the anal sex.  I was fine with the situation until I had a problem with some 3 canker sores a week after and now some skin irritation.  The canker sores could have come from aggressive brushing after the sexual act, though I'm not quite sure.  Also, there appears to be acne, it is colorless, on my neck in a few places and in my arm pit there is some itchy red lumps. I did go to the beach recently and feel it could be sea lice, but again I'm not sure. Essentially, I'm worried about possible HIV infection given the situation where I first unrolled the condom first as I read that it could potentially destroy the condom.  Therefore doctor, I have the following few questions
1.  Given that I engaged in anal sex as a top with a condom but first unrolled it and then as I was trying to put it on, then squeezed the tip and then finished unrolling it, what is my HIV risk?
2.  What could explain these symptoms?
3.  Do you recomend HIV testing based on this?

Thank you.  

[Edward W Hook, MD]

Even before I address your question, I would suggest that if you can find your partner and he is willing, you should both get HIV tests.  That is the fastest single way to resolve your concerns. If he is not infected, you cannot be infected.  You could have these results in less than a week at the outside.

Now for your situation and questions:

1.  Your risk of infection is zero.  Condoms work and your condom, although not put on in textbook style, stayed intact.   When condoms break you know it, they tear wide open, not leak.  The reason that it is recommended to put condoms on by holding the tip and unrolling them is to reduce the risk of breakage  Yours did not break but if you keep doing it wrong, odds are some will break in the future.  
2.  The canker sores in your mouth could be just that - they are unlikely to be oral herpes, HIV or another STD. Your other symptoms are not suggestive of HIV.  If they bother you, see a health care professional who can examine you.  I suspect they are nothing to worry about.
3.  No, not based on the exposure you describe. On the other hand, as a sexually active male, you qualify for periodic HIV/STD "screening (testing in the absence of symptoms) if you have had multiple partners (protected or otherwise) over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).

Hope this helps.  Take care.  EWH

[ned2120]

Just to clarify doctor I am a 21 year old male and my partner, the bottom, was a 19 year old male.  Both white.

Thank you