What are my risks? STD and HIV

[Hiv_Fear]

Hi Doc,

My possible exposure: I went to a massage parlour which provides sexual services on Dec 31st last year. I engaged in protected insertive oral sex with the CSW. Prior to the act, she gave me massage on my back with oil, touch numerous times on my anus, licked my testicles and she is the one that applied the condom using her oiled hands and mouth. After ejacution, I allowed her to continue the act for quite a while before stopping. She is the one that removed the condom and cleaned up my penis with some tissues.

My symptoms: Few days after the act, I noticed a red swell at the tip of my penis, I have burning sensation when urinating and at times I have urge to urinate, but the quantity is very low. For a few weeks till now, I have been having random muscle aches, mainly on my deltoids. I am also having irritation and heated feeling on my neck and both armpits and arm joints. I also noticed a couple of days ago, I have these dark red blood looking, pin size spots on my right testicle.

My checkup: I went to a family doctor who did a quick examination of the swell at my penis tip exactly one week after the act. He said is normal, but to address my concerns, he gave me approx. 10 days worth of Doxycycline. Still worried, I decided to go to see a Demathologist yesterday regarding any STD risk. The specialist concluded that I have inflammation at the tip of my penis and he said could be UTI, but wouldn't rule out STD. So he gave me 7 days worth of Doxycycline and 7 days worth of Augmentin. Both docs say that the dark red spots are not indicative of STD.

My concerns: I read from lots of sources in the internet that my HIV risks are only theoritical and pratically zero. But my concern now is did I happen to contract any form of STD, if so, which is the most likely one? And would getting a STI during that oral episode put me at a HIV risk during the same episode? I have no other sexual history except for this one.

I hope you can address. Thanks.

[H. Hunter Handsfield, M.D.]

No, that is not a significant risk.  For practical purposes nobody ever gets HIV byreceivibg oral sex, regardless of catching NGU oranything else.  And "could be STD" doesn't mean it is.  I truly doubt it.

[Hiv_Fear]

Thanks alot for putting my concerns to rest.

[Hiv_Fear]

To keep things short, and to put my concerns to rest;

You mentioned the urethral symptoms could be due to a STD, however that massage episode is my only risk. I know UTI in men are rare, I am so concerned is because I'm not sure if the oil has compromised the condom and consequently acquiring a STD through oral.

My main concern is still would getting a STI during that oral episode put me at a HIV risk during the same episode?

Thanks.

[H. Hunter Handsfield, M.D.]

The exposure you describe was zero risk for HIV and all other STDs.  I haven't even read the second paragraph of your question yet, because it doesn't matter.what symptoms you have.  They cannot be due to HIV or an STD you acquired during your massage parlor adventure.

Now I have read your symptoms.  Your penile/urethral symptoms conceivably could have been due to an STD, but if so, you got it somewhere other than the massage parlor.  But if you had something, the antibiotics you received would have cleared it up. The other symptoms you mention--muscle aches, spots on your scrotum, the "heated" feelings--are not conceivably due to any STD or anything else related to your massage experience. They could be anxiety/emotional related to that event, but otherwise unrelated.

Follow up with your personal health care provider if you remain concerned.  But truly, you have no STD/HIV worries here.

Regards--  HHH, MD