While I agree that the lesions that you describe around your rectum sound as though they could be herpes, you do not know that, nor do I. Furthermore, you state you do not remember what happened and you do acknowledge that you have a tendency to "believe the worst". In my experience, when people do thing the worst of things, they also tend to over react as I think you may be doing. Your decision to take acyclovir before you knew what the rash on your anus is is one example of how such actions may only confuse things more than they already are. Here are my recommendations:
1. You do not know that you have herpes -there are many things which can mimic herpes. Get tested for herpes with a culture or better yet, a PCR test for herpes viruses ASAP. At this time these tests should be a swab test as blood tests may not yet be positive. The PCR test is preferable because the acyclovir is more likely to make a culture falsely negative than the PCR test.
2. If you have rectal herpes, this does not mean you have penile herpes. In fact, in most people infection is present at one site or another but not both.
3. Get tested for regular STDs such as gonorrhea, chlamydia, etc. This should be done at all sites of sexual exposure, i.e. the penis, the rectum and, if appropriate, the mouth. At this time, unless you have unwisely taken antibiotics in addition to the acyclovir, the results will be reliable.
4. While you should have an HIV test when you are tested for STDs this may not accurately detect HIV. Further testing is advisable. As for the PCR test, it is a good way to spend lots of money but not a good way to diagnose HIV. In your situation, I would not advise it for the following reasons: you do not know that you were exposed to HIV, even if you are, less than 1% of exposures lead to infection; PCR tests have more false positive results than antibody blood tests; over half of antibody tests will be positive at 2 weeks following exposure, the same time that the PCR test has been suggested, but with many fewer false positive results. Just get the antibody test.
5. If your partner had HSV and HIV, you are about 3 times more likely, on average to get HIV than if HSV was not present. This 3-fold increase is still a small increase in overall risk however.
Hope this helps. EWH
Thanks for your answer, helped to ease my mind a little. I am wondering if tests for hepatitis are likely to be accurate at this stage? thanks A.
Tests for hepatitis will not be very accurate until 2-3 months following exposure. EWH