Need advice

[needadvice27]

Dear Dr.

Im a bisexual male who just recently has started experimenting with other men. In February of 07 i engaged in protected anal sex with another man(top). I have only tried this a handful of times, maybe 5 in my life, and never have i dared try it without a condom, This particular time I did not experience a break of the condom nor remember it slipping off, but when i finished and pulled out i pulled the condom off, and somehow as i was fidgeting with the condom i looked down and saw a small amount of feces on the opening of my urethra. I didnt freak out but washed myself off, shared my concern with my partner, and he reassured me that is was HIV negative

I thought nothing of it and am sure i did not experience ARS as i have not had a temperature or felt flu like symptoms since the event. However, in the beginning of July i started experiencing discomfort in the head of my penis, which was exacerbated during ejacultion. noting intense, but mildly uncomfortable, and no discharge or discoloration in any way. This pain comes and goes, lately has been worse than in the past. I dont have many other symptoms, except maybe headaches and what seems to be hemorrhoids as i see small amounts of blood after wiping at times

I also experience tingling in the fingers sometimes, and i have psoriasis which ive had for 10+ years which seems worse nowadays. Anyway, I have a couple of questions regarding everything.

1) do my symptoms seems indicative of anything? I write this one anticipating you saying that symptoms are never indicative of HIV disease, but I feel compelled to as my penis pain seems to be recurring time after time.

3) Lastly, i recently read a reply of yours that rectal bleeding is indicative of STD, which freaked me out. When you say this do you mean STD as inclusive of HIV? Also, if the rectal bleeding has not occurred until more than a year after my risk factor, can it potentially be explained by advanced HIV disease?


Thanks

[needadvice27]

thank you...i appreciate your help, and your speedy reply for that matter. I have thought stress was a factor too, expecially after reading your replies for the last few months.
have a great weekend, I am going to try to as well

[H. Hunter Handsfield, M.D.]

Relax.  This was obviously a low risk event.  Stick to your consistent use of condoms for anal sex, both top and bottom; and also, ask your partners whether or not they have HIV BEFORE any contact -- and avoid sex with those who say they are positive, or don't know, or are invasive.  Do those things and you can expect a lifetime without getting HIV.  But for the immediate situation, it seems clear your partner wasn't infected.

1) The symptoms you describe do not hint at HIV.  It's hard to judge what your penile pain means -- maybe just anxiety?  But if in doubt, see a health care provider about it.

2) Bleeding from the rectum can be evidence of herpes, chlamydia, or gonorrhea -- but not HIV.  But most rectal bleeding isn't due to STD; anal fissures, hemorrhoids, and such things are more likely explanations.  And these tend to be common in people who have receptive anal sex (bottoms).  Less common but more serious possibilities include anal and rectal cancer, and certain other infections.  Rectal bleeding always should be evaluated by an experienced health care provider, and testing for STDs might make sense -- but most cases have other explanations.

I hope this helps allay your fears.  Best wishes--  HHH, MD