Low..or NO risk masturbation encounter?

[19032013]

Same sex encounter.  Absolutely no insertion of penis.  Anal fingering, followed by masturbation.  Following the anal fingering I laid down on the bed and my rear-end possibly came in contact with some of his secretions which had dripped onto the bed.  Concern for hepatitis and other STD's if the secretions dripped INTO, or made contact with my rectum.  #2.  Masturbation...partner ejaculated, and some of his semen leaked down my chest and possibly onto, or what concerns me INTO my urethra/rectum.  I showered 4 minutes later after wiping all the fluids with a towel.

Obviously a low-risk scenario, but further reassurance is requested despite the fact this scenario has been addressed many times on this forum relative to masturbation/partner's semen contact with urethra but not so much in terms of fluids possibly leaking into the rectum.  #3. My penis briefly made contact with his upper-leg near his groin.  Possible HSV/HPV risk?  #4.  Brief kiss on lips(not deep)/cheek for a few seconds.  No sores were present. Please assess HSV 1 risk.

[Edward W Hook, MD]

I suspect you have put your finger, so to speak, on the problem- genital (or rectal)-focused anxiety is most likely what is operative here.  You have been carefully examined by a trained professional who found not abnormalitiy or problems and the symptoms that you describve are not those of an STI including parasites.  I think you need to talk this through with a trained counselor or mental health professional, not look further for infections that are not there.  EWH

[19032013]

Dr. Hook,

You and Dr. Handsfield have written extensively about anxiety and the symptoms anxiety often generates following a sexual experience one regrets.  In my case I believe there is a possibility I have been suffering from genitally focused anxiety.  At least I hope this is what I'm dealing with.

The anal fingering was a traumatic experience I deeply regret, and ever since the encounter I've been experiencing strange rectal sensations, such as anal itching and a feeling that discharge is about to leak out of my rectum but there is never any discharge.

Although I'm passing gas more than I usually do, my bowel movements are the same and there is never any blood.  I was examined by a gastro-enterologist who conducted a rectal exam and he didn't find any fissures or any other abnormalities, nor was there any hidden blood in my stool.  

I know that your expertise is in STD's and that you're quite confident I didn't contract any STD from the type of contact I engaged in, but nevertheless I'm concerned I may have damaged my anal area from the fingering or perhaps contracted some type of parasite and that perhaps this is causing these bizarre sensations despite the lack of physical evidence?  I know I'm venturing into areas beyond your scope but please give me your thoughts if you have any.

Thank You

[Edward W Hook, MD]

False positives continue to be a major problem for the PCR tests.  LAst month we had two clients who had false positive PCR tests but NONE who had true positves to make a diagnosis of HIV.  Test at your own risk (and expense)

Recent vaccination has no impact of HIV diagnostic tests.  EWH

[19032013]

Dr. Hook,

Thanks for your reassurance.  Nevertheless I'm still concerned, although quite likely unnecessarily so.  

I'm debating getting an HIV RNA PCR test.  The encounter occurred 2 weeks ago.  My thinking is if I were your patient in a clinical sense you would be reluctant to test based on the lack of risk...but my anxiety could be assuaged by a negative test result.  Then again it could go through the roof with a false positive from a test that is notorious for such a result.  Although you and Dr. HHH do not recommend HIV RNA PCR testing, are you as steadfast in your opinion about this test as you were a couple years ago?  Has the manufacturer improved upon the number of false positives in the past couple years?

Also, I was vaccinated for HEP B and HPV within the last 5 weeks...could this fact potentially lead to any type of false positive in an HIV or HEP B test?

Thank you

[Edward W Hook, MD]

Welcome to our Forum.  I hope my comments will be helpful.  Let me first congratulate you on your apparent commitment to safe sex, other than total abstinence this is the best way to minimize risk for acquisition of STIs.  As you already know, we have repeatedly characterized the sorts of exposures that you describe (1-4 above) as being effectively no risk for acquisition of HIV or other STIs.  The answer has not changed.  No let me take a moment to provide a qualification since at least some of our clients are seeking a guarantee that they cannot acquire an STI from contact with other.  The qualification is that in life, other than the certainty of death at some time in the future, there are no guarantees.  In truth, science does not deal in facts but in probabilities and estimates because knowledge does not stop accumulating.  As evidence and expereince accumulates, the precision of our estimates improves but they are still estimates. Thus, although there are no cases of HIV known to be transmitted by masturbation, this does not mean that tomorrow or the next day someone, somewhere will acquired HIV through the sorts of exposures you describe above despite the millions and millions of times before when this has not occurred.  This generalization extends to most of the other STIs you mention as well.  Thus in the same way that I cannot promise you that you are not going to be struck by a meteorite falling from space while reading this, I cannot guarantee you that you could not get an STI through the sorts of exposures you describe.

For some of the processes, this risk is infinitesimally higher than for others.  For instance, this is some very, very small risk of getting HSV-1 from a simple kiss on the lips of someone who does not have a sore on their lip but that risk again, is simply not quantifiable and is too low for most people to justifiably worry about.  If that represents "too much" risk for you, then you should not have sexual contact of any sort (and to watch out for meteorites).  Otherwise, my sincere advice is to not worry about the sorts of exposures you describe.  

I hope this comment is helpful to you.  EWH