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Avatar universal

Need peace of mind

Hello Doctors.  Great site.  Appreciate all you do for folks like me.

Here's the rundown:

11 months ago - had protected O and V sex w/ CSW - Showed no symptoms, was never tested.
7 months ago - brief unprotected oral w/ acquaintance - no visible sores on mouth
No symptoms of anything in interim.  No testing.

A few weeks ago; red rash on bottom of penis, left top of scrotum; itchy for a few days; most likely due to not showering soon enough in general after rigorous gym workouts (plus polyester gym shorts - bad idea); cleared up on their own, but some scaliness and soreness, esp. after masturbation.

Saturday night - protected O and V sex w/ CSW; finished unprotected by hand.
This CSW was very adamant about condom use, and we spoke about it for a little while after.  "Condom is life" she said, so it seems she is very protective of herself.

Sunday day - small group of red bumps in space between thigh and scrotum; looks like razor burn; guessing it is due to sweating on very warm Saturday, coupled with the sex.

So, What are my risks for STDs, especially HIV/herpes?  Do any of these skin issues point to larger problems?  Can I still have sex with my current girlfriend?  I understand I am a bit of tweaker, but I just need some peace of mind.  I recognize my view of sex is not healthy, and after this incident and the guilt, I know that I need to make major changes in this aspect of my life.  Thanks for listening.  I look forward to your answer.
10 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Thanks for the thanks about the forum.  I glanced at your discussion on the herpes community forum.

Your symptoms do not suggest herpes.  I doubt you have it -- even if you were to be tested and found to have a positive blood test for HSV (of either type), I would conclude you have an asymptomatic HSV infection plus some other cause of the rashes you describe.  Herpes simply doesn't behave the way you describe.  And recurrent herpes outbreaks almost always are at more or less the same location every time, within an inch or so.  The symptos also don't suggest any other STD, but just local dermatitis, or superfical nonsexually transmitted infections, e.g. yeast, other fungi, skin bacteria like staph or strep, etc.

To the specific questions:

Since all or most of your sexual exposures were condom-protected, your risk of any STD is very low.  I never guarantee someone isn't infected, however -- and all people who are sexually active outside mutually monogamous relationships should have routine STD/HIV testing from time to time, like once a year or so.  So maybe this is a good time for that, since it's on your mind.  But that advice has no specific relationship to either your symptoms or the sexual exposures you describe.  Can you safely have sex with your girlfriend in the meantime?  Since I can't make the guarantee you aren't infected, I am unwilling to say there is no risk.  But I can say that if I put myself in your situation, knowing what I know, I would continue unprotected sex with my wife.

You don't describe anything that makes me think your "view of sex is not healthy".  But since you feel guilty, it's obviously a problem for you.  But that's as far as I'll go; this is an STD site, not for relationship or psychological counseling.

Best wishes--  HHH, MD
Avatar universal
Thank you, doctor, for your response.  You said exactly what I thought you would say, and that's a good thing!

Just for grins, could you go into some detail about asymptomatic HSV?  Does that mean I would have, just never break out?  How does that differ from symptomatic HSV as far as passing it on to someone else.

If now is a good time for testing, would you recommend I go right away, or wait until anything from this most recent encounter could show up?  Oh, and i forgot to mention, I did have a urine test after the oral sex incident, and tested neg. for Chylamidia and Gonhorrea.

I know this is not a counseling site, but sometimes it just helps to say things out loud.  I don't expect anything of the sort from you.  Regardless, this is the last time I will do this.  Your advice to another poster about "getting out of the kitchen" is spot-on, and I intend to take it.  Thanks again.
Avatar universal
Also, purely as a clinician (?) you would say testing would not be recommended; but you would recommend it as general human maintenance?
239123 tn?1267647614
MEDICAL PROFESSIONAL
Asymptomatic herpes has been discussed innumerable times on this forum and in the herpes professional and community forums.  Use the search link.  Or look at some excellent websites on herpes, such as www.ashastd.org, www.westoverheights.com, and www.cdc.gov/std.

Routine HSV screening ("general human maintenance") is controversial; the experts disagree.  But most would say that testing should be limited to people at particularly high risk, e.g. sex partners of persons known to have HSV-2.
Avatar universal
Thanks for the info. I'll some reading.  Just to clarify:  Would you recommend testing now, or in a few weeks?  Is there anything in my most recent exposure that would be worth waiting for?  

BY sex partners of persons known to have HSV-2, you mean a regular partner of specific individuals... and not me, correct?

Thanks for all your help.  I will keep you posted on any results.
239123 tn?1267647614
MEDICAL PROFESSIONAL
I don't recommend HSV testing for you at all.  But if you insist, wait until 4 months after the exposure.

The second question is irrelevant, since in either case it means unprotected exposure to a known infected case.  You didn't have that, so it doesn't apply to you.  For others, it mostly means regular partners, but often one-time partners should be tested.

That's all for this thread (and that's not an invitation to start a new thread either).  
239123 tn?1267647614
MEDICAL PROFESSIONAL
"That's all for this thread" means what it says:  no more comments accepted.  I deleted the discussion between you and username dontworry574 that followed it.  Feel free to take it over to the community forum.
Avatar universal
Sorry, Doctor.  I am having a lot of anxiety over this, and I wanted to update you on my rash diagnosis, and ask about medication versus symptoms.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Updating me that you have confirmed a non-STD explanation doesn't help anything.  Any further questions are more appropriate for your health care provider, not a distant online forum.  End of thread, definitely.
239123 tn?1267647614
MEDICAL PROFESSIONAL
I said this thread is over.  You may not return with every additional anxiety-provoked question that comes to mind.  I deleted the lastest one. Re-read my replies above and pay attention to them.  And do not start a new thread, which would be deleted without reply and without refund of the posting fee.  Good bye.
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