Very anxious...please help.

[MistakeMan502]

Doctors,

Good afternoon.  I am in my 30s, married w/ kids, and incredibly stupid.  Almost 3 weeks ago I had an approx 20-30 minute encounter with another man.  We exchanged oral (with condoms) and had brief (1-3 minutes) anal sex (also with condoms).  There was no ejaculation.  We removed our condoms and masturbated afterwards.   I don't have reason to believe he was infected with anything.  He said he was "safe" and is engaged to be married.  No signs (sores, blisters) of anything.  

Since then I have been extremely anxious at times and nervous about the possibility of an STD. I feel guilty and am beating myself up about having to worry over this around the holidays.  I have had no bleeding or discharge from my penis or anus and no burning sensation when urinating.  I have observed no sores, lesions, blisters, etc anywhere.

In the few days after, I did have some mild-med discomfort around my anus.  This was the first time I've ever been penetrated, albeit brief.  That discomfort seems to have subsided.  However, mostly when sitting, I still sometimes have a burning/warm sensation in my buttocks and back of thighs (also sometimes in my inner thighs, pereneal area, or even in my calf).  But, at other times, usually when distracted by work or social settings, I don't notice any symptoms.

I was recently diagnosed with an annulus tear, disc protrusion, and disc herniation in my lower back.  My ortho physician said that the burning sensation in the buttocks and legs could be attributed to the nerves affected by the back injuries, but I can't seem to shake the fear that it's being caused by something worse.

Can you tell me how much of a risk you believe was involved?  
Would the condoms have protected against most STDs?
Is it possible that these sensations are a result of my anxiety?  
Should I trust that these symptoms are caused by my back injury and move on?

If you can give me some peace of mind, I'd be forever grateful.  Thank you!

[Edward W Hook, MD]

Take Care.  EWH

[MistakeMan502]

Thanks, Doctor!  I think my nervousness over the encounter and anxiety is getting the best of me. I appreciate your service here; however, I plan on not needing this forum again.  I will be moving forward and do not plan to find myself in this situation ever again!

[Edward W Hook, MD]

No, none of these additonal comments change my opinion or advice at all.  You should not be concerned about HIV and need to concentrate on moving forward, not fixate on past events.  

there is no reason related to the exposure that you ahve described to worry about having unprotected sex with your wife. EWH

[MistakeMan502]

Doctor,

Thanks very much for your comment.  It did ease my concerns; however, I can't help but continue to experience some anxiety.  This episode continues to linger in the back of my mind any time that I am not otherwise distracted.

When I really think about it, I convince myself that I was not at any risk due to the use of condoms as you indicated.  And, I still have not experienced any of the symptoms I mentioned in my previous post.  However, I am still having some of these burning/warm sensations that come and go, but I do think they may be decreasing.  I got very nervous over the weekend when I felt it again in my lower leg as I had mentioned.  I think even for two brief periods I felt it in the top of my right foot w/slight flushing that went away.  That even fueled my anxiety further, as I then felt it in my shoulders.  And, I do still have other pains, but I am fairly confident those can be attributed to my back injuries at L4-L5 and L5-S1.


Online research seems to inidicate this all could be caused by anxiety or nerve problems associated with my back injuries.
Does any of this change your previosuly stated opinion?
Assuming it does not, can I also assume that you see no reason for testing or any reason not to continue sexual relations with my wife?

Thanks, again.  Happy Holidays to you.

[Edward W Hook, MD]

Welcome to our Forum. I will be pleased to comment. The activities you describe are not associated with risk for HIV infection or, for that matter, other STIs.  Condom protected sex is safe sex and as long as the condom is worn throughout sex and does not break (and yours did not, when condoms break, they break wide open leaving no doubt that they have failed).  

On the other hand, following a first exposure of any sort, particularly if the exposure represents exposure outside of a relationship, guilt and anxiety are nature occurrences and person often tend to note symptoms that they would not worry about otherwise as a result of increased attention to the possibility of symptoms.  I would not worry about the two exposures you mention.

In answer to your specific questions:
Can you tell me how much of a risk you believe was involved?  
As mentioned above, this was a no risk event.

Would the condoms have protected against most STDs?
Yes, condoms represent the best possible protection from STI (including HIV) acquisition if a partner is infected.

Is it possible that these sensations are a result of my anxiety?
Yes, please see my comment.  This is actually rather common.
  
Should I trust that these symptoms are caused by my back injury and move on?
yes, that would be my advice.

I hope that this comment is helpful to you.  EWH