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Need To Know what to test for
Hello Doctor This is my history 25 year old hetero male ive been with 6 partners in the last 12 months here is what happened 1)Protected Vaginal sex from high end escort seen a little blood on tip of condom when we finished (5 min of total sex)10 months ago. 2)Received oral sex from 2 ecorts unprotected for about 10 min (9 months ago). 3)Protected sex for about 5 min.(8 months ago).4)Protected sex with a condom that was a little too big but never came off it was just loose for about 10min.(6 months ago). 5) Protected sex with a stripper for 2 min (5months ago). 6) protected sex for 1 min and finished by masterbation on her. Never had any symptoms except for last week i got a group of bumps and was worried it was herpes they were red in collar and were grouped together on my buttocks i never had any genital outbreaks ever so i went to the E.R and they did a culture and 4 days later i called back and they said it was not hsv1 or hsv2 they said it was follicullitus is this common in that area and does it group up sometimes. And my last quistion is what should i be checked for i am very scared hiv is a possibility even though all my sex is protected i do have a wife and would not want anything to ever happen to her because of my mistakes in your experience would it be a good bet that i could have hiv or any other stds and is the culture they did 2 days after i seen the bumps on my buttocks accurate in diagnosing herpes can i beleive the result from the culture it cost me $130.00 for the culture so im assuming it was a good test Thanks very much for your time
MEDICAL PROFESSIONAL
Thanks. With this more detailed description, your problem sounds much more like folliculitis than herpes. You can disregard my advice above about further HSV blood testing, unless you're just curious about your HSV-2 status. (Should it be positive, I would conclude that your buttock lesions probably were folliculitis and that you also have an asymptomatic HSV-2 infection.)
The rest of my advice about routine STD/HIV standing still holds. Even though you have had no obvious condom lapses, your sexual lifestyle still warrants testing from time to time. If you are successful in changing that behavior, with or without counseling, obviously you won't need further testing in the future.
The rest of my advice about routine STD/HIV standing still holds. Even though you have had no obvious condom lapses, your sexual lifestyle still warrants testing from time to time. If you are successful in changing that behavior, with or without counseling, obviously you won't need further testing in the future.
Thanks for your comment i will do everything you suggest and hopefully everthing is negative
Thanks for your fast response for dr. handsfield the it was about 4 inches in diameter not any pattern just scattered but some were right next to each other. Lookied more like pimples then blisters. i took the culture 2 days after the rash came so hopefully if it was herpes it would have shown up. I am not continuing in this type of behavior i am going to counseling for my sex problem i just hope with the condom protected sex in all my single episodes doesnt lead to any stds Thanks For your Respose.
To Dr.Hook i never had a condom come off it was just loose and i received oral once unprotected by two girls at the same time would this change anything as far as possibilities of stds including hiv Thanks for your fast response from the first quistion
To Dr.Hook i never had a condom come off it was just loose and i received oral once unprotected by two girls at the same time would this change anything as far as possibilities of stds including hiv Thanks for your fast response from the first quistion
MEDICAL PROFESSIONAL
As sometimes happens Dr. Handsfield and I worked on your questions simultneously, thus you get two answers for the price of one. As you will see, we come to similar conclusions.
Your overall risk for STDs, including HIV, from the assortment of activates you describe is very low. Most of the vaginal exposures were condom protected and thus safe sex. Otherwise, your unprotected activities include a single episode of unprotected vaginal sex due to condom slippage, several episodes of unprotected receipt of oral sex and masturbation of a CSW. The combined risk from all of these activities is rather low. Most people, including commercial sex workers do not have STDs and most exposures to infected partners do not result in transmission. This, combined with your condom use make you rather low risk. Low risk however is not no risk. You do qualify for periodic STD "screening (testing in the absence of symptoms) because you have had multiple partners over a period of less than a year - just to be sure. As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).
Finally, the rash you describe is really more consistent with folliculitis than with HSV. I suspect your HSV culture was fine. Cultures for HSV however and not perfect but, when combined with the doctors assessment, your description and the negative culture, it is unlikely that you have HSV from your encounter of concern.
Hope this helps. EWH
Your overall risk for STDs, including HIV, from the assortment of activates you describe is very low. Most of the vaginal exposures were condom protected and thus safe sex. Otherwise, your unprotected activities include a single episode of unprotected vaginal sex due to condom slippage, several episodes of unprotected receipt of oral sex and masturbation of a CSW. The combined risk from all of these activities is rather low. Most people, including commercial sex workers do not have STDs and most exposures to infected partners do not result in transmission. This, combined with your condom use make you rather low risk. Low risk however is not no risk. You do qualify for periodic STD "screening (testing in the absence of symptoms) because you have had multiple partners over a period of less than a year - just to be sure. As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).
Finally, the rash you describe is really more consistent with folliculitis than with HSV. I suspect your HSV culture was fine. Cultures for HSV however and not perfect but, when combined with the doctors assessment, your description and the negative culture, it is unlikely that you have HSV from your encounter of concern.
Hope this helps. EWH
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'll try to help.
On one hand, a health professional's judgment about a diagnosis of folliculitis usually is reliable. On the other hand, I disagree that folliculitis often appears in small clusters. How widespread were the individual lesions? If you had a cluster of blister-like or pimple-like lesions, and if the cluster was small (say an inch in diameter or less), then herpes sounds more likely than folliculitis. Another possibility is herpes zoster (shingles), which is due to a different sort of herpes virus -- specifically, HZ is localized recurrence of the virus that caused your probably chickenpox as a child. Or maybe the folliculitis diagnosis was correct, even for a localized cluster. A negative culture test does not rule out HSV-2, the usual cause of genital herpes -- especially if the test was taken more than 2-3 days after onset of the lesions.
If you have herpes, it almost certainly is a recurrence of a genital infection you have had for a long time, i.e. a few months or even years. None of the sexual exposures you describe is likely to have been the source, since all were protected or otherwise at low risk for exposure to HSV-2. In any case, many new genital HSV-2 infections are asymptomatic, and first cause symptoms when there is a recurrent outbreak. Although most recurrent episodes are on or near the genitals, it can happen anywhere in the "boxer shorts" area, including a buttock.
What to do now? You should have a blood test for HSV-2. If that's negative, you can be very certain herpes was not the cause of your cluster of lesions. If positive, it will mean HSV-2 was the probable cause. In addition, if you ever have another, similar outbreak, see a doctor or clinic immediately, i.e. within 1-2 days, at which time a culture or PCR test is most likely to be positive.
There is nothing in your sexual history or your symptoms to suggest HIV or any other STD. But since you're nervous about it and obviously have a pretty active non-marital sex life, it would make sense to be tested to be certain. Talk to your doctor or clinic about routine STD testing (gonorrhea, chlamydia, syphilis) and an HIV blood test. Most likely all will be negative, but better safe than sorry. Assuming they are negative, if your sex life continues as it has been, plan on repeat STD/HIV testing about once a year.
Good luck-- HHH, MD
On one hand, a health professional's judgment about a diagnosis of folliculitis usually is reliable. On the other hand, I disagree that folliculitis often appears in small clusters. How widespread were the individual lesions? If you had a cluster of blister-like or pimple-like lesions, and if the cluster was small (say an inch in diameter or less), then herpes sounds more likely than folliculitis. Another possibility is herpes zoster (shingles), which is due to a different sort of herpes virus -- specifically, HZ is localized recurrence of the virus that caused your probably chickenpox as a child. Or maybe the folliculitis diagnosis was correct, even for a localized cluster. A negative culture test does not rule out HSV-2, the usual cause of genital herpes -- especially if the test was taken more than 2-3 days after onset of the lesions.
If you have herpes, it almost certainly is a recurrence of a genital infection you have had for a long time, i.e. a few months or even years. None of the sexual exposures you describe is likely to have been the source, since all were protected or otherwise at low risk for exposure to HSV-2. In any case, many new genital HSV-2 infections are asymptomatic, and first cause symptoms when there is a recurrent outbreak. Although most recurrent episodes are on or near the genitals, it can happen anywhere in the "boxer shorts" area, including a buttock.
What to do now? You should have a blood test for HSV-2. If that's negative, you can be very certain herpes was not the cause of your cluster of lesions. If positive, it will mean HSV-2 was the probable cause. In addition, if you ever have another, similar outbreak, see a doctor or clinic immediately, i.e. within 1-2 days, at which time a culture or PCR test is most likely to be positive.
There is nothing in your sexual history or your symptoms to suggest HIV or any other STD. But since you're nervous about it and obviously have a pretty active non-marital sex life, it would make sense to be tested to be certain. Talk to your doctor or clinic about routine STD testing (gonorrhea, chlamydia, syphilis) and an HIV blood test. Most likely all will be negative, but better safe than sorry. Assuming they are negative, if your sex life continues as it has been, plan on repeat STD/HIV testing about once a year.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
