[Question #10933] Continued concerns

18 months ago

Hi, and thanks in advance for your help. I am sorry to be back but I am reaching out once again in an attempt to put a line under this episode. My first was question answered by Dr Hook was number 10899. I have become very frightened of engaging in sex with my boyfriend due to continued fears surrounding possible herpes, HPV, Molluscum and other bacterial urethral infections - potentially though hand to genital contact, jacuzzi water or other fomites at the gay sauna. I am hoping that the added clarity you can provide on potential risks will help me move on as I am by this time, thoroughly mentally exhausted.

18 months ago

Following the unprotected oral sex, I have now tested negative gonn/chlam, HIV, Syphiliis, and Hep C at 14 weeks - Hep B at 30 days. I also took a single dose of 2000mg of Metronizadole on the off chance of trich. However guilt and the high-risk and sordid context of the gay sauna as well as the fact I also manually stimulated the man’s and at least one other man’s genitals (I was very drunk) before touching my own mean that I continue to worry about Genital infection despite no one actually touching my penis or anus.

18 months ago

As the event happened largely submerged in surely filthy (though fully highly chlorinated) jacuzzi water I am also concerned about infection through water or other fomites at the sauna.

Due to anxiety induced hyper vigilance I am continually finding and panicking about almost certainly innocuous signs- anal itching and redness, balantitis like symptoms of the glans, itchy scrotum.. I also found a pimple on my stomach which i convinced myself was molluscum. I squeezed it rather forcefully and no white sebum was expressed, it just bled a little.

H. Hunter Handsfield, MD

18 months ago

Welcome back, but I'm sorry you found it necessary. I reviewed your recent discussion with Dr. Hook and agree with all he said, and these questions generally repeat your questions at that time. As Dr. Hook said, "I would not worry further, I suggest you move forward without concern. I see no medical or scientific need for further testing, for concern, or for abstinence from unprotected sex with your regular partner."

There really isn't much more to say. Here are a few basic facts you should understand. Sexual contact with other men is no risk for trichomonas at all; your metrondizole self treatment was nonsense. So was repeating the STD blood tests etc at 14 weeks; and that test panel mostly was for infections that cannot be acquired during the kind of contact you reported. Hand-genital contact always is risk free for all STIs. Everybody gets and has genital HPV, but rarely from oral sex -- in any case, you and your partner undoubtedly have been repeatedly exposed and infected and your one-off event in the sauna did not raise that risk. I've never seen molluscum contagiosum transmitted by oral sex or after a one-time contact like you report. And infection from jacuzzi water or famine??? Are you serious??? The cleanliness of the environment means nothing in terms of STI risk. Finally, you're obviously over-interpreting trivial symptoms and normal body sensation and skin changes that mean nothing.

The severity of your concerns is overwhelmingly beyond rational reason and almost certainly reflects underlying mental health issues, perhaps about your homosexuality or perhaps sexual events more generally. It simply is not normal to remain so concerned after the reasoned, science based reassurance you have had. This forum cannot help any further. Pleaseconsider professional counseling, which I suggest out of compassion, not criticism. In the meantime, I hope these comments are a little bit helpful.

HHH, MD

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18 months ago

Hi Dr Handsfield,

I apologise for taking up your time on these perhaps trivial concerns… I understand only too well how patience trying illogical anxieties can be in others. I am typically a lot more clear eyed and practical than I appear just now, but as you can probably glean I have been having a hard time emotionally after this event.

This over estimate of risk and amplified concern is certainly due to this and I assure you it is born out of concern for my boyfriend and not for me.

Just wanted to say that In no way doubted Dr Hook’s advice. I have great respect for him and felt he answered clearly and authoritatively. I simply felt compelled to get reassurance on the additional possibility of transmission from water/ surfaces/ hands. I didn’t not realise that this was foolish as a suggestion as it clearly is!

Thank you for your help and candour.

H. Hunter Handsfield, MD

18 months ago

No apology necessary, of course. And of course the concern is for your partner more than yourself. But the absence of any realistic risk in you means he in turn is not at risk, no matter what your sexual practices together might be.

And to reiterate, there is never any STI risk from water, surfaces or hands. If these were significant risks, these infections would be far more common than they are and would not be classified as sexually transmitted!

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