[Question #11351] Help Please
15 months ago
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Hello I am a gay male is is just starting to experience sexually and I think I may have gotten carried away. Last mont (5.5 weeks ago) I hooked up with several guys. All we did was deep kiss, jerk each other off and lick on each others bodies. Now I am super nervous.
1. Are there any stds I can get from deep kissing and having these guys lick on my body (nipples and stomach)? I am particularly concerned about syphilis and herpes
2. Are there any stds I can get from jerking these guys and having them jerk me? What if they had semen on their hands on vice versa.
I went out to get a tested. I am still waiting for the RPR Syphilis test and my mind is racing. Usually it does not take this long to get results back. Should I be concerned.
While waiting I got a rapid syphilis antibody test. Should this give me reassurance or should I wait for the RPR test? I’m not sure what’s taking so long.
I am only 21 so I’m so scared and don’t want to tell my parents
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H. Hunter Handsfield, MD
15 months ago
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Welcome to the forum. Thanks for your confidence in our services.
You're not (yet) at risk for any STD. Without penile-oral or -anal (or -vaginal) penetration, there typically is little if any risk. You'll find online resources -- largely run by anxious or otherwise biased posters, e.g. places like Reddit -- that will advise differently, saying that some STDs are transmitted by skin-to-skin contact, that saliva is a risk, or that (they swear) they were infected by hand-genital contact, fingering, kissing, and so on. And indeed there is some controversy about gonorrhea risk from kissing among men having sex with other men (MSM). But all these are nonexistent, or so rare the risk should be ignored. The business about skin-skin transmission doesn't mean ANY skin contact; it only refers to the skin-skin component of penetrating sex. Syphilis, HPV and HSV are transmitted primarily by contact between infected and susceptible surface during sex, but only then. By contrast, gonorrhea, chlamydia and HIV are transmitted in genital fluids.
Those comments pretty well cover your specific questions, but explicitly: kissing conceivably small risk of gonorrhea, and syphilis is rarely so transmitted; and you could acquire herpes due to HSV1 (but oral herpes isn't generally considered an STD). Oral contact with breasts and nipples is risk free. Nobody has ever been known to acquire any STD by hand-genital contact, even when genital fluids are used for lubrication. One can imagine a potential risk for herpes, but in 50 years in the STD business, I've never seen or heard of it happening.
So I would not have recommended any testing you describe. Time to receiving a result almost always is simply related to when the lab does the test once a specimen arrives (which can take time), and time to convey the result after doing the test. Increased time does not imply a positive result. Your RPR will be negative. (What other tests did you have?)
If and when you begin having real sex with other guys, please take proper precautions: Never without first discussion STD/HIV status; ideally condoms for anal sex, either insertive (top) or receptive (bottom). Or if not condoms, consider pre- or post-exposure prophylaxis with anti-HIV to prevent HIV (PrEP, PEP); and if especially high risk (multiple non-monogamous partners), doxycycline after exposure to prevent chlamydia and syphilis (doxy-PEP). A knowledgeable sexual health clinic or HIV/AIDS provider will be familiar with these details.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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15 months ago
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Thank you doctor. This reminds me of a follow up question. Right after my encounter with the guy, I took PEP(out of nerves). Half way through my PEP I had sex with my female partner. Now she has recurrent thrush (confirmed as thrush by the doctor.) she took antifungals a few weeks ago that worked but now the thrush has returned (confirmed as thrush by a doctor). My questions are below:
1. Is it possible that I could have transmitted HIV to her while I was on PEP even though i am now negative? Could the PEP have cleared the HIV out of my system, but still transmitted to her? (I would like to add that through out my PEP treatment and beyond I have tested neg on various tests).
2. I only find info saying that oral thrush is a result of HIV. I know she hasn’t been with other people, and she also has iron deficiency anemia. Could the anemia be causing her thrush?
This whole situation is driving me with anxiety.
15 months ago
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I forgot to add that I initially took PEP because the guy tried to insert into me and rub is penis against my anus
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H. Hunter Handsfield, MD
15 months ago
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Yeast infections (thrush) are not common in early HIV infection; they are common problems only in longstanding HIV with substantial immune deficiency, i.e. overt AIDS. While I can't comment on the reliability of the diagnosis in your wife, vaginal yeast infections occur in virtually every healthy woman from time to time. Even recurrent vaginal yeast infections almost never are the result of HIV infection. And even if she has oral yeast, it is NOT a sign of immune deficiency; and anyway, immune deficiency cannot occur sooner than many months to a few years after acquiring HIV. So her diagnosis does not change my evaluation and advice above. There is no possibility her yeast infection(s) have anything to do with your sexual exposure(s).
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1. No, impossible.
2. Anemia is not a likely cause of yeast infections, but that doesn't mean HIV is the explanation. It is not.
PEP was not warranted in this situaiton. Its main effect now means a long delay when you can have conclusive HIV testing.Too bad.
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14 months ago
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Thanks doctor. It has now been 5 weeks after I finished my course of PEP and I tested negative with a 4th generation test. I am relieved but have a few final questions:
1. Does this final test result mean that it is no way possible that I could have given my female partner HIV when we had sex while I was taking PEP?
2. She told me that her doctor told her she had oral thrush on her toungue via virtual consultation. However she said that her toungue does not hurt or doesn’t feel weird at all. Is oral thrush usually painful? Everything I read associates oral thrush with HIV.
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H. Hunter Handsfield, MD
14 months ago
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1. It was already impossible you have HIV or could have infected your partner. The negative test result confirms it.
2. Visual diagnosis of oral thrush is inherently unreliable; and many doctors use the term "thrush" even when yeast infection isn't known to be involved. Your "everything I read" statement reflects your non-objective searching. Re-read my comments above and limit your online searching to reputable professional or professionally moderated sites. I've personally cared for innumerable patients with oral yeast infections who did not have HIV -- in far greater numbers than those who did have the virus.
That concludes this thread. Do your best to accept, believe and understand the reasoned, science based advice you have had. Best wishes and stay safe.
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