[Question #11627] Herpes and HPV risk?

13 months ago

Hello doctors, I had risky exposure 6 weeks back. I got unprotected blowjob from a woman for 10-12 seconds and protected vaginal sex for like 1 second. It was 1 pump and I freaked out and stopped it. She is Bi-sexual. At 6 week mark I tested for gonnorhea, clamydia, herpes, syphilis, HIV, trichimoniasis, Myco plasma genitilia. All of them are negative. I have penis burn sometimes after I urinate, Tingling sensation and my groin area will ache sometimes. These symtpoms are on and off for the past 6 weeks. I'm not able to empty my bladder completely sometimes, It drips for 2-3 times after I urinate, not everytime though.
1. I know my results are conclusive for all the tests, except HSV and there is no test for HPV. What are my chances of contracting HSV from this? On day 41, I noticed my urethra had lot of tingling for like 30 min but I see no sores or outbreak. It went away and nothing till now. I gave test on day 43 after that extreme tingling and everything was negative. Today is day 44. Do you think the tingling was related to HSV without any outbreak for 4 days after it?
2. As I don't have any sores for 6 weeks and symptoms are persistent all 6 weeks, Do you think it is Herpes? Will herpes symptoms be this long without outbreak? I tested yesterday and it was negative IGG. Am I out of woods for herpes? I saw terri saying at 6 week mark 70% conclusive on other tickets.
3. Is HPV transmittable from oral to genital (penis), if yes what are the odds? What is my exposure to HPV? As woman was Bisexual, I'm not sure if she had oral HPV. If I don't see any warts for next 6 -8 months, Am I out of woods?
4. Have you seen anyone get HPV from oral sex (Blowjob, from a woman) without condom in one-time exposure?
5. If I take HPV vaccine now, will it be effective after my risky exposure? I'm 26 yrs old and recently came to usa. Never had HPV vaccine or exposure to it.

H. Hunter Handsfield, MD

13 months ago

Welcome to the forum. Thank you for your confidence in our services.

You describe a low risk sexual exposure, even if your partner was at pretty high risk -- because the vaginal exposure was condom protected and very brief, and oral sex is low risk -- and that event also was brief. In addition, you are correct that your test results are conclusive. As for your symptoms, they do not fit with herpes, HPV, or any other STD. They are very typical for genitally focused anxiety -- i.e. the physical component of your anxieties and worries about the exposure, and perhaps regret about it. To your specific questions:

1,2. Herpes does not cause the kinds of symptoms you describe, and the risk of herpes from the exposure was nearly zero. Although you will find "tingling" mentioned online as a herpes symptom, that only happens with actual herpes blisters and sores: tingling sometimes starts a day or two before a recurrent herpes outbreak, then clears up as the sores develop then heal. Otherwise, tingling is not a herpes symptom. I would have advised against a blood test for herpes -- but the negative result at 6 weeks is reassuring. Most newly infected people would test positive by then, although many would not.

3. Oral sex rarely transmits HPV. The brief condom-protected vaginal (or anal?) sex probably was higher risk for HPV, but still low for such brief contact. Your closing question suggest you never had sex before? Is that what you mean by "never exposed" to HPV? If you have been sexually active, you can safely assume you already have been infected with HPV. Over 90% of all people acquire genital HPV at least once, within their first few lifetime partners. It is normal to become infected. Either way, this particular event did not significantly elevate the chance you have HPV.

4. No, I am not aware I have ever seen a patient -- or even heard of one -- who acquired HPV after a single oral sex event.

5. If you indeed have had few sex partners, you certainly can be vaccinated against HPV. It will prevent infection with the nine types of HPV that cause 90% of genital warts and cancers. (There are over 100 types of HPV -- you will not be protected against most of them, but the large majority never cause symptoms or disease.) Vaccination will not prevent HPV from the exposure 6 weeks ago, but that was such low risk that it really should not matter.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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13 months ago

Thanks doctor. I have this burn feeling on my penis though. It is there for like 6 weeks now. It tingles sometimes and dull ache in my balls and groin area. It goes away for 2-3 days and come back to stay for another 2 days. Today morning before urinating I noticed small drop of pre-cum like discharge. I’m freaking out now, I dont have any discharge all these days but I dint masturbate for like 6 weeks and got 4-5 wet dreams.

1. I went to urologist they did urine culture and it was negative. He said there might be urethra inflammation and gave me neproxen. Can this be NGU or any bacteria that is going undetected? Should I ask for doxycycline to remove it or do you recommend anything? Do semen culture?

2. Are these signs of herpes? You said they are not with out blisters and I tested negative at day 42 on IGG. But online reddit forms saying hsv can cause burn, tingling feeling. I’m freaking out as Im in long term relationship. How possible is herpes with no sore and negative results at 6 week mark.

3. I’m sure there is some bacteria transmitted from oral, not able to figure out what? Based on your experience what can it be? Have you seen cases like this?

4. Can I have sex with my partner, will ai infect her?

H. Hunter Handsfield, MD

13 months ago

Assuming "pre-cum like" means clear discharge, not cloudy, probably nothing is abnormal. Urine culture takes a couple of days -- has there been time for that result? Anyway, that just checks for UTI, for which I see no concern.

1. The vague sort of aching you describe also doesn't sound significant; it's typical for increased awareness on trivial symptoms or even normal body sensations that you would ignore or perhaps not even notice, except for your concern about your sexual exposure. Do not ask for doxycycline or any other antibiotic until or unless an infection is diagnosed. (But it sounds like your urologist is not familiar with standard evaluation methods to diagnose urethritis, i.e. "urethra inflammation". I remain confident you have no infection or any other health problem related to the sexual exposure you desecribed.

2. No. Herpes does not cause such symptoms.

3. Oral bacteria can cause urethritis, but symptoms would have started within a few days of exposure. You have no way to be "sure" that you have such a problem.

4. I have no suspicion at all that you have any infection that could harm your partner.

Your symptoms continue to be typical for genitally focused anxiety, and not for any infection. Or chronic pelvic pain syndrome (CPPS), the long term version of the same thing. Google it for more information; the Wikipedia article is good, and so is information on CPPS from the Stanford University Dept of Urology.---

13 months ago

Thanks doctors. One last question, I was taking biotin 5000mcg for 3 months. When I read articles online about biotin interference with HiV tests. So, I stopped it for 2 days and gave test after 58-60hrs of last dose. Is that conclusive or do you think it will still interfere with my results? I gave tests on day 42. I’m asking because I have tight throat for 10 days now. Not sure from inside or outside, feels like throat muscles are very stiff. It feels like someone has put a hand around my neck. Doctor said it is allergies and gave some medications few days ago and have pain, tingling, dull ache on penis. Urine retention sometimes. I have no discharge, sores, rash, fever. I was seen by urologist today and said everything looks down there. Are my tests conclusive, do you suggest giving any testagain based of symptoms and biotin?

If not I’ll leave everything behind, have normal life and be close to my patner again. It’s been 7 weeks now I’m avoiding her. It is affecting us.

H. Hunter Handsfield, MD

13 months ago

I have little knowledge at all about biotin as a conditioning supplement, but 5,000 mcg strikes me as a pretty high dose -- a lot higher than in typical multivitamin supplement. I believe two days is enough time to avoid interference with the test. But I'm not a laboratory medicine expert and it wouldn't surprise me if it takes longer.

That said, it is impossible to have symptoms from HIV and test negative -- probably independent of biotin. Those syptoms don't suggest HIV anyway. Your symptoms are typical for the physical manifestations of anxiety, in particular gentially focused anxiety. And in 20 years of this and our preceding forum, with thousands of quesiton from people worried about HIV exposures and testing, not one has yet tested positive. You won't be the first -- especially after a virtually zero risk exposure.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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