[Question #11935] Concerned about STD risk level and suggested next steps.

11 months ago

Gm had 2 recent unsafe events:

1. Body-to-body massage with genital-to-perineal contact (~1 min)

2. Saliva/hand-to-genital contact + 2 seconds unprotected oral.

Since exposure, had 2 sets of STI tests, including herpes, all neg. Symptoms began with a red mark on the penis (lasted 1 day), followed by 3+ weeks of intermittent irritation, dull pain, and a burning anal sensation that worsens after defecation (with tiny blood spots). The penis, scrotum, and anus are red/irritated, but no lesions have been found in multiple exams. Mild urethral irritation, with weak urine flow slowly improving. The penis is still irritated 3+ weeks later.

Could this be an STD? What should I do to protect my long-term partner? Concerned about the possibility of a permanent STD.

H. Hunter Handsfield, MD

11 months ago

Welcome to the forum. I'm happy to help.

Both events were near zero risk for any and all STIs. The frottage (body rubbing) genital-anal contact without penetration could have been risks for the infections transmitted skin-to-skin, i.e. syphilis, HPV and herpes, but all are unlikely; Mpox could be an issue if currently occurring frequently among men who have sex with men in your geographic area. The second was entirely risk free; no STIs are transmitted by hand-genital contact, even if genital fluid are used for lubrication.

Ad your symptoms really don't with any STI. You don't say how long it's been since the exposure, but presumably at least a couple of weeks since you've had time for two sets of STI tests. Given the natures of the exposures, negative examinations by at (more than one?) health care providers, and your negative test results, I would say they are typical anxiety over the event. magnifying minor symptoms or even normal body sensations that otherwise you would ignore or perhaps not even notice.

I'm confident you have no STI or any other infection from the events described and would advise no more testing and that you continue your usual relationship with your regular partner. However, if they continue -- especially the urethral "irritation" and weak urine flow -- you could see a urologist for what probably would be a reassuring evaluation.

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

HHH, MD

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11 months ago

The massage was perhaps a couple of minutes of massage therapist genitalia rubbing against my peraniel and outside of but. Also other incident was hand to genital to my genital to clarify. My symptoms are persistent.

H. Hunter Handsfield, MD

11 months ago

The duration of the exposure events doesn't change my evaluation or advice and I understood that your symptoms are continuing.---

11 months ago

Thank you I’m sorry I sent that last response before I saw your response they passed each other. My fear is mostly herpes related as I know it can have different reactions on different people. I just keep wondering if the burning anal issue, pain, on going and changing redness could be atypical heroes presentation. It’s been 4/5 weeks since exposure and 3 weeks since onset of symptoms. I did also have a rash on my arm a week before other symptoms started. I am hopeless OCD now with as you suggested anxiety. Whatever is happening seems to wax and wane over the 3 weeks with worsening symptoms at times. I also had a day or two of some irritation itch but I also dumped gobs of powders and creams in my genitalia to try and fix. Thank you for your service

H. Hunter Handsfield, MD

11 months ago

OK, understood about our responses passing in the ether. No problem.

Herpes clinical manifestations indeed are quite varied with "different reactions in different people", but there is a limit to it -- and in my 50 years in the STI business I've never had (or even heard about) anyone with symptoms like yours in whom herpes turned out to be the cause. In addition, in the 20 years of this and our preceding forum at MedHelp.org (now defunct), with at least a thousand questions with exposures and symptoms similar to yours, not one has later reported to us that an STI was found to be the explanation. You won't be the first. And everything you describe is entirely typical of genitally focused anxiety. Truly, the exposure events described were extremely low risk -- and your test results are conclusive.

You simply have no STI from those exposures. Do your best to believe it and move on.

I'm sorry there's nothing more this forum can offer you; and threads are closed after two follow-up comments and replies. I do hope the discussion sinks in and has been at least somewhat helpful. Best wishes and stay safe.

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