[Question #12900] Question about STD
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4 months ago
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Dear Doctor(s),
i hope you are doing well. As you can see from my previous questions, i am somehow a sexually active person, and since my last question i had around 8 or 9 exposures, involving oral and vaginal sex with escorts, normal people at Pub and 1 prostitute in streets. all of my vaginal and oral sex were condom protected except 2 times oral sex without condom with 2 escorts. so far i did not have any symptoms and not even got sick.
1- My last exposure was with a prostitute around 23 years old from Romania all protected and condom was intact after all, do you consider this exposure as high risk?
2- recently i noticed 2 or 3 black spots (not too much black but different in color from surrounding sking) on the head of penis and shaft, they look flat and are not bumped as i noticed. i suppose i had one of them before, it looks like penile melanosis but i am not sure, i want to know can be these spots due to hpv or hiv?
3- how do you evaluate my conditing surrounding STDs like hpv, hiv, hsv2, since all of my vaginal sex were protected, and i had 2 oral sex unprotected with escorts.
4- is it possible that these black spots are due to bowenoid papulosis? i have heard it is caused by immunosuppresion like hiv? is it true?
5- i am planning to do some tests period to period, however i am somehow afraid of positive results specially about hiv and hpv, how likely is it?
at the end i appreciate your help and happy easter.
i hope you are doing well. As you can see from my previous questions, i am somehow a sexually active person, and since my last question i had around 8 or 9 exposures, involving oral and vaginal sex with escorts, normal people at Pub and 1 prostitute in streets. all of my vaginal and oral sex were condom protected except 2 times oral sex without condom with 2 escorts. so far i did not have any symptoms and not even got sick.
1- My last exposure was with a prostitute around 23 years old from Romania all protected and condom was intact after all, do you consider this exposure as high risk?
2- recently i noticed 2 or 3 black spots (not too much black but different in color from surrounding sking) on the head of penis and shaft, they look flat and are not bumped as i noticed. i suppose i had one of them before, it looks like penile melanosis but i am not sure, i want to know can be these spots due to hpv or hiv?
3- how do you evaluate my conditing surrounding STDs like hpv, hiv, hsv2, since all of my vaginal sex were protected, and i had 2 oral sex unprotected with escorts.
4- is it possible that these black spots are due to bowenoid papulosis? i have heard it is caused by immunosuppresion like hiv? is it true?
5- i am planning to do some tests period to period, however i am somehow afraid of positive results specially about hiv and hpv, how likely is it?
at the end i appreciate your help and happy easter.
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H. Hunter Handsfield, MD
4 months ago
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Welcome back to the forum. However, as we have discussed previously, you continue to describe pretty much the same kinds of exposures every time. My replies again are the same as before.
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1. This exposure was little or no risk for HIV, and no higher risk than the others you have described.
2,4. These symptoms do not sound like HPV and certainly HIV would not cause darker spots on the penis. They certainly do not sound like bowenoid papulosis; and this would never be the only consequence of immunosuppression due to HIV. It sounds to me like nothing is abnormal; you clearly tend to over-interpret or over-worry about HIV/STI symptoms; see my comments below. But seeing a doctor in person is the only way to judge whether this needs medical attention.
3,5. All in all, you are at very low but not zero risk for HIV and other STIs. As suggested by question 5, you are doing the right thing by planning to be tested. Rather than getting tested after every exposure, a much smarter approach in your situation is to be tested periodically, maybe once every 6-12 months; or perhaps after every 5-6 new sexual partners. Such routine testing should include only urine for gonorrhea and chlamydia and blood tests for HIV and syphilis. There are no useful tests for HPV, and you shouldn't worry about it. However, it would be wise to be vaccinated to prevent infection with the 9 types of HPV that cause 90% of HPV related health problems.
As for not testing for HIV because you fear the results, you know that is nonsense. When people delay testing because they fear the result -- whether HIV, colonoscopy, mammograms for women, etc, etc -- anxiety always declines after testing, even if the feared result is found (e.g. HIV positive). Fear of the outcome is more stressful than knowing the answer. So for sure do not hesitate to be tested for HIV from time to time. Based on your sexual history, the chance you ever will have HIV is very, very low.
Let me know if anything isn't clear.
HHH, MD
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4 months ago
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Dear Doctor,
I appreciate your help. i would be grateful if you could help me with following questions.
1- As you said, my chance for HIV is very very low, is it theoretically ? since all my vaginal sex were protected and i was cautious that condom does not break or slip away, can i say practically it is really really unlikely that i got infected?
2- recently i started a committed relationship, however so far we just had sex with condom. can i start having unprotected sex with her? and like giving and receiving oral sex without protection before my test? since here in italy for 2 weeks everything is closed and we are going on a vacation.
3- have you ever had a client with sexual history like me turning positive?
thanks in advance
I appreciate your help. i would be grateful if you could help me with following questions.
1- As you said, my chance for HIV is very very low, is it theoretically ? since all my vaginal sex were protected and i was cautious that condom does not break or slip away, can i say practically it is really really unlikely that i got infected?
2- recently i started a committed relationship, however so far we just had sex with condom. can i start having unprotected sex with her? and like giving and receiving oral sex without protection before my test? since here in italy for 2 weeks everything is closed and we are going on a vacation.
3- have you ever had a client with sexual history like me turning positive?
thanks in advance
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H. Hunter Handsfield, MD
4 months ago
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1. This just states what I said in different words. Of course I agree.
2. I have no way of knowing the chance your partner has an STD. You mention your plan to be tested. Why don't the two of you both get tested together for syphilis, HIV, gonorrhea and chlamydia? If both your results are negative, you'll know you can safely have unprotected sex.
3. If you mean positive for HIV, the answer is no; I have never had such a patient. Of course that doesn't mean it can't occur: rare things happen. I've never had a patient struck by lightning, but of course that doesn't affect your chance of being struck. Same for HIV.
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4 months ago
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Thanks doctor. regarding the second question, she is safe, i was talking about my situation towards her, like based on what i described about my history (also i was tested 6 months ago), would you trust enough these numbers and statistics so not putting her at risk if you were in my situation? thanks in advance
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H. Hunter Handsfield, MD
4 months ago
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Even with a new partner for whom there is confidence in her sexual safety, many couples get tested together as a show of respect and commitment. But of course this is up to you.
I've already said there is almost no chance you have HIV or any other STI. How many times and in how many ways do you need me to say it?
As I said in my opening comments, all four of your questions over the past year have been pretty similar to one another, and your risks have not changed. Repeated questions on the same topic are not permitted, especially when anxiety driven as your have been. This will have to be your last along these lines; you may not keep returning to ask your risk every time you have a new partner. Such repeated questions may be deleted without reply and without refund of the posting fee. This policy is based on compassion; experience shows that repeated answers tend to maintain anxiety rather than relieving it. And the forum sponsor is not keen on collecting fees for questions with known answers. Finally, such questions have reduced education value for other readers, one of the forum's goals.
Thank you for your understanding. I hope this and your previous discussions have been helpful to you. Best wishes and stay safe, as you have been.
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