41 year old male, unprotected oral and vaginal at an Asian massage parlor. She  45-50 years old. I didn't go in looking for sex but got charged up. She tried to avoid sex but gave in, she asked for a condom which neither of us had, she cleaned my penis with and alcohol I gave her brief oral and penetrated  for a brief few minutes.   I'm married and this was the first sex outside of my marriage in 16 yrs.  Next day went to a walk in medical center . Baselines where negative and I asked for PEP which I completed and was referred to an infectious disease specialist. At 4 weeks rapid oral negative, syph, gon, chalmidia, tri, negative.  Oraquick(anxiety driven) OTC at 7 weeks  negative.  I've had some strange tingling around my scrotum Dr. said looked like a little jock itch which I do get but no herpes I hit it with cortisone cream and it dried up.  She basically said if I had herpes I would know it in no uncertain terms. Went to a dermatologist and he also saw no evidence of any STI. I am so hypersensitive I think I'm losing my mind.  I went back to the walk in at 8 weeks for a full round of blood and urine testing again and expect the results back today or tomorrow. Essentially, it's unlikely that I have HIV based on the testing. I am worried about Herpes and HPV(warts.) I've been having sex with condoms with my wife for the last 2 months and avoided sex as much as possible. I told her I don't like pulling out and like finishing in the condom. She is noticing my distance and knows something’s  going on with me. I asked for Herpes testing and was told the "panel" was type specific and would tell if there is old or new infection. Based on what I've read testing doesn't seem like a good idea but I can't stop thinking about it. Based on my history how should I move forward? I’m afraid of making my wife sick yet I kind of have to try and get back to normal. Do I go back to unprotected sex with my wife? I'm I over thinking this. It's a one and done...never again. 

Welcome to our Forum.  I will try to help and hope that I can.  you have over reacted to the exposure you describe.  Most commercial sex workers do not have STIs (including HIV) and most exposures to infected partners do not lead to infection.  Were you my patient I would not have suggested PEP and am not sure I would feel it was ethical to recommend it following such a low risk exposure. Further, your tests now show that you were not infected and you have no signs of infection.  It is way past time for you to relax and move forward without concern.

As for herpes, had you had herpes you would have had an outbreak by now. 

Regarding HPV, most people your age have already had HPV (here in the U.S> more than 80% of adults have or have had HPV), the figure is even higher for Americans over age 40.  As already mentioned above, most exposures to infected partners, if yours was which you do not know, do not lead to infection.

It is time for you to move forward.  There is virtually no chance that you are now going to transmit and STI to your wife and it sounds as though your guilt and anxiety are having a negative effect on your relationship.  If you cannot do this on your own and it sounds like you are having trouble, then my advice is to seek out and work through this with a trained counselor.  EWH

Misunderstanding of STIs is not limited to the general population. Many health care providers also have little or outdated knowledge (there is only so much that you can teach in medical school and many studies show that sexual health is among the topics which are poorly taught).  Further, by their very nature, web sites need to give general, not person-specific information.  Be confident that your tests prove that you did not get HIV.  As for HSV, it can take up to six months for a blood test to become positive.  That said, given the rather low risk nature of your single exposure and your current test results, I urge you not to worry further about HSV or other STIs and to move forward with your life.  If you feel strongly about repeat testing, PLEASE DO NOT repeat the herpes IgM test.  Even with a negative test, your odds of having a false positive test next time are far higher than your risk of getting herpes.

Take care.  EWH. 

Our Forum Guidelines allow up to three replies to a client’s questions.  You have received three answers and this will be my final, brief reply.  I hope my comments and the information I have provided has been helpful. 

Your experience is precisely the reason we recommend against blood tests for herpes and particularly against IgM tests.  False positive tests are common.  If your repeat IgG is still negative, this is proof that you did not get genital herpes. 

My concluding recommendation is the same as I made with our initial interaction -"It is time for you to move forward.  There is virtually no chance that you are now going to transmit and STI to your wife and it sounds as though your guilt and anxiety are having a negative effect on your relationship.  If you cannot do this on your own and it sounds like you are having trouble, then my advice is to seek out and work through this with a trained counselor.

This thread will be closed later today.  Take care.  EWH