[Question #1462] Update from question #369

96 months ago

Hello again Dr. Hook, my apologies for coming back with more questions. Last year we talked about my situation and in January I took a HIV test and it came back negative as u said it would. Should I trust the results? I haven't had any exposures of any kind, not that I know of. I am curious about something. I started having anal problems like itching and burning irritation. I went to my doctor and he did a digital on me and said it's hemorrhoids and anal prisitus(itching). He prescribed me hydrocortisone cream, Tusk pad, and to do Sitz bath and keep clean there as much as possible. It started in July and I still feel irritation but not the itching anymore. Do u think my anal problem may be corporated with an STD like HPV, syphilis, or herpes? My wife just start in November with the same problem but she doesn't have the anal itching though? I also look at her bottom and I seen skin hanging out a little bit. Plus I seen rough patches around her anal opening. Thanks in advance

96 months ago

I forgot to mention there was bleeding as I wipe with toilet paper as well not a lot. My wife the same.

H. Hunter Handsfield, MD

96 months ago

Welcome back to the forum. Dr. Hook and I take questions at random, and I'm up at the moment. However, I reviewed your previous discussions with Dr. Hook almost a year ago. I'm sorry to see you remain unnecessarily concerned (obsessed, even) with your past sexual exposure.

As Dr. Hook informed you (repeatedly, I'll point out), the HIV tests are always conclusive if done more than a few weeks after the last possible exposure. There are no exceptions: the HIV blood tests are among the most accurate diagnostic tests ever developed, for any infection. The results always overrule everything else, such as symptoms and exposure history. And in your case, neither your exposure history nor symptoms even hint at HIV. So you definitely should trust the result.

As for your anal symptoms, they indeed sound like hemorrhoids, pruritus ani, or both; or maybe a localized yeast infection, which is common in the anal area. They are not typical of any of the STDs you mention, none of which causes anal itching of the sort you and your wife have experienced. The scant bleeding goes along with hemorrhoids.

So all in all, my advice is to do your best to forget and move on with no further regard to the sexual exposure that started all these concerns. Psychologically, it seems to me you have conflated your anxieties about a sexual decision you regret with the medical consequences of that decision. But they aren't the same. Deal with the former as you need to, but go forward without any concerns about the latter. You cannot go through life assuming that every health related tingle and twich is somehow related to it. None have been in the past, none are now, and there will be none in the future.

I hope that helps, but let me know if anything isn't clear. Best wishes-- HHH, MD

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96 months ago

Hopefully this my last response. I haven't noticed any breakouts of any kind after the events I've done last year that I know of(lesions, sores/bumps). I quote your words from another question you've answered about condom slippage but didn't come all the way off. Base of penis skin to skin contact, "However, absence of typical symptoms by 13 days(urethral discharge with or without pain urination penile blister/sores) at 13 days is strong evidence you didn't acquired gonnorhea, herpes, or NGU." Does that include syphilis and HPV?

Also from my reading from you and Dr. Handsfield on medhelp and here. In fellatio, a woman and man can contract STD during the event? In cunnilingus, only the female can contact a STD and not the male because it nearly zero risk for all STD, right?

H. Hunter Handsfield, MD

96 months ago

That quoted statement was specifc to the STDs mentioned. Syphilis takes longer to show up, typically 2-4 weeks. Most HPV never causes symptoms; when it does, e.g. warts, they appear anywhere from 2 months to a year after exposure, average probably 3-6 months. Cunnlingus risks STD transmission for either partner, but very rarely for both.

You're just not getting it. You had an extremely low risk event and all evidence is that you were not infected with anything. Please re-read my last paragraph above; and also go back and carefully read every word of both this discussion and your previous ones with Dr. Hook. Then move on with your life. If you cannot, professional counseling may be in order. It is quite abnormal to remain so irrationally concerned after the repeated, reasoned, science-based reassurance you have had.

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96 months ago

Ok that's all I needed to confirm everything. I trust you and Dr. Handsfield because you all have done this for years. So in conclusion I "WILL NOT" think about this ever. I salute and thank you all for all everything. Wish I can do something for y'all. What I've learned from yall, I will teach others. Thanks again!!!

H. Hunter Handsfield, MD

96 months ago

Thanks for the kind words. That's why we're here. Take care.

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