Dear doctors,

I’m a 30 year old Asian male from Jakarta, Indonesia. My extra-marital exposure (my first and last exposure) was more than 2 and a half year ago on December 11, 2014. Which is a condom-protected oral sex with a CSW that last for about 10-15 minutes. I put the condom through the whole exposure and before she started she put some blanket in base of my penis, so i guess she was being careful too, the condom did not break or tear until finish. I do have concerns about this sexual contact and my chances of passing on or getting an STI, so i get tested (and retested) for STI, such as syphilis, HSV 1 & 2 using IGM and IGG test. Chlamydia through blood test, hep b and hep c and hiv. My latest HIV test was on January 11, 2017 using 4rd generation test and on April 28, 2017. All negative, i guess my HIV test is conclusive, right?

I am a very anxious person and have intrusive thought that i caught something from this. This is worsened when i went to a dermato-venerologist about my reddish skin bruise (which i suspect came from my rough masturbation) and some brown spot on the scrotum. The doctor told me that it was herpes and GWS respectively only from visual diagnostic. Quite upset i told him that my hsv 1 and 2 is negative. He is quite hesitant and asked me to do another hsv 1 and 2 igg only. The next day i went to a different doctor, and to my surprise he is acquainted with the first doctor. He looks at my bruise and brown spot and told me that was skin chaffing and benign Seborrheic keratosis and i have nothing to worry about and actually no testing is ever needed for my exposure in the first place and prescribe me clobazam for my anxiety. He also told me that the doctor was a young doctor who focus more on the cosmetic side and quite inexperienced dealing the venereal disease and told me that I’m in the clear.

Please assess my situation.

Welcome to our forum. I cannot make a diagnosis of your lesions over the Internet but the sexual encounter you describe was close to no risk and the lesions you describe do not sound like STIs of any sort.  Most CSWs do not have STIs and when they do they are less commonly oral infections.   Your exposure was condom protected which makes infection less likely as well.  If you had asked me if you needed testing, I would have said no.  I suspect the doctor you saw was inexperienced and was incorrect.  My advice is not to worry.  EWH---

I should add that blood tests for gonorrhea and Chlamydia are not recommended as they are often incorrect, being both falsely negative and falsely positive.  I say this NOT because you need testing but for future information, should you need it. Please do not be worried.  EWH---

Thank you doctor,

Could you elaborate more on your answers, how about my HIV test? It is conclusive? Is that mean that i don't have HIV? I've been obsessing about this exposure for two years now and would really like a closure. I have a bad fever and tonsillitis couple days back and all i could think about whether this is ARS, but ARS could not be after 2 years right? Regarding the false positive test, i do have an low positive titer on my first IGM HSV 1 test, i got retested again in 1 month and 6 month using IGG Only and it is negative. Is it also conclusive for my HSV 1 status? My HSV 2 IGM and IGG is negative, but i got it tested 18 days after exposure, do you think it is to early? My first doctor did not tell me to get tested again for HSV, because he think the odds is low for me to acquired HSV 2 from this exposure. Do you think i need to get retested for HSV 2?

Your HIV tests are conclusive and should be believed.  You should be totally confident in the results..---

Dear Doctor Hook,

Thank you for your explaination, i am very nervous and scared about this exposure. What about HPV or other STI? Can i assume that i did not contracted any STI from this exposure and could move on with my life without worry that i might transmitted anything to my spouse? I do have a bad fever and tonsilitis a couple days back, and I remembered that I had bit off a hangnail on one of the fingers that I used to finger her earlier that day.  I yank it up and looking at it, it still had the crusted blood on the hangnail wound (where the hangnail used to be). It had probably been many hours since I yank the hangnail, and I don't think it was bleeding anymore, but I'm not completely sure. if it was indeed closed up, it was fairly recently that it had closed up.

The area I'm referring to is where the back of the nail meets the skin in the corner.  It was bleeding in the corner of my nail, but was a few hours earlier so it had some time to heal, but I'm not sure how much it healed.  Furthermore, there was now a hole in between the skin and the nail because I had bitten the skin off...

What are the chances that I can get HIV from this hangnail wound? I don't remember touching anything, but i am worried that my hangnail wound could transmit anything because i'm using the bus and all. Maybe it is just my OCD mind playing tricks on me, do i have a real concern about this? Thank you again for your assurance

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