[Question #2981] Can I Survive this Encounter?

39 months ago
Good afternoon.  I am a 44 year old(male) sexual assault survivor and a recovering alcoholic.  I do have hpv, although I dont believe I had a outbreak at the time of this encounter (never know).  

On November 6th 2017 I met up with a girl for our second date.  She claims to be on a lot of medication due to various medical conditions including two bouts of cancer.  She seemed to be shaking a little.   She claims to have been tested for HIV.  She also said her last boyfriend was a drug addict  (all kinds of different drugs) and had been to jail.  We kissed, I played with and licked her breasts, and she performed oral sex on me.  During the oral sex she leaned over and took her false teeth out.  I was shocked.

Symptoms: Four days after this event I had a white sore in my mouth.  My dentist and an oral physician / dentist said it was not thrush.  Since then I have had other little white sores in my mouth which are painless.  They have been mainly on the bottom of my gums and a few on cheeks.  They cant really be wiped away only picking may remove them   I have had these same problems before many times.  But I cant keep going back to the doctors.

About a week or so (dont remember exactly when it started) after this event my testicle started to hurt.  Today while on business i went to the doctor.  He said since I was traveling he wouldnt bother testing me for common STDS.  Instead he gave me: One pill of Suprax 400MG &Two pills of Azithromycin 500MG (each)

He did an in office urine test which he said was clean.

Questions:
1.  What is your opinion about my testicle discomfort and the treatment given?
2. What is your opinion about my mouth issues?
3.  Is thrush in isolation a symptom of ARS?  (I think I heard you say no)
4.  Do I need need STD testing after the treatment I described?
5. Do I need hiv testing?
6. As my luck is usually bad, my ex NOW wants to get back together.  Is it safe to be sexually active with her? 

Thanks for your time.  I look forward to your response
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome back to the forum. Thanks for this additional question.

My first reaction is to congratulate you for deciding to only have safe sex with a partner who, from what you say, could have been at risk for HIV or other STD. Oral sex also low to zero risk for HIV, and also low risk for all other STDs (and zero risk for some). To your specific questions:

1) I'm confident your testicular discomfort is not from any STD or any other infection from your recent sexual encounter. Although epididymitis (testicular infection) from gonorrhea or chlamydia can cause testicular pain, it would also cause discharge of pus or mucus from the penis, and epididymitis pain is accompanied by swelling and serious pain and tenderness of the testicle. Your doctor apparently knows this, and your seemingly mild symptoms plus his apparently negative examination further argue against any infection as the cuase. Had you been my clinic patient, I would not have recommended the antibiotics you were given. However, they did no harm and, in the very unlikely chance you had gonorrhea or chlamydia, would have cured it.

2) You cannot have genital exposure by oral sex and then have an STD show up in the mouth.  The canker sore was just a coincidence and had nothing to do with the sexual encounter 4 days earlier. 

3) ARS can be associated with yeast infections (thrush), but not as the only symptom. And this wasn't at all like thrush, which doesn't cause canker-like sores. Also, new HIV infection cannot cause any symptoms of any kind sooner than 10-14 days after catching it; as noted previously, oral sex doesn't transmit HIV (or so rarely it can be ignored).

4,5) No testing is needed at this point, including HIV.

6) You cannot transmit an infection you don't have. It is entirely safe to resume sex with your ex pertner.

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD

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39 months ago
Hello  Dr. Handsfield

Thank you so much for your response.  I suffer from anxiety and OCD hence it definitely helped to calm me down.  My testicle also feels a bit better today.

One point I wish to clarify about the issues I had in my mouth (that I referred to in my  post yesterday).  

What i had was a bit of coating  just below my gums and and maybe a sore as well.  I also had one or  two little sores / coating on my cheek.  Nothing hurt.
I did in the past get canker sores and this was different.  I also had thrush one time after a lot of antibiotics.  This appeared different as well, I think.  The doctor and dentist didnt really see all that transpired (during the week) just one specific sore.  They said my sore was created by picking.  

A lot of my mouth problems this past week (NOT ALL) may have  been from self examination and picking.  I see something get nervous  and and pick.  This has been a problem for me since my assault.

1.  What do you think about the new information I provided regarding my mouth and the sores / coatings / thrush I described?  

2.  If it were thrush could can I still feel confident sleeping with my ex? (my mouth looks good today)

3. Do you  have comments on her removing her false teeth being removed?

4.  Does my hpv affect my exposure?


**I will refrain from further questions in case I need your guidance if my testicle pain does not go fully away.

Have a great weekend Dr. Handsfield.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
1) These new details don't concern me at all, especially since your doctor found nothing important.

2) Everybody carries yeasts on their skin, in the mouth and GI tract, genital area, and elsewhere; and people rarely catch it from other people. Even if you had thrush, it would not harm your partner. And it's also not a sign of something else that can be trantmitted.

3) Removing her teeth for oral sex sounds like an issue of comfort for her. Or perhaps she believes it would be better oral sex for you. Why not ask her? Certainly it's not a health issue for either of you.

4) HPV does not significantly change the risk of other STDs if exposed.

Thanks for the thanks. I'm glad to have helped so far.

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38 months ago
Hello Dr. Handsfield

Good Morning.  My testicle pain subsided shortly after our last correspondence.

On day 23 post exposure I went to my community health fair.  Unexpectedly they were doing testing. They provided me with the alere determine rapid hiv duo test.  The result was negative.

The last three days (33, 34, 35 days post event) I found  tiny white "looks like a piece of skin or chicken meat" on my tongue (which very easily can be removed with my finger).  Once removed it looks just as stated above. There were 3 of these.

I also found some white skin on my lips which rubs off (I have seen this before).  Might be due to the cold weather.

Neither of these symptoms hurt in anyway.


Question:

1.  What are your thoughts about what I described in my mouth?

2.  If it was thrush should I be freaking out?

3.  Can thrush be my only symptom?

4.  Did I even have a risk or am I being paranoid?

5.  Can I continue to sleep unprotected with my partner who I have since reunited with?

6.  Do have to go for more testing?

I continue to take medication and see my therapist on a weekly basis.  As mentioned I have anxiety / PTSD.


Thanks and have a Merry Christmas!!


38 months ago
Dr. Handsfield

I thought I might mention that when I removed those tiny mouth things they just came off very easy like a piece of food.  They didn't bleed or hurt, and you couldn't tell they were there afterwards.

Thanks again..
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
These all are repeat questions that I answered in my original reply above. I see no need to repeat myself. I already said this doesn't sound like thrush, that thrush occurs from time to time in healthy people, without HIV, that thrush would never be the only symptom of a new HIV infeciton, that you were not at risk from the exposure described, that no testing is needed, and that you cannot infect a partner with something you do not have.

Your test results also prove you did not catch HIV.

That completes the two follow-up comments and replies included with each question and so concludes this thread. Please do not be tempted to start a new thread with questions about this exposure and your worries about it. Repeat questions are discouraged and there is no additional information you can provide that would change the opinions and advice you have had.

I hope the discussion has been helpful. Best wishes and stay safe.
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