[Question #3168] Risk of STD

40 months ago
Hello sir, here are details of my sexual encounter..
I met this girl online and we hit it off on the 23rd of dec.  We came home and started deep passionate kissing. She smoked weed while kissing. She didn’t seem to have any sores or lesions around her lips visually.
We then proceeded to have oral sex.... I had a condom on while getting oral sex and I only fingered her but didn’t give her oral sex.
After this we proceeded to have protected vaginal sex. After that I finished on her breasts. I don’t remember seeing any sores or lesions around her vagina but I didn’t pay attention to be honest. 
11 days after the encounter I am starting to have a sore throat with a little trouble swallowing.
1) I have a rash around my groin area that itches a bit and I see peeling skin but no bumps. It is tender and red . I don’t have any lesions or irritation or sores around my genitals or my mouth. At this point I am having panic attacks of having herpes and had to take a day off from work to manage these attacks by sleeping.
2) I went online and read about transmission of std and thinking about it I feel like I have all the symptoms of rash and sore throat and what not..none of the online stuff actually address my situation.
3) as I read more I am starting to have a red spot or bump over my eyebrows and this makes me think I have all std’s.
4) also I realized that I had dry skin and a cracked skin with tiny tiny amount or dried blood when I fingered her. Am I at risk for all std’s because of this?
I am not sure what to make of the std info online since none of them are addressing my specific case.
Based on all this I would like to know what I am at risk for and what testing I need . 

Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Welcome to out forum.  I'll be glad to comment.  Let me start by congratulating you on your practice of safer sex.  This will do much to markedly reduce and, in most cases prevent STIs.  The encounter you describe is essentially a nearly no risk event and the symptoms you describe do not suggest any typical STI.  In beginning to comment I should point out that most people do not have STIs, that when they do, most exposures to infected partners do not lead to infection, and that condoms are highly effective for preventing STIs if exposed.  Rather your symptoms seem to suggest that since this encounter you may have been worried and perhaps hyper-aware of potential symptoms which might reflect an STI.  No STIs are transmitted by kissing (although common, every day sore throats certainly can be) and when STIs occur in the throat they are most often asymptomatic.  The rash in your groin in no way sounds like an STI and is more suggestive of chaffing or a non-STI, fungal skin infection ("jock itch").

I will also add that exposure to an infected person's blood or genital secretions when you have scrapes or recent cuts also does not put persons at risk for STI acquisition. 

Thus nothing that you describe suggests any immediate or related need for STI testing. OTOH, we do recommend that persons with multiple partners, entering new relationships or whose partners may have other partners should consider periodic sexual health check-ups which would primarily include testing for gonorrhea and chlamydia at sites of exposure and a blood test for syphilis and HIV.  We recommend against testing for herpes with blood tests in these situations as false positive results are not uncommon and results can be misleading.

I hope these comments are helpful to you.  Take care.  EWH
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40 months ago
Hello dr Hook, thanks a lot for calming my nerves.
I have a follow ups:
The reason I was so disturbed is that a lot of forums kept saying std’s like Herpes pass on from kissing and even protected sex..
So could you please explain why my encounter is safe? This is more for my own understanding.
Also, I know u said am nearly at no risk, but am a little nervous because m arm pits are itching like crazy. Is this a sign of swollen lymph nodes due to sti?
Also, you did mention about me being hyper sensitive to symptoms of sti.. is this because a human brain is so powerful to simulate or keep thinking about the sti due to anxiety and is this normal to think about an sti so much?
I do accept that I was freaking out like crazy because I did read stuff online and assumed everything was true but didn’t factor in the real encounter I had.... I just went with the flow which was kind of wrong.
Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
The internet is not your friend here.  Much of what is said there is either incorrect or taken out of context.  Further, many internet sites tend to amplify risk.  Other than perhaps HSV-1/cold sores which you may or may not consider and STI, there are no STIs that are transmitted at any appreciable rate through kissing.  Further, condoms when used throughout sex markedly reduce the risk of all STIs, some more than others. From a theoretical perspective, since condoms my not cover the entire penis, acquisition of STIs like herpes, HPV and syphilis is possible but much less likely than without condoms, and then ONLY if your partner has that STI. 

Itching arm pits are not a sign of swollen lymph nodes but do suggest a heightened state of awareness.  Indeed, the brain tends to both focus and edit out many sensations.  Take a minute to think about how your clothing feels where it touches your body- many people say it is a little itchy when they focus on it but again, we typically are not aware of this.

Hope this explanation is helpful.  EWH
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39 months ago
Thanks a lot dr.Hook. 
Am sorry I keep coming back to this, but this week, around 16 days after the encounter, I started to experience burning during pee. And my pee is deep orange and slightly red.this is freaking me out now coz this may be blood and because of an sti.
Also yesterday, on my little toe, I noticed a kind of bulge blister but with no fluid inside. I don’t know if It had fluid or not. This doesn’t hurt though nor is it itchy .. I read that Herpes blisters form on the toe and am freaking out. Could you help me with this?
Also, final question,when u said in your first reply that I was at nearLy no risk event, was it a nearly no risk to exposure or catching any std?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Sigh:
Change in urine color is not a sign of any STI. 

There is no medical reason to think that the "bulge" you have noticed on your toe (which I presume in no way contacted her genital areas) could represent an STI.  Herpes blisters (which you apparently do not have) do not appear on the toe (sounds like something else you may have heard on the internet).

You are seeing things in my note that are not there.  The sexual encounter you have described was a virtually no risk event.

As we close this thread with this answer, I urge you to stop worrying about STIs. If you cannot, you may want to prove that you are not infected by seeking evaluation by a trained clinician which might include testing. When the tests demonstrate that you did not acquire an STI from the exposure you described, if you cannot put your concerns aside, I would urge you seek counseling to help you move forward.  This will end this thread.  EWH
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