[Question #3179] Concerned.

39 months ago
Thank you in advance for your guys' advice and expertise!

I'm feeling a bit anxious, as I have a new partner and am concerned about an incident. On Friday (12/29), my partner and I had protected sex. However, before we had protected sex, what I thought was his finger rubbing  my vagina, was actually the head of his penis. I was a little bit upset, as I do not feel comfortable having unprotected sex. This incident took place for about 2 minutes before I realized it was not his finger that was rubbing me. The head of his penis never penetrated my vagina and was never inserted in me either. We also had protected sex on new year's, but everything was protected. What i'm worried about is the incident in which the head of his penis was rubbing the outside of my vagina, like naked frottage. 

Questions:
1. It's been exactly 10 days since the head of his penis was rubbing against my vagina, what're the chances that I will contract hsv 2 from this incident?

2. What are the chances I could contract an STD such as chlamydia or gonorrhea from the head of his penis rubbing my vagina? No penetration occurred. 

3. Today, I felt like my anus was a little itchy so I took a look in the mirror and after spreading my cheeks & poking around, I noticed 2 small red, cuts/abrasions on the rim of my anus. However, they were not there when I first looked in the mirror, which is why i'm thinking they occurred from irritation from me looking down there. What is the likelihood that this is hsv 2?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to the Forum.  I'll be glad to comment.  congratulations on your commitment to safe sex.  It will help to keep you safe.  The events you describe were very low risk for STI acquisition and I will expand on this with specific answers to your questions below but, before I do, let me suggest that it might be good for both you and your new partner to go (together if at all possible) to go for a sexual health check which includes screening for STIs.  This is not an accusation but simply acknowledgement that both of you appear to have had other partners in the past, that many STIs can occur without symptoms, and that while it is unlikely that either of you are infected, knowing this based on mutually negative tests will provide a measure of confidence and trust as your relationship moves forward.  We routinely recommend this for new relationships and suggest that such testing should include testing for gonorrhea, chlamydia and for the woman and sometimes the man, depending on the test performed, tests for trichamonas using either vaginal swabs of for the male a urine test.  Testing for HIV and syphilis, while far, far less likely can be easily added with a blood test if desired.  We specifically recommend against blood tests for herpes unless one partner has a history of the infection as they have relatively frequent false positive test results and can be misleading. In the US confidential testing can be obtained for little cost at health departments.  Now on to your questions:

1.  Not sure why you are worried about HSV.  If there were no lesions present rubbing of this sort is low risk.   As I am unclear on the reason for specific concerns about HSV, for informational purposes, I should point out that in persons with HSV condoms markedly reduce but do not entirely prevent transmission and that the infection can rarely (estimated at less than 1 in 10,000 exposures in the absence of lesions) transmit infection without lesions being present through direct contact.  Your risk for this seems quite low however and unless I am missing something in your question I would not worry. 

2.  There is no meaningful risk for acquisition of gonorrhea, chlamydia (or trichamonas) with frottage without penetration.  The cells of the vagina do not get infected with gonorrhea or chlamydia (the cervix, which is the mouth of the uterus deep within the vagina are where gonorrhea and chlamydial infections occur).

3.  The symptoms and lesions you describe certainly do not sound like typical HSV and as I understand it here was no contact with your anus making it most unlikely that the abrasions you noted are HSV.

I hope these comments are helpful. If my comments raise additional questions or are unclear please feel free to use your up to two follow-up questions for clarification.  EWH
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38 months ago
Thank you for answering my questions Dr. Hook! 

I was hoping you could help me get up the courage to get an STD test. I am so anxious and nervous- the anxiety just kills me.

I’ve never had unprotected sex with anyone and I’ve never had anal. The last time i was tested was in february of 2017, but i have given 3 people oral sex since then. One of the exposures, i think i even had a canker sore, which is making me nervous about contracting HIV. I might add that no man has ejaculated in my mouth either. I have not had flu like symptoms either yet, but i did get a cold/congestion in the beginning of this month. With one of the men i was dating, i would say i gave him oral sex about 15-20 times. 

1. What’re the chances i have contracted HIV from from the exposures of giving 3 different people oral sex throughout a year? 

2. What’re the chances of contracting hiv when you have a canker sore in your mouth? 

3. I’m also concerned about hsv 2- i have not had any symptoms yet, but I’m worried that i could have contracted it and not had symptoms. What’re the chances of contracting hsv 2, even though I’ve used a condom every single time? 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Please go get tested for STIs, particularly gonorrhea, chlamydia, trichamonas and HIV.  Regular sexual health check-ups should be part of your routine- not because you are at risk (as I said above, I do not think that you are- but to verify for yourself that all is well.  Further, please remember that testing will not change whether or not you have an infection, but it will all you to do something about it in the unlikely event that you are.  (Parenthetically, we specifically recommend AGAINST blood tests for HSV as part of sexual health check-ups as the test has far too many false positive test results)

As for your specific questions:
1. It is most unlikely that your partners had HIV and even if one of them did, your risk for acquiring HIV from giving oral sex to an infected partner is less than 1 in 10,000. 
2.  The presence of a canker sore will not meaningfully change the infintesimal risk that you acquired HIV from performing unprotected oral sex.  I would not worry about this.
3.  Your risk is low.  You have not had an outbreak, you do not know that partners had genital HSV, and condoms reduce the risk for acquiring genital herpes by at least 50-60%

I hope these comments help.  Please do not worry.  EWH
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