[Question #4106] Masturbation- Risk Assessment

31 months ago
Dear Doctor. Before I ask  my question let me explain my situation. 
Two and a half weeks ago I had an encounter with a transexual CSW in Paraguay. There was not intercourse at all,  she only masturbated me for around 30 seconds to less than a minute after which I ejaculated.  I am really stressed about that situation as I am married.
1- Can you provide a Risk assessment as to std and hiv? 
2- I was suprised by how fast I ejaculated. She may have pressed hard certain veins. Although  I did not see blood does this change your assessment?
3- Three to four days after the event I started feeling a slight tingling, burning sensation on the tip of the penis that fade away after 3 days. At the same time I started to experience sweaty palms and feet despite low temperatures here (which continue until today) without fever and one day in which I felt chills for a short period of time (around four days post exposure) lasting probably one hour.  A week post exposure I started to feel disconfort around both armpits (Apparently with no swollen lymph nodes) which continue until today. Right now I am having troubles sleeping.  Does this sound to ARS or any STD or just anxyety driven symptoms?
4-Is testing needed? 
5. If I take a combo duo 3 weeks post exposure what is the accuracy level?
6. Can I continue  unprotected Sex with my wife?

31 months ago
I would like to add and that a week post exposure I had 3 events of dyarrhea during one hour.
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to our Forum.  I'll be happy to comment and am pleased to tell you that receipt of masturbation, as well as mutual masturbation in which both persons are masturbating each other are considered no risk sexual activites, even when participants get each others genital secretions on each other- still no risk. 

1- Can you provide a Risk assessment as to std and hiv? 
See above- no risk.

2- I was suprised by how fast I ejaculated. She may have pressed hard certain veins. Although  I did not see blood does this change your assessment?
No, still no risk.

3- Three to four days after the event I started feeling a slight tingling, burning sensation on the tip of the penis that fade away after 3 days. At the same time I started to experience sweaty palms and feet despite low temperatures here (which continue until today) without fever and one day in which I felt chills for a short period of time (around four days post exposure) lasting probably one hour.  A week post exposure I started to feel disconfort around both armpits (Apparently with no swollen lymph nodes) which continue until today. Right now I am having troubles sleeping.  Does this sound to ARS or any STD or just anxyety driven symptoms?
These symptoms began much too early to suggest the ARS.   Further, these symptoms as described are not symptoms of the ARS or other STIs.

4-Is testing needed? 
No, there is no need for testing.

5. If I take a combo duo 3 weeks post exposure what is the accuracy level?
I see no need for testing related to this exposure.  If you take a combination HIV antigen/antibody tests it will tell you whether your symptoms are due to HIV or not.   These tests detect about 99% of recent HIV infections by 4 weeks after exposure and are completely conclusive at 6 weeks. 

6. Can I continue  unprotected Sex with my wife
Yes, there is nothing about this exposure or the symptoms you describe that suggest any reason to abstain from unprotected sex with your wife.

I hope this information is helpful to you.  EWH
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31 months ago
Dear doctor, your response are really reassuring. I really appreciate them. 
So you think that my symptoms may be just anxiety driven or do they suggest something for you?
I am due for routine testing this Friday/Saturday which will be the third week after exposure.  I know no testing is required but if I take the test, how effective will be the test, I know you said 99% for four weeks. Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
When persons are anxious they tend to notice sensations that they might have discounted or overlooked otherwise.  Alternatively, some of the symptoms that you noticed may have come from other, non-STI problems.  There are not solid data on the accuracy of three week testing, that is the reason I gave the results for 4 weeks which are well described and agreed upon.  Sorry.  EWH
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31 months ago
Thank you doctor. I am becaming increasingly anxious about this event. I know you say I did not have an exposure but my mild symptoms are worrysome and knowing a bit more will calm me down. Yesterday I went for a control check up and according to my doctor the armpit feeling involved no swollen glands and there was no sore throat. However, I just started to develop a mild sore throat around 18 days post exposure, with slight difficulty when swallowing saliva.
1.Does this change your assessment?
2. How bad is ARS sore throat?
3. The lack of fever and rash says something?
4. When people get ARS,  all symptoms  come together and how intense they are?
5. Taking throat medication may affect STD test results?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Don't let your anxiety get out of control.  This is not the ARS.  I am confident of this.  In answer to your specific questions:
1.Does this change your assessment?
No one bit. 

2. How bad is ARS sore throat?
The sore throat of the ARS is severe and accompanied by HIGH fevers and muscle and joint aches.  Patients describe it as the worst flu of their lives.

3. The lack of fever and rash says something?
yep, see above.

4. When people get ARS,  all symptoms  come together and how intense they are?
Yes, the symptoms all occur at about the same time.  The symptoms are intense. 

5. Taking throat medication may affect STD test results?
No, not at all.

As you know, we provide up to three replies to each client's questions.  This is my 3rd reply. Thus, this thread will be closed later today.  EWH
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