[Question #458] Concerned

33 months ago
Dear Experts,
This is my second question here and I hope my last. The other question I had details my situation but to be brief, 5-12 seconds of genital to genital contact and possible penetration of vagina, unprotected with Asian massage lady. I do not believe I did but I can't be certain I didnt slip inside her at some point. This was single one time incident that I'm distraught and disappointed in myself about. I took tests 3 days after, All came back negative but I know this is to early for HSV and HIV. As precaution I was given dioxycycline and Rocefin. For about a week and half after incident I would have pressure around head of penis and felt the need to urinate a lot although every time I did I would pee. After I came clean to my wife about what happened I started to feel a lot better and the sensations in my penis went away it seemed. Now 6 days ago I had a small sensation in my penis head which made me concentrate on my genitals. That turned into a feeling of cold penis head and the need or pressure urinate, but I would never say I was in pain. It finally subsided it seems tonight. I decided 2 days ago to go get re tested. I did HIV p24/AB this time, and the same other tests as last time. My HSV's came back negative today. I'm waiting on HIV but will feel better once I get results because everything I've read says this test in conclusive after 4-6 weeks. Even with the heightened senses on genital area and the wierd feelings I've had on my penis, I've NEVER had any skin irritated to touch, sensitive to touch, no discharge what so ever, no pain during or after urination, no wierd looking urine, no lesions or sores.  Only these "pains" on/in penis.
My concerns are: 
1)can my symptoms be NGU or Trich? I'm worried about passing one of those onto my pregnant wife
2)can I go ahead and get treated for Trich just to rule it out? Any downsides?
3)can all my sensations down there be just genital anxiety and how strongly do you feel that way if so?
Thank you very much

33 months ago
Just to add today marks 7 weeks and 4 days since the incident. 
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
I'm a bit sorry that you continue to be concerned about this very low risk event which occurred nearly two months (7+ months) ago.  The likelihood that your masseuse had an STI, as well as the likelihood that you even penetrated her, and that these are related to symptoms that you are experiencing at this late date is so low as to effectively be zero.  This is not something you should be worried about.  In answer to your specific questions:

1.    Your symptoms are not at all suggestive of either NGU or trichomonasis.  Further, as mentioned above, your timeline is inconsistent with these infections which, even if present would have likely cleared/self- cured by now.

2.  We do not recommend treatment "just in case".  This is bad medicine and bad from a public health as it leads to antibiotic resistance.  Further, every antibiotic has side effects.  While I can't prevent you from doing it, I recommend against this sort of treatment.

3.   I am quite confident that your current symptoms are a manifestation of genitally focused anxiety rather than a true infection.

I hope these comments are helpful to you.  EWH
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33 months ago
Dr. Hook,

Thank you for your sound advice. I agree with your opinion that it's genital anxiety, I just want to be overly cautious and not give my pregnant wife anything. We're are working thru it, and things are a lot better. I guess when you feel like your gonna lose the most important thing in your life, it's hard to find positives or be positive and not dissect every little thing when you wish you could take back one dumb decision you'll always regret. That's why I appreciate this forum so much as to get honest answers quick.  Just a few quick questions I have and then my last response will be after I take my 12 week tests. 
1) just to confirm, a HIV p24/Ab combo test is conclusive after 6weeks?
2) is my HSV 1-2 Igg test conclusive at 12 weeks if there are no lesions or sores at anytime before the 12 week mark. 
3) if I wanted to test for Trich at the 12 week mark, what test would you suggest for best accuracy? I believe you when you say I don't have Trich with my symptoms, just trying to be extra cautious again with my wife pregnant before we resume unprotected sex as a lot of sites say men don't usually show any symptoms. 
4) after negative tests at 12 weeks, can I resume unprotected sex with my wife. 
Again thank you for this service, it's great to get info from experts in the field.