[Question #5087] Risk check

77 months ago

Hi Docs,

I have calmed down significantly since my last post, but perhaps due to an overactive mind I am back again. Since I last posted I have started regular weekly CBT to stop catastrophising things. I have good days and bad and this is a bad one.

10/9 days ago I had a sexual encounter with a girl I met online - we both are 30 and live in Scotland (UK). My question about 10 days ago is threefold: 1. We shared chicken nuggets (piping hot) that is to say that she bit into them and fed me some as I was driving. It turns out days later I had a bad dental abscess/infection in my molar for which I've been taking metronidazole 400mg. Is there any risk from doing this? 2. We engaged in moderate frottage, naked, during which my penis head touched but did not insert in her vagina. She was quite wet I recall but now my mind is playing tricks on me, I feel I would have consciously have had to penetrate/would've known.3. We then had protected vaginal intercourse during which condom was properly used, in tact and water tested. I did perform Cunnilingus before this though for a short period, while unbeknown to me having an infeciton - never any blood in mouth or anything like that, just tooth pain.Day 9 we had 2 instances of condom protected vaginal intercourse - everything remained in tact / water tested. Fast forward to today and I have a very dry throat. I've read metronidazole can do this though as its a heavy antiobiotic? Temp seems normal. Quite awkward to ask my partner about testing - she had said before that she had an abnormal smear test a few years ago which gets checked every 6 months. She said they check for other things (STIs?) as well with this - but I'm not sure if this is common practice on the NHS. Just hoping I haven't started another HIV risk as I was ultra careful with contraception but feel I've somehow let myself down. Obviously the solution is to be more conservative sexually (I usually am and don't sleep around) - the last 2 months are a bit of an anomally for me.

All the best.

H. Hunter Handsfield, MD

77 months ago

Welcome back. I'll be replying this time, but I reviewed your recent discussion with Dr. Hook and agree with all he said. Since these questions generally repeat the same ones, my replies are succinct. I think your username says it all.

1) Why would it even enter your mind that sharing food in this manner could transmit an STD? Of course zero risk.

2) No penetration = little or no STD risk. Hand-genital contact or fingering rarely if ever transmit STDs.

3) Condom protected means little or no risk. And as Dr. Hook replied, it seems your partner is unlikely to have any active, transmissible STDs. With the exception of HPV, which is present and transmissible in up to half of all sexually active people at any point in time. Her abnormal pap smear undoubtedly was due to HPV, but that was years ago so probably no longer an issue for that particular HPV infection. Cunnilingus also is minimlar risk.

The rest of your "question" is sort of a stream of consciouness without specific questions. A few comments: a) Water testing of condoms is pointless and of no value. There is no such thing as micrscopic or tiny leaks that permit STI transmission. If a condom doesn't break wide open, protection is complete. Sore throat is almost never a symptom of any STD; by far the main causes are common colds, allergy, and similar conditions. Metronidazole is not a likely cause.

Bottom line: Little if any STI risk at all, and for sure zero risk for HIV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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77 months ago

Thank you Doctor, I'm glad my username doesn't show publically!

I should just make it clear this was a new partner to he last and thus don't know her medical history as last one was tested in Dec 2018.

Just two final questions/clairty:

The tip of my penis did press against her vagina externally and remember it feeling most - it wasn't vigorous and was almost certainly not sexual penetration. Not sure if this changes a thing really? My understanding is that proper penetration inside a female sexual partner is the key part for something like hiv?

I have minor lip/cheek swelling and burning sensation at mid section between upper/lower lip/mouth - I'm guessing this is due to dental infection (root canal needed) despite anti-BIoticd and not a manifestation of oral.sti?

Anyway another cbt session tomorrow but thank you once again for assessing the situation - apologies for the ramble .

H. Hunter Handsfield, MD

77 months ago

Sorry I misunderstood this was a new partner. But it doesn't signficiantly change my opinions or advice. Penetration certainly is the main risk. I cannot say a near-penetration scenario is zero risk, but certainly it is low. The oral symptoms you describe are not typical for any STD.---

77 months ago

Hi Doc,

Thanks for your reply. Like I said I've replayed this event in my mind and I am 96% certain it was just frottage - pressed against her vagina but no insertion - though her vagina was wet, I can recall that. Cunnilingus was performed briefly as well. Was there a big risk here? My partner said she's tested every 6 months and hadn't slept with anyone since September - though I did notice a slight rash on her the night we had sex.

I'm finding it hard to discern between symptoms of anxiety and if I did catch something. Obviously the ARS symptoms are so generic though this evening I have a temp of 37.7C, some pinkness on my skin below chest cavity (though I am very pale so think the natural countour of British skin?), and briefly had a sore throat at 3pm today - though I'd had a lot of coffee, little water and just came of metrondizole. Throat is now fine after a few pints of water over the last few hours. Do these raise any concerns for you? I also still have an active dental abscess and infection under two teeth which could maybe explain a few things

Logically for peace of mind, I'll go test. Though expensive, should I just get the PCR RNA test? Not sure a false positive would do my mental health any good.

I know it's my last reply, so thanks again for your advice and your service.

All the best

H. Hunter Handsfield, MD

77 months ago

Whenever someone suspects his or her own symptoms have a psychological origin like anxiety, almost always they are right. And these subtle symptoms are not are not suggestive of ARS. A "slight rash" on your partner's arm does not imply HIV or any other STD. So no, none of this raises any concerns at all in my mind.

I recommend against PCR testing.

That concludes the two follow-up comments and replies included with each question and so ends this thread. Please note that the forum does not permit repeated anxiety driven questions on the same topic--in this case, about HIV following obviously low risk exposures. Just remember that there is never significant HIV risk if here is no penile-vaginal or -anal penetration; our replies about other kinds of sexual exposure will always be the same, that there is little or no risk (regardless of the risk status of the partner). So this will have to be your last one; future questions of this sort will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. Also, experience shows that continued answers tends to simply prolong such anxieties, rather than helping them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

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