[Question #6248] Any more Testing?

17 months ago
Need a professional opinion/advise on situation.

Typically my sexual practices are very "standard", but on two different incidents I did some totally uncharacteristic things, and have since been a little anxious about these events, just because they are totally out of my character.

Event #1---In adult bookstore.  Masturbated on another mans anus.  Did NOT touch his anus (or any other part of his body with my penis), and actually there was no physical contact at all.  Is there anything that can be acquired by this "close" contact, but no REAL contact.  Penis was no closer than an 1" away from his anus.

Event #2---Oral and vaginal sex with woman of unknown status.  Oral unprotected, vaginal protected.

These events happened one day apart.  I think I COMPLETELY know the answer to event #1, but maybe not all risks from Event #2.

Testing was as follows:  (all dates listed below were from 2nd event, but events were only 1 day apart).  All tests from online testing service STDCheck.com

Day13---HIV RNA Test---Negative
Day28---10 Test panel----All Negative  (HIV1 and 2 4th Gen, Hep A/B/C, Gon, Clam, Syphillis, HSV1/2)
Day42---4th Gen HIV Duo Test/Syphillis RPR test ---Both Negative.   (Retook the "Scary ones" when I found out the the 28 day HIV test was no longer conclusive at 28 days)

I have had absolutely no physical symptoms, other than some mild penis pain/irritation which I would DEFINITELY contribute to anxiety since its comes and goes and it feels totally normal when waking up each day, but gets a little worse by the end of the day (after thinking about it all day).   No discharge, lesions, pimples, etc..

I realize the HSV tests were early, but in the absence of symptoms for that, I'm really just concerned with what I would call the the "scarier ones" HIV and Syphillils.

With events listed above, can you give opinion on risk from each event and recommend if there is any additional testing needed or can I consider testing conclusive and put these events behind me?

J


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Welcome to the forum. Thanks for your confidence in our services.

These were low risk events (nearly zero risk), even if you were unlucky enough that either of your partners was infected with HIV or other STDs.

HIV:  Certainly no risk by ejaculating and perhaps penile touching of a partner's anus. And statistically it was unlikely your female partner was infected, given the infrequency of HIV in even the most sexually active women (in the US and other industrialized countries). Further, the vaginal sex was condom protected, and there has never been a scientifically proved case of HIV transmission oral to penis. But perhaps of most interest to you, the HIV test results you report are 100% conclusive. (You could have stopped after the 28 day AgAb [Duo] test:  the combination of that result plus negative RNA at 13 days is conclusive.)

Other STDs: The gonorrhea/chlamydia tests were conclusive at day 28 (and could have been done as soon as 4-5 days after exposure). The 4 weeks hepatitis tests were superfluous:  you were at zero risk for any of them. That test was too soon for syphilis, but the negative RPR at 6 weeks is conclusive. (You were at almost no risk of syphilis anyway.) That leaves HSV1 and 2, for which you are right not to be concerned:  there was no realistic chance of either type of herpes, except potentially HSV1 from the oral sex event -- but absence of symptoms was itself strong evidence against infection. I recommend against any further HSV testing; it would be a waste of money, time, and perhaps anxiety while awaiting another result.

Bottom lines:  You were at very low risk for anything; you are correct that absence of symptoms by itself is pretty good evidence you weren't infected; and the "scarier ones" (HIV and syphilis) have definitely been excluded by the test results you have had. No more testing is needed.

I hope these comments are helpful and resolve any remaining anxiety about all this. You're home free! Let me know if anything isn't clear.

HHH, MD
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17 months ago
Everything is perfectly clear in your detailed response..... Thank You so much for your quick reply.  So there is no reason at this point to abstain from relations with my normal partner then i gather?  If the answer is, in your opinion, I should be ok to do so, I have no further questions, and feel free to close the thread.

My Anxiety is starting to wane.....

Thx!

J
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Thanks for the thanks. I'm glad to have helped.---