[Question #6524] Is this genital herpes or other STD?

13 months ago

I had condom-protected vaginal sex with a black female coworker who has had multiple partners.  My penis may have touched her vagina slightly above the condom.  Our groins did not press against each other.  I touched the outer part of her vagina with my hands briefly.  I had no broken skin on my penis or hands before or after.  I showered shortly afterward.  During sex she seemed uncomfortable when I penetrated more deeply.  I’m not large!  I’m concerned she had an STD I could not see.  Fourteen days after I sensed a bit of an itchy anus and decided to take a look because I was paranoid.  In one of the folds on the perineum just outside where the anus constricts I saw what looked like a partially healed lesion about a third of an inch by a quarter of an inch.  It was dark looking as if it was bruised and looked like blood under the surface.  Only part of the area looked as if the skin had been broken and was healing with no visible scab.  This area was mostly lengthwise along the fold line and there were no other abnormalities.  Thinking I needed to hurry before anything changed I got an examination by an ER doc.  He said he saw no indication of herpes or STD and thought if the lesion was herpes I would have felt much more discomfort, “like knives” he said.  In fact he thought the lesion was a large freckle at first because of the darkness of the area with the folds bunched up.  During the next week the lesion gradually disappeared.  During the same period I noticed about half a dozen small red pimple-like spots that were spread out.  Two on left thigh, three across both buttocks, one on testicles.  None in a cluster.  I do normally have some pimple-like spots on my buttocks and thighs but I normally don’t pay attention to how they develop.  I’ve had some minor anal itching off and on, though I’m not sure if it is from having cleaned too much with soap or over/under wiping.  I haven’t had any other recognizable symptoms that I think go along with herpes or STDs.  I’m in a long term relationship with another woman and need to understand how I should proceed.  I don’t feel as if I can bring this to her attention.  Does my history indicate a clear risk and is consistent with a STD or am I overthinking this?  I would appreciate your frank assessment on what I should do from here.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
Your history does NOT present any significant risk, no.  A single intercourse that was condom protected by itself is incredibly low risk.  Add to that, a possible lesion that appeared 2 weeks later that a physician didn't think looked anything like herpes, not even on the penis?  I would bet a lot of money that you did not become infected with herpes at this occasion.  Given that I don't know anything about your previous sexual history, I couldn't say whether you may have herpes before this or not.  But this does not sound to me like you acquired herpes at this encounter, no.  Most often, when men acquire new herpes, they get lesions on the shaft of the penis, or when condom protected, at the base of the penis.  Not so in your case.  You may well be way overthinking this.

Terri
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13 months ago
Terri thanks for the reply.  I had been monogamous for several years and previously had a full STD screen to include type specific igg testing, all which came back negative.   My partner has been monogamous as well, I believe.   So I don't think I have any previous history.  

With regard to the doctor I felt he did not recognize the potential lesion on his own and thought it was a freckle.  I made sure he knew that I thought it was an area that was healing.  Even after a second look he still seemed to think nothing of it.  So that is good.  I assume he is pretty familiar with herpes symptoms but if he was reaching his conclusion on the fact that I had no pain and there were no crops of blisters, I thought he might be mistaken since  so many people report symptoms that remain below recognition levels.  So it is not to say that I don't trust his conclusion.  I just think it best to say it was indeterminate.  He saw no clear signs to support that conclusion.  But in my mind he couldn't rule it out either.  

I guess my question came down to this:  if the lesion wasn't caused by a STD, what was it?  Considering the timing was so close to a potential exposure, I was starting to think the worst.  Hence my question to you.  I was looking to see if you felt this had any merit at all.  Sounds like you don't.  I also wondered if somehow I transferred a virus from my hand to anal area when showering.  Unless you have any other thoughts I'll put this behind me.  Thanks again.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
I have carefully re-read your first post and it just doesn't sound like herpes to me.  So much speaking against it - negative physical exam, condom use, no sores or blisters, not anything noticeable for two weeks.  I'm not saying herpes is impossible but I would say, given all you've said, it seems extremely unlikely to me!

Terri
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13 months ago
Thank you for the most recent reply.  However, I have new information to add that I didn't realize may be significant.  I previously asked you a question a week before this one that was about oral herpes (question #6484 in my account).  I mentioned a single lesion on the side of my tongue that could be an aphthous ulcer.  I falsely assumed that oral and genital manifestations of HSV were discretely separate/different, but I'm led to believe HSV-1 or -2 could have symptoms both orally and genitally.  Anyway, the sex event for both questions is the same.  To put the pieces together, I had an oral lesion show up on my tongue on day 6 and I noticed the anal lesion on day 14 (partially healed).  As I look at these two things together, I guess they could be caused by the same infection event.  Please review my previous question and let me know if the two things together add up to something.  Sorry for not reporting to you more fully earlier--I thought I was looking at two separate issues.   Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
Because these two things happened more than a week apart, I feel quite strongly that they are unrelated.  Also, you didn't report any your-mouth-to-her-genitals type contact.  That's how you would acquire an oral infection, that or kissing.  Previously, you reported only condom protected intercourse.  I am going to assume that that is still the case and that your mouth had no contact with hers.  If you are still concerned and get any other oral manifestations, you could have them evaluated by a professional but given what you've told me, I am not concerned.

Terri
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