[Question #8619] Risky encounter
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41 months ago
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Hi Doctor
Around a week ago I had a risky exposure or what I.count to be a risky exposure with an older male. I am a male as well.
We met on a night out and he returned to my flat. We ended up kissing and masterbating each other. I was quite intoxicated, I think I remember most of it but off course paranoia is setting in.
I think he gave me oral sex as well. I don't recall giving him oral, I think he asked me too but I didn't. Neither of us were wearing condoms. I don't recall any penetrative sex, my mind is playing tricks with me though. I can't imagine there was as I would like to think I would have remembered it given I remember most other things about the event. He may have stuck his finger in my anus though, I'm not sure but he may have. I'm a bit worried about that given he may have had pre-ejaculate on it.
Soon after he did ejaculate, made up an excuse and left. It was probably no longer than 10/15 mins.
In summary it was essentially mutual masterbation, I received oral sex and he potentially stuck his finger in my anus.
In your opinion does this event warrant any kind of testing. My obvious concern as it always is would be around HIV. Also would there be a risk of any other STIs. I was off for a few days after it with a chesty cough and a bit of a sore throat. I've had no pain whilst urinating etc.
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Edward W. Hook M.D.
41 months ago
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Welcome to our forum and thanks for your questions. I’ll be glad to comment. Let me start by pointing out that you do not know whether or not your partner had HIV or other STI’s. Most people do not. I would suggest that for future encounters you might ask your partners about their status. Most people tell the truth.
More importantly however this was a very low risk exposure. In terms of HIV it was a no risk event. There are no proven cases in which someone has acquired HIV from receipt of oral sex or engaging in mutual masturbation, including anal penetration, even when partners are exposed to each other’s genital secretions in the course of the encounter. The fact that your partner may have had pre-ejaculate on his finger during anal penetration is still a no risk event.
There is a slight risk of having acquired Gonorrhea and an even lower risk of chlamydia from receipt of oral sex although the risk is small. Depending on your level of concern regarding this exposure, you may want to get a urine test for gonorrhea and chlamydia.
Thus, in summary, this was a very low risk exposure. The only testing that you might want to consider would be testing for gonorrhea and chlamydia. I hope this perspective is helpful to you. If there are additional questions or any clarification is needed, please don’t hesitate to use you were up to two follow-ups for that purpose. Please don’t worry. EWH
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41 months ago
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Thanks for your reply Doctor.
I spoke to the other male today. I was a bit shocked after speaking to him when he said that he had never been tested for an STI. He stated that he had only ever had about 5/6 encounters MSM and the last encounter previous to me was pre covid.
He states that he has never been involved in anal penetration as the giver or the receiver. He did state that he couldn't exactly remember what all we did whilst in the same company but did confirm mutual masterbation. He couldn't rule out some form of anal sex but I find it unlikely given neither of us remember it and I wasn't sore the following day and neither was he apparently. Given the fact I have never had anal sex I would have expected to be tender at the very least.
He states he has never experienced anal sex either, if he is being honest then I would expect he would have have remembered it or had some form of tenderness the following day. I think paranoia gets the better of me sometimes after such encounters when realistically I'm confident there was no penetration.
In terms of the potential oral sex that I believe took place, I have had no penis discharge or pain when urinating, it is 9 days after the event at this stage. Would it be typical to have had some form of symptoms at this stage?
The whole episode was over very quickly but I think the guilt has had an effect on me (I have a female partner). Should i test before resuming sexual relations with her?
Thanks
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Edward W. Hook M.D.
41 months ago
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Thanks for the additional information. If both of you are questioning whether or not you had anal sex and we’re not tender the likelihood you had anal intercourse is virtually zero. You both sound to be relatively low risk and you are asymptomatic. The likelihood you are infected is minuscule. If you wish to test for reassurance, you should do so but we’re I you, I would not hesitate to have unprotected intercourse with your wife. EWH ---
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41 months ago
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Dr, sorry for the delay between questions. One final question.
I had some lower back pain and pressure in my lower abdomen. I decided to go for a private std test after 13/14 days. The consultant done a syphilis test and a HIV instant test, negative but I know the timescales are to soon. I'm not overly concerned about these anyway. A urine sample was taken and a culture was checked under the microscope, these were taken from my penis. They were negative but the Dr gave me 1g of Azithromycin in the event chlamydia was still incubating. Over the past day I noticed a jelly like secretion from my anus, it was clear. I may have been trying to force a stool though that didn't come and the result was this. It was strange though and got my paranoia going. I haven't noticed any pain whilst passing stools or any itchiness but it was still strange.
I really don't think I had any anal sex, I stand by that but as I've said before there may have been some fingering with potential pre-cum and receipt of oral. The anal mucous has kind of thrown me off now though. I wonder would it have been/be best placed to get an anal test. Would the 1g of Azithromycin only be of any use for potential chylmidia? Maybe I'm just being paranoid and it was the over straining and over alertness to potential risks is making things worse.
Your advice would be greatly appreciated. Thanks.
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Edward W. Hook M.D.
41 months ago
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Anal fingering of the sort you describe is a form of masturbation and STI‘s including chlamydial infection are virtually never transmitted through exchange of secretions in the course of masturbation. I’m of the opinion however that testing for anal chlamydia would be reasonable, in large part to help resolve your ongoing anxiety and concerns. While I remain confident that you do not have an STI, I should also add that azithromycin is no longer recommended for treatment of chlamydial infection as it is considerably significantly less effective than a seven day course of doxycycline taking twice daily for seven days. Finally, if you were to test for chlamydial infection a day or two following receipt of azithromycin, since these tests do not detect living chlamydia but detect chlamydial DNA, the test would still be relatively reliable.
I hope this additional information is helpful. EWH
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