[Question #8971] Possible STI? Risk?

37 months ago

Had a protected anal (insertive partner) encounter with male csw. Claims he is tested every 2 weeks due to doing this. (no reason not to believe him). Unprotected Oral. No visible sores, cuts, etc. A week later I do not feel great. High heart rate, some burning in legs / muscle aches, tired. I noticed a pea sized pimple, on the lower back side of my scrotum, has gotten smaller. It's not a traditional pimple more of a hard "pebble". No pain or anything. I did receive notice I was around someone with covid. I also haven't slept much lately. Prior to the encounter and 2 days after I took Doxy 100mg 2X a day. as a "doxy prep". Could this be something other than a cold or possible covid? I always use protection, maybe I should with oral? As always thank you for your service.

H. Hunter Handsfield, MD

37 months ago

Welcome back.

Your symptoms do not suggest any STI from this encounter. And no STI causes a skin bump like this, and one on the back of your scrotum can't be related to that event; it sounds like that site wasn't directly exposed anyway. Your symptoms certainly could be COVID, or other non-STI viral infection. The only step I would recommend at this point is to test for COVID.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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37 months ago

Thank you, Dr. Handsfield - That makes sense. I thought that would have been an odd place since it isn't exposed during sex. Is 10 days the norm for HSV 1/2 symptoms to show? A couple of other questions:

1) From oral sex can you get hsv1 or hsv2 or both? How transmittable is it? Is there any way to protect ones self from this without abstaining?

2) What are your thoughts on monkeypox? Is it an STI? or can you get it like you can covid-19?

3) I know doxy is not the recommended treatment for gonorrhea but had one been taking it before and a couple of days after exposure - would it have aborted an infection from oral sex?

H. Hunter Handsfield, MD

37 months ago

The opportunity for follow-up discussion is for clarification of the original question, not entirely new queries. So my replies are brief.

1) Oral HSV2 is rare, and therefore oral to genital HSV2 transmission almost never happens. Oral to genital HSV1 transmission is common, but only if the oral partner has an active oral herpes outbreak and if the genital partner has not previously had HSV1. New herpes symptoms typically start 3-5 days after catching it.

2) In the US, so far the monkeypox outbreak is being transmitted by sexual contact among men having sex with men. Probably not airborne, like covid.

3) Doxycycline would prevent any and all syphilis and chlamydia, but would reduce gonorrhea risk by less than 50%. Most gonorrhea strains are resistant to it.

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37 months ago

Thank you. Today I feel worse. Sore throat comes and goes is red In the back. Sinus pressure. Headache. Teledoc gave me a a pack. I assume based on reading the forum that this isn’t an sti. Appreciate your work. Thanks.

H. Hunter Handsfield, MD

37 months ago

You have a virus. I'm amazed you weren't tested for COVID, and also that the teledoc prescribed azithromycin (Z pal). You have a virus, not a bacterial infection, and the Z pak won't help. Get tested for covid -- if positive, you need Paxlovid, the recommended treatment.

In any case, this isn't an STD.

That concludes this thread. Best wishes and stay safe.

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