[Question #922] STD/HIV Exposure + Testing questions

50 months ago

Hello doctors, I have some questions concerning a recent exposure I had with an escort. The encounter happened on April 19th of this year. The exposure was rather brief, lasting about 10 minutes or less. She told me that I was not allowed to touch her genital area with my hands or mouth and that kissing was also not allowed and I agreed. She began by applying some sort of lub or clear substance onto my unprotected penis with her hand, she then placed a condom on me and gave me oral that lasted for about 1 minute or 2. Afterwards we had protected vaginal sex with the same condom that lasted a few minutes. After this she gave me a wipe to clean off and then gave me a new condom and we repeated the cycle again. Lub with her hand, protected oral, and protected vaginal with the same condom lasting a few minutes again. Again she gave me a wipe to clean off, after this I headed home. As far as I could tell, both condoms were intact and didn’t seem to have leaks but I didn’t have a close look and I didn’t fill them with water to check.

I have tested for Syphilis, Gono, Chlamydia, and HIV and all have been negative. Here is a list of my latest tests for each.

Syphilis – May 23rd - 4 weeks and 6 days after exposure

Gono and Chlamydia – June 6th – 6 weeks and 6 days after exposure

HIV – July 6th -  11 weeks and 1 day after exposure

I plan on retesting for everything tomorrow through LabCorp including Hep C which my provider added in the lab order without me knowing. I plan on testing again for HIV and Syphilis at the end of this month to wrap up the 3 months of waiting to hopefully end this nightmare. I was told not to test for herpes unless I have an outbreak which I agreed with.

 

Now my questions and concerns

I have a bump on the tip of my penis that I was told was a result of a scratch by a GYN. I was also told that it looked like it was a part of my penis and nothing to worry about by a PA. This bump doesn’t hurt or seem to grown and looks to be something normal on my skin. I am uncircumcised so all my foreskin connects at the tip and the bump is on top of this. I noticed this 3 weeks ago and it doesn’t seem to have gotten worse.  What can it be?

I have had very minor pain in my penis, so small I barely notice it. It comes and goes very fast and it doesn’t happen often. Is this a symptom of anything?

Are all my tests accurate at this point? Is 3 months enough? Can I stop worrying about this?

I have the HPV vaccine, should I not worry about genital warts or having HPV in general?

What are my risks based on my encounter for any STD and HIV?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Welcome to the forum. THanks for your question.

This sounds like an entirely safe exposure. I'm glad to hear both you and your partner were very careful about sexual safety. Further, it sounds like your escort partner is quite careful, and in general escorts (expensive female sex workers, as opposed to street walker and brothel workers) are believed to have low rates of STD. Many get tested regularly, and their clients typically are low risk (like you, I would guess). Further, your negative STD tests are highly reliable.  To your specific questions:

1) Not being able to see the penile bump, I can't say more than you PA has told you. From your description, I'm inclined to agree it isn't anything abnormal. In any case, it doesn't sound like an STD from the events described above.

2) Symptoms like this usually are due to anxiety, which results in increased awareness of trivial symptoms or normal body sensations that otherwise wouldn't be noticed.

3) All your test results are conclusive. There is no need for any additional testing.

4) The risk of HPV infection was low, and immunization is highly effective. Everyone gets HPV, and you could have (or have had) HPV infections not covered by the vaccine. But that happens to all sexually active people and is rarely a significant health risk. In any case, the chance of a new infection from the exposure described above is trivial. Nothing to worry about.

5) At this point, you can be confident you weren't infected. No worries!

I hope this has been helpful. Best wishes and stay safe--   HHH, MD
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50 months ago
Thanks a lot Dr. Handsfield, it really means a lot to me that you were able to answer my post. It makes me feel so much better now knowing what you told me. I have been reading many of your previous posts here as well as the ones you left on Medhelp. This encounter has served as a major lesson to me, its been my biggest cause of worry and anxiety and I'm ready to end this nightmare. I know you said I dont need further testing, but I want to take these last set of tests to get complete reassurance. I just have two quick questions for you.

1) At 3 months, if (and I'm very hopeful now) all my tests turn out negative again, can I finally say I'm STD and HIV free?
2) Is it safe for me to have a regular sexual relationship with or without protection with my long term girlfriend right now?

Also, I'd like to follow up with you when I get the results for tomorrows test as well as the ones for the end of the month if that's okay with you.

Thanks again Doctor, I really appreciate your answer.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Thanks for the thanks. But I have to say I am skeptical of your plan. You have already had conclusive testing. When someone is so anxious they think they need "just one more test panel", they continue to worry even after those tests are done. The problem isn't your intellectual understanding you aren't infected, but the underlying anxiety over a sexual choice you regret. I hope I'm wrong and that your additional negative test results resolve your fears once and for all. If not, professional counseling should be your next step.

1) You can say you are HIV/STD negative now. You will still be able to do so after another round of tests, which for sure will be negative.

2) You could have resumed sex with your partner a few weeks ago. You certainly can do so now.

Each question comes with two follow-up comments and replies, so you have one more coming on this thread. Feel free to report one more round of test results, but if they are negative as expected, I really don't see the need for me to agree they are negative!

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50 months ago
Hello Doctor, I have come back with the test results and a couple of new concerns.

As far as my tests go, I have tested yet again negative for Gono, Chlamydia, HIV, and Syphilis as well as Hep C. I took the tests on July 7th, 11 weeks and 2 days after my exposure on April 19th. Here are my new concerns.

1) The pains in my penis seem to have increased a bit yesterday, it is now just a bit more painful and noticeable. The pain seems to pulse sometimes, it will be there for half a second, it will go away and come back again. The pain that worries me is the one that feels like its in or around the head of my penis, close to the tip. I first felt this yesterday, it wasnt strong or very painful, but I could tell it was there and that it was coming from that area. Before yesterday, I wasnt feeling this, or at least it didnt seem like it was coming from the head or the tip. Also, I have felt some more noticeable pain near my right testicle. Im not sure if its coming from the testicle it self as when I touch that area nothing hurts. When I mention "pain" I dont mean anything extremely painful, but its something that I can sometimes barely feel, other times especially since yesterday, the "pains" seem to feel just a bit stronger. I dont know if being erect brings the pain in the head of my penis, but today when I was with my girlfriend I started to feel the pain slightly as I got erect. However, yesterday when I noticed the similar feeling, I was just on my computer with no erection. I am worried about these "pains", I know you mentioned that anxiety can make one feel these regular feelings, but my anxiety has gone down dramatically since I first posted to this thread.  The "pains" seem to be growing a little and spreading, at least thats what I think. 
What can this possibly be? What STDS cause pains like this? Am I missing any STD tests that I should take? Is it safe for me and my girlfriend to have unprotected oral and vaginal sex if we chose to do so?

2) My other concern is a just a small pimple like bump that a PA told me yesterday was nothing to worry about. I just want to know if you can stretch warts out flat when pulling on the skin? When I tighten the skin that the bump is on it seems to get smaller. Could this be anything major?
50 months ago
I forgot to mention that I dont feel pain when I urinate still, the only time I did was while the other pain was happening, but that started before I went to pee. I have no discharge that I can tell.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
I'm glad to hear your additional tests were negative, but of course not surprised.

1) No STD causes this sort of pain. It's not an STD or any other infection related to your sexual exposure 3 months. If it's related to that, it's purely anxiety over th event.

2) Warts don't "stretch out" in the way you describe. And it appeared too soon to be a wart from the exposure 3 months ago. As discussed above, this doesn't sound abnormal. But see your doctor (or return to the PA) if you would like additional reassurance about it.

That ends this thread. Take care and stay safe.

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