Help...Please

[bigtime123]

Good morning Doc!

In September I cheated on my wife while absolutely black out drunk....I exchange unprotected oral sex with a white female.  I am 90% sure no vaginal intercourse.  I was tested in December (11 weeks) and was negative for Hep B and Hep C, HIV (antibody), Chlamydia, Gonorrhea, Syphilis, HSV 2 and was HSV 1 positive (but I knew I was and have been for quite some time).  My ONLY concern is not endangering my wife.  I have had no real symptoms just tons of regret, sleepless nights....and some red bumps on my butt that are scattered and I am most sure they are simply pimples which wouldn't be uncommon for me...no itch, slight pain/sensitivity like a pimple.

Below are a couple questions;

1) Of the aforementioned STDs - am I in the clear or should I be re-tested?  If so, for which ones?
2) What about other STDs (Trich, NGU or HPV, other?)
3) What about things like pubic lice or Scabies?  Would these have shown by now?

Again, I need to ensure myself that my wife is not endangered for my HUGE mistake - thanks in advance.

[Edward W Hook, MD]

Welcome to the Forum. At this time, the testing you have had effectively clears you for virtually all STIs.  Time for you to relax and move forward.

1) Of the aforementioned STDs - am I in the clear or should I be re-tested?  If so, for which ones?
Clear for Hepatitis B and C, HIV, Chlamydia, Gonorrhea, Syphilis, and HSV 2

2) What about other STDs (Trich, NGU or HPV, other?)
NGU or trich would have been obvious by now.  No need for testing. There are no recommended tests for HPV in men and even if there were, I would  not recommend them as there is a greater than 80% probability that you and your wife are both already or have been infected.  This is not a concern.

3) What about things like pubic lice or Scabies?  Would these have shown by now?
You certainly would be aware of these problems if they had occurred by now.

As I said above, time for you to relax and move forward from this exposure.  Take care. EWH

[bigtime123]

Dr Hook,

Thought I'd try sneaking in one more question - I also asked in the STD Community Forum.  From your experience do the chlamydia and gonorrhea urine tests catch oral versions of these STDs...ASHA.org suggests they may not?  Your thoughts?

[Edward W Hook, MD]

Glad to help. EWH

[bigtime123]

done and done.  Happy New Year!

[Edward W Hook, MD]

As I said, there is no recommended HPV test for men. Further, just to be clear, if there were and you were tested and tested positive, you would not know if this was a new or longstanding infection and there would be no recommendation for you or your wife to do anything than for you to be vigilant regarding any visible changes you might experience and for your wife to get her regular PAP smears as recommended.  You need to put this behind you and move forward. EWH

[bigtime123]

Doc,

One last thing...you said "There are no recommended tests for HPV in men and even if there were, I would  not recommend them as there is a greater than 80% probability that you and your wife are both already or have been infected.  This is not a concern."  

I get the statistics and odds - but we've been together for 10+ years...my concern is I transfer one of the cancer bearing HPV strains that I would assume she most likely does not have since she always has regular paps...  I would feel significant lymore comfortable if there was a way to ensure I don't have one of those high risk strains - is there no where to test?   I don't mind paying even if its expensive.  Or am I missing something here???

[Edward W Hook, MD]

It takes an average of 6 months for warts to form and they virtually never appear until at least three months after exposure my guess is that you are seeing mormal sturctures which you never looked close enought to notice before.  One of my colleagues once advised a patient to "ease up on the crotch watch" - I think this would be a good idea for you too.  If you need a professional assessment, you should see a trained clinican who can take a look at things.  EWH

[bigtime123]

Sorry Doc, I just couldn't help myself.  I have a bunch small white bumps on my penis shaft that are much more visible when I am erect.  They don't itch, hurt or have any feeling whatsoever.  Could they have always been there...sure.  I really don't know but my concern is they could be warts.  How can I differentiate between warts and fordyce spots or something else?

[bigtime123]

Gotcha - just wanted to understand if you felt the way you did based on risk level or based on timing and accuracy of the testing/results...thanks for the clarification...that's all from me!  Much appreciated.

[Edward W Hook, MD]

Not in terms of my interpretation of your results.  I would however had told you that there was really no need for testing if the exposure was condom protected and the condom did not break.  EWH

[bigtime123]

Thank you sir - just curious, would your advice have changed if I told you I had unprotected vaginal intercourse?