Encounter with a sex worker

[questionencounter]

Hi Terri,

First off, thanks for all that you do on this forum. I know for myself reading all responses has provided me with some ease of mind by knowing others are going through the same thing.

On March 4th I, Male, had protected vaginal sex with a female sex worker. It started off with her kissing my cheeks, then protected oral, but then I lost my erection so she sat on top of me trying to grind on my genitals for about a minute (condom was still on) before I told her to get off.

From there she began licking my perianal area and then began to rim me for about a minute or two. The room was dark so I couldn’t see if she had any active oral outbreaks or not. We concluded with protected vaginal sex in doggy-style for a minute before finishing.

From there, about 5-6 days from exposure date (March 9ish) I felt the following symptoms:
Minor left testical pain with slight inflammation, some sensitivity in the skin between my thigh meeting my genitals, anus throbbing/discomfort and high difficulty in initiating a bowel movement.

From there, 10-15 days (March 23ish) from exposure I felt:
a cool (maybe burning idk?) sensation in the anus area. it was slighty more inflammed than usual, i grew this very small circular rash type lieson on my face which has stayed so far till today (1 month), and the constipation continued. I also started breaking out with pimples on my skin.

I wasn’t experencing any headaches, swollen lymph nodes or flu-like symptoms. I took a quick thermometer and it was a high flu for like 10 minutes and then the next 10 it was normal temperature which was weird.

I went to the ED and they prescribed me valtrex 500mg twice daily which didn’t make much difference for the constipation but did alleviate that groin sensitivity. They also took a viral culture swab of the anus which came back negative.
By late march the constipation started declining and I almost had normal bowel movements again. The little circular face rash was still there.

[questionencounter]

I went to the ED and they prescribed me valtrex 500mg twice daily which didn’t make much difference for the constipation but did alleviate that groin sensitivity. They also took a viral culture swab of the anus which came back negative.

By late march the constipation started declining and I almost had normal bowel movements again. The little circular face rash was still there.

Fast forward to present day. The circular face race is beginning to come down, facial skin is still breaking out. And the constipation has come back. I see a little bowel movements and even in my stool there is some white/clear looking type of mucus here and there.

I have never tested for HSV before but I’ve also never had a coldsore in my life.

Normally, I wouldn’t be that worried about something like constipation, but the loss of bowel movements and anus discomfort had me completely had me worried.

What are your thoughts on this in terms of exposure? I’ve scheduled a blood test to find results for this 1.5 month mark to see if I do have any form of anti-bodies forming or not.

1) Is it possible that she had oHSV2 and was shedding while giving oral at that time? and this encounter would transmit it to me anally? Or maybe it was the initial genital rub that she did that transmitted the virus to my pubic region (never shaven, only trimmed)?

2) Could these symptoms be still possible if she maybe had oHSV1 and transmitted that strain of the virus to me instead?

[Terri Warren]

1) Is it possible that she had oHSV2 and was shedding while giving oral at that time? and this encounter would transmit it to me anally? Or maybe it was the initial genital rub that she did that transmitted the virus to my pubic region (never shaven, only trimmed)?
on my, I think that is highly unlikely! Was the genital rubbing on bare skin?

2) Could these symptoms be still possible if she maybe had oHSV1 and transmitted that strain of the virus to me instead?
It is possible you could acquire HSV 1 but you had protected oral sex so I think that is also very unlikely.

If you take Valtrex for an extended period of time, it can cause a false positive on future testing, so if you really want to know if you have HSV, which I seriously doubt, I would advise using it with caution.

Terri

[questionencounter]

on my, I think that is highly unlikely! Was the genital rubbing on bare skin?

It was indeed yes for about 30 seconds

It is possible you could acquire HSV 1 but you had protected oral sex so I think that is also very unlikely.

But the analingus was unprotected and most of my burning symptoms seems to be in the anal region which is the scariest part for me right now.

I live in Canada and I just got back my HSV testing and it was non-reactive for both HSV1 AND HSV2. The GP mentioned that they do not provide IGG testing levels. My exposure date was March 5th and I blood tested on April 7th.

I am going to inquire from the lab about IGG scores and also retest next month to see if there is any change in my results, but a full month, shouldn’t I have had an Indeterminate score by now?

Also, what is the “range” that an IGG level is considered negative, indeterminate or positive? Is negative in the less than .90 range?

[Terri Warren]

If your results are negative, there is no need for the index value.
Generally, with IgG tests, less than-.90 is negative, correct.
Assuming you’ve not taken any antiviral meds, you MIGHT be positive by now. At 3 weeks out, 50% of those who are going to test positive will do so and at 6 weeks, 70%

Terri

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