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Ask Dr. Rick, MD Your Own Question

Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 8077
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Dear dr pauline. This is me again the boy who sees a prostitute

Customer Question

Dear dr pauline. This is me again the boy who sees a prostitute but is so afraid on hiv. She was n escort that didnt bring protection. I tried to penetrate he rubbing my penis to her anus a little and tried her vag. It was tight i did one hard push and pulled out cause i got my senses back. But before that we did do bbbj . Do this merit a checkup???
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Pauline replied 1 year ago.

DrPauline :

Hello, my name is XXXXX XXXXX I am happy to help with your question today.

DrPauline :

If you had unprotected penis to vagina or anus contact then there is a potential for risk of STD transmission, and although it sounds like contact was fleeting, then HIV cannot be ruled out 100%.

DrPauline :

You should really keep a condom in your wallet at all times for occasions like these so that you never put yourself at risk.

DrPauline :

The risk of HIV from full penetration and sustained vaginal intercourse is 0.5% (depends on the study looked at) so minimal penetration will be less than this but not zero.

DrPauline :

You should see a STD clinic to check for chlamydia, gonorrhea and herpes and then a HIV test either RNA at about day 21 or antibody testing at week twelve.

DrPauline :

And avoid any unprotected intercourse regardless of nature of partner.

Customer:

it probably doesnt matter to state but i barely tocuhed the anus . and the vag she tried to put it in and i pushed it was so tight that i pulled back before it fully went in and i even think i wasnt fully hard at the time which made it hard to penetrate

Customer:

i guess im never going to hear the

Customer:

you have 0% transmission

Customer:

i most likely have it dont i

Customer:

i even scared the driver asking him if they test they're girls

Customer:

according to them they are a highly prestigious

Customer:

so to speak and they always test they're girls and ask me to coem to the office if i get anything .

Customer:

also this was a relatively expensive

Customer:

dunno if it counts for anything

Customer:

but yeah

Customer:

i dont think my brain can stand waiting for another 3 months to be certain

DrPauline :

I suspect your risk is tiny, but the problem is that the only way to be sure is to use protection. Also, if this is a quality escort agency then they probably do test their girls but if they do not encourage their escorts to carry condoms then this is slightly worrying.

Customer:

no

Customer:

they offred to ask the driver to go buy condoms for me

Customer:

even the girl was hessitant

Customer:

to do without a condom

DrPauline :

Use HIV RNA testing at either day 21 or day 28 (depends on your clinic protocol) for a faster test.

Customer:

called the management to tell me to use one

Customer:

but i said to him

Customer:

it was only a blowjob

Customer:

cause that isnt really dangerous for HIV

Customer:

but i just HAD to try to penetrate

Customer:

even if it didnt really went it

Customer:

i even asked the driver to ask the girl if i actually did went in

Customer:

she said no

Customer:

so

Customer:

i really dont know what to do

Customer:

HIV RNA are notoriously unreliable arent they?

DrPauline :

It does not sound like you exchange body fluids, but without getting stressed by the test...just do a test so that you have a documented negative.

Customer:

would one half penetration cause HIV

Customer:

would i be the first most unlucky person in the whole world to catch HIV like that

Customer:

??

DrPauline :

We are starting to develop more confidence with RNA testing, although the official policy is to repeat an antibody test at 12 weeks, a negative RNA test can be worth doing.

DrPauline :

Your exposure is not enough to suggest that you need antivirals medication.

Customer:

what do i do

Customer:

i dont think i can stand 3 months

Customer:

again

Customer:

do i tell my parents?

Customer:

do i worry them then turn out to be nothing?

Customer:

do i break they're hearts

Customer:

its killing me that i betrayed them like this voer and over again

Customer:

is this a mental condition that i have

Customer:

DR pauline

Customer:

i jsut have to say

Customer:

that

DrPauline :

Do not tell your parents. Go to a confidential clinic for testing, and buy a big box of condoms for future use.

Customer:

you helped me get through the first 3 months last time . youre word actually calmed my heart so many times . i feared i would die if i didnt keep talking to you

Customer:

i really do hope that you are actually a practicing doctor

Customer:

i know common knowledge is to talk to aphisically present doctor

Customer:

but you seem to calm me down more then my derm can .

Customer:

i REALLY hope you are an expert in HIV

Customer:

there are no confidential clinics in Malaysia

Customer:

i will just have to go to the hospital ive been going to

DrPauline :

I am glad this helped last time. I am indeed a practicing doctor, I have looked after HIV positive patients and arranged tests for others.

DrPauline :

Your hospital records will be confidential, they will not be able to share information with your parents.

Customer:

yes

Customer:

i think so

Customer:

hospitals should have RNa test right?

Customer:

especially private ones

Customer:

??

DrPauline :

Yes, they should be but I do not work in your country so you need to check. But RNA tests are becoming more popular in UK and USA because they can be done so quickly.

Customer:

yes

Customer:

but are they accurate

Customer:

taht is what troubles me about doing it

Customer:

i dont want to do it

Customer:

get negative (hoepfully)

Customer:

then someday when i get married and get tested before that find out im HIV positive for this one enoc**ter i did years ago

DrPauline :

The RNA tests have become more accurate. Basically the scientists are able to check the blood and look for actual virus. So it gives a result before the antibodies develop.

DrPauline :

But it can be very expensive

Customer:

but are those scientists in my country .

Customer:

price is not an issue

Customer:

price is never an issue about health

Customer:

i know i contradict myself when i sayt hat

Customer:

can i feel better if i get the negative on the RNA and move on?

DrPauline :

The tests have been produced in USA and UK. Provided that your laboratories have access to the same processing equipment and chemicals then it should be available.

Customer:

or do i still take the 3 months / 6 months place

Customer:

also in your honest opinion . is this an exposure i should worry

Customer:

i know i should cause it was unprotected

Customer:

but i barely penetrated

Customer:

and she even said i didnt

Customer:

and taking into account this escort company is very famous and says they check they're girls and almost screamed at me not to worry

Customer:

would BBBJ cause HIV?

DrPauline :

I do not think your risk is high at all, even with full blown intercourse with a known HIV positive person then the risk per episode is not high.

DrPauline :

BBBJ risks is also very tiny, only made higher if the partner was HIV positive with bleeding gums or sores in her mouth.

Customer:

okay

Customer:

RNA confirmation is enough?

Customer:

can i do after 21 days?

Customer:

way after 21 days

DrPauline :

Check with your hospital, I can see that an organisation called PT foundation offers confidential testing but I think they use antibody testing.

Customer:

also i heard there are antibiotics that i can take 1-2 days after possible exposure to jjust kill the HIV there

DrPauline :

If your risk of getting HIV was high then I would have suggested PEP- but your encounter is not high enough to really justify this. The side effects from PEP are horrible - vomiting & loose stools. So not to be taken without consideration. You have 72 hours to decide to take them, so you could ask your doctor for their thoughts.

Customer:

well if you dont think i should

Customer:

i really am telling you everything

Customer:

not holding back anything

Customer:

trying to not overplay or udnerplay anything i tell you

Customer:

what i telly ou is what happened

Customer:

is there anything i can look for as an indication fo HIV infection

Customer:

health wise?

Customer:

how fast are RNA tests? and can i take them way after 21 days?

DrPauline :

If this is really going to play on your mind, then go to your doctor and ask for PEP meds. he/she will assess your risk and consider if the risk is worth the side effects.

DrPauline :

The RNA tests can be done at day 21 or 28 depending on the laboratory protocol. It varies in different locations.

DrPauline :

But is much quicker than waiting 12 weeks.

Customer:

RNA Tests
Unlike antibody tests, RNA tests can detect the presence of the virus itself. They look for HIV's genetic material -- its RNA -- which can be detected much sooner than antibodies. The window period for RNA test detection is 9–11 days.


RNA tests are done from blood samples and it usually takes two weeks for the lab to process the test. However, if you are experiencing some of the classic symptoms of seroconversion (or becoming HIV positive), doctors are often able to arrange to get the results much faster.

RNA tests are more costly and used less often than antibody tests; however, they are used in some parts of the United States. Happily

Customer:

so it says that it takes 2 weeks to get the results back

Customer:

again

Customer:

if you dont think i need a PEP

Customer:

i dont see the need to pay another doctor to tell me i dont need it

DrPauline :

If you came to me, I would discuss the benefit /risk but at the end of the day it is the patient's decision. The medication makes people feel terrible and so tends to be used by people with intercourse that was with a known HIV partner or high risk partner such as IV drug user. Or sometimes PEP is used while waiting for the partner's blood test to come back. So if you had a very willing escort then you could ask her to do an antibody test which would prove she was negative.

Customer:

i dont think i will ever see he again

Customer:

her*

Customer:

its an agency and not an independant escort

Customer:

so

DrPauline :

Then do the testing, and try not to worry.

Customer:

the RNA?

Customer:

does it actually take 2 weeks/

DrPauline :

It depends on the lab, our results are available in 7 days.

Customer:

wait

Customer:

these test

Customer:

are actually 1000 RM

Customer:

for me

Customer:

are they that expensive

Customer:

that is about 350 usd

DrPauline :

The chemicals they use are very expensive, all our patients get them free on NHS

Customer:

yeah

Customer:

1000

Customer:

for somethign that may not be certain

Customer:

may not be a viable option right now

Customer:

its 10X more exp thent he normal tests

Customer:

again

Customer:

what are symptoms i should look for and in what range of days should i look for them for HIV and stds if you could state some

DrPauline :

Look at this site here: they were offering free tests here

Customer:

HIV screening is the antibody test is it not?

Customer:

nto the RNA?

Customer:

not*

DrPauline :

If you were HIV positive then you may get a non specific flu like illness so muscle pain, fever etc within 1 week to about 4 weeks after exposure.

DrPauline :

Swollen glands and sore throat are other things to look for,

Customer:

location of these glands?

DrPauline :

under the chin, down the neck, under armpits and in the groin.

Customer:

okay

Customer:

so its the 3 months test then for comfirmation

Customer:

cause at the moment

Customer:

as much as i want to spend 1000 on a test

Customer:

i just cant afford i

Customer:

it

DrPauline :

It is a lot of money.

Customer:

i just really fail to think i could get , and im sorry if i sound pretentious , HIV for one push ( not even a full push) and maybe a rub at the anus .

Customer:

HAS anyone gotten HIV in that way?

Customer:

and ive been looking at the numbers for HIV in malaysia

Customer:

for some reason males are 3x more affected from hetero sexual sex even when ppl say it is so much more unlikely for a man tog et HIV in this way .

Customer:

this really troubles me

DrPauline :

There are some people where we do not know for sure how they got HIV, but studies do not really explore non pentration encounters.

Customer:

well is there anythign else youw ant to know or tell me about my encounter? in your minda nd heart do you think im at any risk putting away your doctor coat for 5 seconds

DrPauline :

I think your risk is too small to easily quantify the percentage. I just cannot say that the risk is zero.

Customer: Can i ask honestly. Why are the percentage for hiv contraction solow for almost all encounters even from gay sex? But then ppl getting hiv are still exploding apparently. Why are the risks 0.05 % when more and more ppl get hiv
DrPauline :

That is the statistical results for a population, it is difficult to transfer the results of a study to the individual.

Customer: Okay. I really wished i didnt try to penetrate . This is really breaking my brain. Playing it over and over in my mind. I dudnt even penetrate her fully. And she was kinda hygenic cause even when i barely penetrated she asked me to wash before the bbbj. And she took a full mouth of water for the bbbj. Is that weird using water for a bbbj,
DrPauline :

It sounds like sge

DrPauline :

she does worry about hygeine.

DrPauline :

Using water may be to do with the taste, some girls do not like taste of BBBJ

Customer: Sge??
DrPauline :

typo...she

Customer: Do you deal with escorts at all? When ppl say they test theyre girls. Do they actuslly test them. I dont know how escorts come into hospitals to test for hiv. And wgat do they do if one is hiv positive. I also fail to see they would make them stop making money. What do you think?
DrPauline :

The escorts tend to go to the free confidential clinics.

DrPauline :

If positive then the girls are advised to use protection and ideally change profession.

DrPauline :

They would also be started on antiviral medication depending on their blood results

Customer: Hmmm. Well this agency apparently has an office , apparently very famous. Fairly expensive . So i hope they do test and i am free from hiv. 3 month test then right? And you really think im fine right?
DrPauline :

Yes, do not do multiple tests. Either wait for 12 weeks and do antibody tests, or do the RNA test.

Customer: So june then. Dont think i can survive that long but okay . Dyibg shouldnt be soo bad i guess
DrPauline :

Do not get downhearted, this is a low risk exposure as contact with escort was so short.

Customer: Would it make a diff if the contact was longer? No right?
DrPauline :

To contract HIV you need

DrPauline :

1. a partner who is HIV positive

DrPauline :

2. exchange of body fluids

DrPauline :

So if we assume that your partner is positive because she is an escort (although we have no proof of that) then the risk is based upon your contact being long enough to allow body fluid from her vagina to come in contact with the urethral surfaces in your penis.

DrPauline :

I suspect that your contact was not long enough to allow body fluid contact, especially if she was not well lubricated.

Customer:

yeah she asked me to put some water to make it slide better i guess ? so if its not lubricated its ahrder to get HIV?

Customer:

HIV generalyl is hard toge t though right?

Customer:

also

Customer:

for HIV to be contracted other than actually having cuts is for the fluids to go into your urethra right?

Customer:

also

Customer:

would PEP totally eliminate HIV altogether?

Customer:

this is important because if it does and is not that expensive i would actually do it

Customer:

getting scared again

Customer:

..

Customer:

also i am wondering

Customer:

if when i put it in her vag

Customer:

would it be like incredibly tight where i pushed hard and it barely went in or would that be the anus?

Customer:

i know that is a really dumb question

DrPauline :

HIV risk is reduced by PEP but there have been cases where PEP has failed. However usually we would expect a standard course of 4 weeks to reduce the risk of HIV in high risk HIV cases.

DrPauline :

It is the contaminated body fluid coming in contact with your urethral surfaces that is the risk for you, so anal or vaginal...does not really matter. The point is that you had unprotected contact, even if it was limited.

Customer: So im just ging to go on dangerously depressed for 3 months then ???
DrPauline :

Your contact was limited, but by not using protection then you exposed yourself to the risk and the worry. So really important that you do not do this again.

DrPauline :

If the stress of all of this is affecting you then you need to see a therapist to talk through your anxieties and look at ways of coping.

Customer:

i just cant help but think of the worst . sicne it was un protected . but hen my logical mind comes in and tell me that one insertionc ant possibly cause me to catch anything unless im the most unlucky person in the world . but most of all the not knowing part is whats killing me

Customer:

how do normal people cope with an active sex life when they have to check every 3 months

DrPauline :

Most people have a policy of always using condoms with partners, and only moving to unprotected intercourse when in a monogomous relationship where the partners get a set of STD checks before stopping using condoms.

DrPauline :

I had one patient who requested a HIV test when moving into a new relationship so that he could prove to his new partner that he was HIV negative,

DrPauline :

But using condoms is the most common and easiest way to keep your mind at ease.

DrPauline :

It also protects you from causing an unwanted pregnancy.

Customer:

lets say i didnt really put in my penis into her vag even a little . would that merit a test?

Customer: Should i be worried at all? Do you think i have hiv? Why cant i get over this? I cant even talk to my parents now ...
DrPauline :

If you did not put penis into vagina then that would change things, as there was no risk that vaginal fluid would come into contact with urethral surfaces

DrPauline :

So I do not think that you should be worried,

Customer: Urethral surface is in the penis yes? Nothing outside?
DrPauline :

Yes, it is the lining of the tube where urine and semen comes through. So fluid has to get up into this to give you a risk. External skin of penis would not allow passage of HIV

Customer: So one very tight push from a not fully erected penis in either vag or anus would cause these fluids to enter? Also for anal dont you need to actually have sex for the anus to 'bleed' then cause a risk or am i wrong?
DrPauline :

If the penis was not fully erect then it was unlikely that there was sufficient pressure to cause bleeding at anus, and if vagina was not penetrated then little risk of vaginal fluid coming in contact,

Customer: But you do need to bleed the anus??? Again though. Could a vag be so tight to push in? Im a real incompetant . I cant even tell if it was anal or vag
DrPauline :

Was there any fluid or blood on penis when you withdrew?

Customer: Blood no. Fluid i dont remember. Should it be really slimy? Shiuldnt it be wet since there was a bj before that. I did wash off after trying to penetrate
DrPauline :

I think you are trying to overthink this now. To catch HIV you need reasonable amount of contact with infected body fluids, I do not think that the episode that you describe would be sufficient to catch HIV

Customer: What is reasonable amount of time with infected fluids??
DrPauline :

Impossible to quantify, but usually a sexual encounter of several minutes

Customer: Okay. Trying to remember if any thrusting motion was used. I dont think so
Customer: I should be fine then?
DrPauline :

I think this was an incredibly low risk encounter but if you had not stopped then could have become high risk.

Customer: Yeah im still trying to remember if i went in. So far only thing i remember abou that is that one push that was so tight then i pulled out
DrPauline :

Try not to focus on this, but do use condoms for all encounters and choose one type of test or the other to have for piece of mind.

Customer: Yeah 3 mooths. Hope i can last that long
DrPauline :

Do not focus on it, just get on with life but put a note in the diary for a blood test in a few months. In the meantime ensure you carry condoms.

Customer: The test is just to confirm a negative or positive?
DrPauline :

Yes, just to draw a line under the encounter,

Customer: So theres still a big chance fir a pisitive?
DrPauline : The chance is tiny, but when people do not use protection then we can give a 100% guarantee that there is zero risk.
DrPauline : sorry that should read .....cannot give 100% guaranteeb
Customer: What guarantee can you give then?
DrPauline :

That is the point, I cannot put a figure on an individual risk. Statistics do not help us in your situation.

DrPauline :

I am sorry that I cannot quantify this for you, but it is a tiny, tiny risk

Customer:

why doesnt statistic help in this situation?

DrPauline :

Because although studies can quote that rate of HIV from full penetration vaginal intercourse is about 0.05%, this is based on a population of thousands.

Customer:

but should the risk be lower then for me?

DrPauline :

Absolutely, you did not have full penetration and contact was fleeting.

Customer:

it just sounds scary that you can say its possible that i can get it even when its a tiny chance

Customer:

is all

DrPauline :

I really think your risk is very very low.

Customer:

why do i feel like i have it?

Customer:

even more then the otehr time

Customer:

is this a mental problem

Customer:

why

DrPauline :

Yes, you have health anxiety and I imagine it is playing a lot on your mind. So the anxiety you have is excessive compared to the risk and you tend to dwell on it.

Customer:

yes

Customer:

what do i do?

DrPauline :

Firstly, I do think that you need a counsellor to help you put this in perspective. Speaking to someone can help work out why you worry so much about your health but take chances by unprotected contact with escorts.

Customer:

can you tell me why?

DrPauline :

Sorry, considering aspect of people's behaviour is not my expertise. We do have a mental health section if you wish to open a new question in that section where experts may be able to work through your thoughts.

Customer:

but is this essential?

DrPauline :

No, but if your life is being affected by persistant and ruminant thoughts about HIV then it is worth exploring these so that you can get on with your life.

Customer:

but like you said you cant guarantee that i dont have it . even when the contact was limited

DrPauline :

Unfortunately there are a very small number of HIV positive people who cannot identify when they contracted HIV, so that means that we cannot be 100% sure that you are negative. Medicine does not easily provide guarantees for individual patients. We can only talk about high and low risk.

DrPauline :

Your enounter was low risk

Customer:

i just noticed soemthing . i was just casualing looking at my penis when i saw what i thought was dead skin like the ones you see like a scar . right beside the penis hole . i picked it i felt no pain and it came off . im still looking at it and see no scars or anything that would suggest a scar . could a scar develop in 1-2 days and just peel off with no pain and me not noticing it giving it is right beside the pnis ureter.

DrPauline : The skin on the penis can be dry and flaky however if it started off as a red bump that blistered then you need to consider herpes. But it would usually take a number of days to develop after exposure.
Customer:

yeah

Customer:

no blister

Customer:

i would have notices soemthign bigger then the PPP i have . it was just like a scar i just picked off . it was weird

DrPauline :

Lack of blister is good. Keep an eye out for any new bumps or sores in the next few days. Or any pain when passing urine.

Customer:

well ill just wait for the positive test then?

DrPauline :

If you get any more bumps or sores then go to STD clinic for general STD screen, but otherwise do a HIV test at the correct interval.

Customer: At 3 months? It should be a negatif?
DrPauline :

Yes, 1

DrPauline :

Yes, HIV antibody test at 3 months and then you can put this behind you.

Customer: Pu this behind? What if its positive?
DrPauline :

I would be very suprised if it were positive, as your actual risk is tiny. However you always need to consider the potential outcomes of blood tests before taking them.

Customer: Yes true. Still trying to rember . I dont remember any actual pumping or thrusting motion on her vag. Even if these was it was a fail attempt to put it in. And when i tried to put it in her , i noticed i can still see my base so i assume it didnt even go all the way in. But now this 'scar' scares me that was there a cut at the head of the penis. But then how can i not notice a cut that crusted on my penis at all. And theres no blisters before and im sure herpes blister have to hurt somewhat even a little it should be noticeable. What do you think? If you could give a longer respond for me to read , as you replies calm me.
DrPauline :

This area of 'dead skin' could be several things, it could be flaky skin from penis skin being dry, a fungal infection, eczema or a healing blister. If there is no redness or discomfort then there is a lot less to be worried about. Cuts on the end of the penis can occur in fungal infections. However unless there was active bleeding from an open wound then I would not consider this to add to your HIV risk.

DrPauline :

Herpes is very common but starts with a tingling area that becomes red, raised and then crusty. This process takes several days so you would notice this.

Customer:

what about the whole mot thrusting thing?

Customer:

not*

DrPauline :

The thrusting would only be relevant if this increased risk of penis to vagina contact

Customer:

i dont udnerstand that statement

DrPauline :

By thrusting you increase penis coming into contact with vaginal lining

Customer:

so what does that mean

DrPauline :

More thrusting increases risk

Customer:

more thusting trying to get it in? meaning it didnt even fully went in also increases risk?

DrPauline :

No, what I mean is that thrusting into the vagina increases risk. If you did not penetrate then minimal risk.

DrPauline :

You are looking at this is too much detail again.

DrPauline :

Try to look at the bigger picture.

Customer:

which is?

DrPauline :

That your overall risk is tiny, as your contact was limited with minimal (or even none) exchange of body fluids in a person who may be HIV negative.

DrPauline :

By overanalysing every aspect then you heighten anxiety without achieving anything concrete.

Customer:

jsut to make sure which part of the encoutner is low risk?

DrPauline : The whole encounter that you describe is low risk. Do not try and divide up the individual aspects. For future encounters, use condoms for all intimate encounters.
DrPauline : i hope that this has been helpful, please remember to take a minute to rate. We can still continue with follow up on this topic as needed.
Customer:

before that . i just saw this statistics

Customer:

dunno how accurate it is

Customer:

but i saw in malaysia for HIV

Customer:

men are twice as more abundant

Customer:

then women

Customer:

and the main contraction oF hiv is from IT

Customer:

escort or prostitute arent even 4th higher

Customer:

very little

Customer:

and odd jobs are the ones taking most of the ppl in HIV

Customer:

rather then escorts

Customer:

why is this?

Customer:

does this help at all?

Customer:

no then

Customer:

no then?

DrPauline :

Hello, yes the data is very interesting, the implication is that escorts must be using protection. However the overall statistics can only be used as a guide and do not help in your scenario.

DrPauline :

Your contact was minimal therefore your chance is very low. Try not to focus on it.

DrPauline :

I will be offline when you reply, but I will get back to you.

Customer:

what part of it is low risk?

Customer:

im rethinking now

Customer:

adn i cant remember if i did penetrate her

Customer:

or if i did

DrPauline :

You told me that you did not penetrate. So the entire encounter is low risk. You are obsessing about the details, and that is a indicator that you have health anxiety. Dwelling on this encounter is not helping you move on.

Customer:

im just tryign tog etit right in my mind thinking that =am i sure i didnt penetrate . she even said i didnt so means i didnt right?

DrPauline :

Yes, if your partner said that too then that is reassuring.

Customer:

also if i did get to penetrate her i would have finished like that if you know what i mean

Customer:

the fact that i finished with just a boojob means i didnt penetrate her i guess

DrPauline :

From the description that you gave me when this was all fresh in your mind, this was a low risk encounter and I would encourage you not to dwell on it. It must be affecting your concentration for other things in your life. So try not to rethink this too much.

Customer:

okay jsut oen more thing

Customer:

taht when i penetrated i dotn remeber actuallyfeeling something slimy

Customer:

when i tried to penetrate it felt so tight and dry

Customer:

and i dotn actually remember penetrating i think

Customer:

damn

DrPauline :

I really do think that you need to spend time talking with a counsellor about your underlying anxiety. There are cognitive behavioural therapies that will help you cope with the anxiety and the recurrent thoughts on these types of episodes.

Dr. Pauline, Doctor
Category: Medical
Satisfied Customers: 8631
Experience: MBChB. BSc(Hons)Pharm
Dr. Pauline and 6 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

sorry for the alte rate . just havent been on and still been stressing about thiss. still recalling if i infact penetrated her and if i have HIV , been getting too depressed . can you justify maybe that i dotn have it?

Expert:  Dr. Pauline replied 1 year ago.
Hello, thank you for rating the answer. I am sorry to hear that this is still causing you stress.

I think it highly unlikely that you have caught HIV from this encounter.
Firstly although your partner was an escort, we have no proof that she was HIV positive .
Next you did not have full penetrative intercourse, so the opportunity for exchange of body fluid was minimal. We know that statistically, the risk of catching HIV from full penetrative intercourse is only 0.05%. So that is a tiny actual risk.

Overall I think you should try and look forward rather than back at this.
Customer: replied 1 year ago.

what if i did have full penetrate but not for long

Expert:  Dr. Pauline replied 1 year ago.
The longer you have full penetration, then the higher that you increase the risk due to contact between vaginal fluid and urethral lining.

So if you feel that full penetrative intercourse then your risk is now 0.05%

If you use that figure then that will quantify the risk, and help you put this into perspective.
Customer: replied 1 year ago.
Which is
Expert:  Dr. Pauline replied 1 year ago.
If you convert the percentage risk of 0.05% then this works out as 1 in 2000. So does that help you view the statistical risk in perspective?
Customer: replied 1 year ago.
It means its highly unlikely??? Also I just found a lump around the crotch area. Not near the penis just above where the pubic hair is. Also there's a pubic hair petrifying out of this lump
Customer: replied 1 year ago.

Doctor hoep you reply as soon as possible , i found somethign very disturbing . i found a big dark red ( i wanna say blister) inside my mouth . its big kinda . hasnt happen to me before or i havent noticed before . could this be an std ? how can an std end up in my mount when i didn t do any kind of oral and never had any std anywhere else for it to sread in my mouth. what is this . PLEASE HELP


 

Expert:  Dr. Pauline replied 1 year ago.
Hi it sounds like you have two problems:
1. groin may be a lymph node but if there is a pubic hair sticking out of the lump then it is likely to be a sebaceous cyst. Use warm compresses on it, but if it gets large and red then you may need to have it incised and have antibiotics.

2. The oral blister may simply be a mouth ulcer, very common and can happen after trauma such as biting your cheek. These should heal in 2 weeks, so if still present in 3 weeks then see a dentist. You can use soothing antiseptic products in the meantime but avoid mouthwashes with alcohol which will sting.
Customer: replied 1 year ago.
So it's not std?? Cause itrs really dark almost black . No pain.
Expert:  Dr. Pauline replied 1 year ago.
Without examination in person then it is difficult to be precise. It is possible to get herpes lesions in the mouth but usually there are a number of blisters rather than one.
From your description then it is possible it is a "blood blister" which is when a blister fills with blood rather than yellow/clear liquid . Do not try to puncture it but see a doctor for examination. Blood blisters are usually result of trauma to the lining of the mouth and will heal by themselves but any lesion lasting longer than 3 weeks must be seen by a dentist
Customer: replied 1 year ago.

but it is most likely not std related? because sicne ive been putting on weight . i often bit my cheeks and my cheeks are in contact with my teetht he whole time . so maybe that caused it . is that normal?

Customer: replied 1 year ago.

but it is most likely not std related? because sicne ive been putting on weight . i often bit my cheeks and my cheeks are in contact with my teetht he whole time . so maybe that caused it . is that normal? adn well now i checked it again it went away ... the blood blister is gone now . i didnt touch it


 

Expert:  Dr. Pauline replied 1 year ago.
Biting your cheek is something to avoid, even if you are putting on weight then this should not affect you biting your cheeks. you may wish to see a dentist to check your teeth are not causing local trauma.

The fact that it has gone away is reassuring and supports the impression that it was trauma related.
Customer: replied 1 year ago.

okay last confirmation . my risk was minimal eventhough it was unprotected because i didnt penetrate enough . it was really hard to penetrate and seems dry . so i guess lube would increase risk? is this all correct?


i still have to go for the 3 month test? i still cant recall all what happened that night . seeing if i did infact penetrate more . seeing as if i could have penetrated easily i wouldnt have stopped till climax . so it can be said that being unable to penetrate kind of saved my life . is this smewhat the summary?

Expert:  Dr. Pauline replied 1 year ago.
Your risk is reduced because the limited exposure to body fluids limited your exposure, you need the three month test because you need to be able to draw a line after this event and confirm that you are HIV negative so that you can stop ruminating on the level of risk which is small but not zero.


Customer: replied 1 year ago.

would you be suprised if i did get HIV from thsi encounter? simply because it was that promiscous as the last one caseu i actually had 'sex' the last one

Expert:  Dr. Pauline replied 1 year ago.
I would be surprised if the result came out positive due to the limited exposure that occurred at that time,

Try not to focus too much on it.
Customer: replied 1 year ago.

so i have this kind of lump on my butt . it is nowhere near the anus just on the buttcheck. does have a tiny bit of pain like kind of a pimple but as you can imagine i cant really see what it looks like . is this any indication fo STD or HIV?


 

Expert:  Dr. Pauline replied 1 year ago.
A single pimple or boil is very common. I would not assume a STD or HIV, but if it increases in size then it may need to be lanced.

You can use a warm compress on it to see if it comes to a head, but do not squeeze it or you risk causing local infection.

If you have multiple bumps then this would need to be examined by a doctor in person.
Customer: replied 1 year ago.

hello i just found something disturbing again and this does actually look like somethin that needs to be inspected personally . but yeah so i just noticed this bump . well its not a bump totally cause a bump is usually round but this is kind of in a line at the bottom of my penis . its like at the line at the bottom part of the penis linking the shaft and the head . i noticed this when i was masturbating and felt kind of irritation . so i thought maybe it was a cut when after i masturbate with soap so it becomes dry and becomes prone to a cut . so i was thinking could this be soemthing of an std? if it is shouldnt it appear sooner then this or is this still in the window for symptoms. upon seeing the picture i took i does look like a wart . please tell me what you think! :(

Expert:  Dr. Pauline replied 1 year ago.
Its not always easy to define bumps by photo, a wart is certainly a possibility so looking at this I cannot rule out wart as the cause.

I think this is something to be seen in clinic with. Do not use any topical products on it so that the appearance is unchanged when it is inspected in person.
Customer: replied 1 year ago.
But what does it look like to you? Just from the picture
Customer: replied 1 year ago.

But what does it look like to you? Just from the picture. Or in other word what could rule it out most definitely that it isn't std related? looking at it now . would a wart have kind of like peeled skin aroudn it kinda ? cause isnt that like a dry skin cut?

Expert:  Dr. Pauline replied 1 year ago.
The photo is not enough to be 100% sure of diagnosis and the scale also makes a difference. There is evidence of skin trauma but that does not rule a wart in or out. If you can remember a specific injury such as a catching the skin with a finger nail then this would reduce this risk of wart.
Customer: replied 1 year ago.
I remember thrusting into a kinda rough surface or I guess sharp in my pants. It can hardly been seen. It's a line but can be changed when pinched so I think maybe its part of the skin. And harly can see it when I bathe if that helps
Expert:  Dr. Pauline replied 1 year ago.
If its not too obvious as a lump then you could wait to see how it heals but if you get any redness around the area or the bump gets bigger then get checked out straight away.

Customer: replied 1 year ago.

okay but if redness from me touching it counts ?

Expert:  Dr. Pauline replied 1 year ago.
If the redness persists then that is more concerning. Try not to touch it. Also avoid getting irritants such as soap in the en wound
Customer: replied 1 year ago.

okay how long would this take to go away for this bead like bump not to be concerning?

Expert:  Dr. Pauline replied 1 year ago.
If it was getting larger after three or four days or more red in that time then that would be enough time to see if it was going to settle or not.
Customer: replied 1 year ago.

are warts big cauliflower looking things that relatively harder then the skin around it? this feels like skin . peeled but it looks like a lump for soem reason . im scared now . so i have a development . upon lookinga t it again today . it looks like its a scar now .a line scar . can this be herpes? doesnt herpes hurt alot? given the position of it?

Customer: replied 1 year ago.

i was wodnerign if you could reply , its not too much

Expert:  Dr. Pauline replied 1 year ago.
I am sorry I've not been online, I've had a family bereavement.
Warts do become tough after time and develop a cauliflower appearance but initially can be simple small bump.

Herpes usually blisters and crusts over quite quickly, also usually more than one bump.

For full peace of mind then examination in person will give you answers.

I'm not going to be online for a few days. If you still have questions on this in the meantime then you may wish to open a new question for other experts.
Best wishes
Customer: replied 1 year ago.

it is gone now ? its skin now again no scar . does herpes move this fast . examination may not be relevent now cause its gone

Expert:  Dr. Pauline replied 1 year ago.
If it has completely gone then that is great and is unlikely to be anything sinister. So you can forget this for the time being but any new lumps or bumps then get checked out.


Best wishes
Customer: replied 1 year ago.
hope your back . windeing to ask if any bumps on the hand mean anything. ive gotten like kind of clusters on my hands. they are bumps that heppen and go away noe i see only crusts. . what i gathered these bumps are commong for ppl with pale or white skin. i have multip other bumps. other more like pore blockage and pimple. are these maybe the start of hiv cuase my immune sysytem is failing or just something loke bacteria. and also how can i tell from a lymph node and a pimple.
Customer: replied 1 year ago.
Relist: Other.
not available
Expert:  Dr. Rick, MD replied 1 year ago.
Internal medicine internship in NYC with two decades of clinical experience. I am online and available to assist you today.

I noticed your relisted question and have reviewed your chat with the DrPauline.

How may I be of assistance?
Customer: replied 1 year ago.

wondering to ask if any bumps on the hand mean anything. ive gotten like kind of clusters on my hands. they are bumps that heppen and go away noe i see only crusts. . what i gathered these bumps are commong for ppl with pale or white skin. i have multip other bumps. other more like pore blockage and pimple. are these maybe the start of hiv cuase my immune sysytem is failing or just something loke bacteria. and also how can i tell from a lymph node and a pimple.

Expert:  Dr. Rick, MD replied 1 year ago.
From what you have posted, I would not worry that these bumps you are noticing are a sign of HIV or impending failure of your immune system.

A lymph node is deeper then a pimple and located in specific areas of your body. They are usually firm and slightly mobile, sometimes tender,sometimes not.

Here is a diagram of where lymph nodes are found in your body:

http://diseasespictures.com/lymph-node-locations/

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.
what do you think of my situation?
Expert:  Dr. Rick, MD replied 1 year ago.
I've reviewed your entire conversation and post.

I would say that your risk of catching HIV or any other STD from the experience you described is so close to zero as to not even worry about.

I also do not think the bumps you are taking about are genital warts.

I think what is happening here, as you have already noted, is that your fears are getting the better of you.

So. What is my professional "take home" advice? Do not worry. :)

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.

sorry about the alte reply i havent been able tog et online recently , stablily i guess . well before i rate you , i must ask again after reading the whole conversation you are totally positive that i contracted nothing from that encounter? is a test warranted a. along answer is much appreciated :)

Expert:  Dr. Rick, MD replied 1 year ago.
I am sure that you did not catch any STD at all from that encounter.

The only reason you should have tests done is if you are so concerned that a negative test result -- and that is what the tests will turn out to be -- will give you peace of mind that you can not get in any other way.

If I were in your shoes I would not bother testing.

Does this make sense to you?

As a person who as asked 15 questions on this site, you already know how much fun the excellent feedback button is to push.....so go ahead. Push it. You know you want to... ;)
Customer: replied 1 year ago.

will do but you said std . what about HIV?

Expert:  Dr. Rick, MD replied 1 year ago.
I include HIV as an STD. Sorry I didn't make that clear.

You are safe from any infection from your activity.

Time to mash the excellent feedback button again :)

Have a good day.
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 8077
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 6 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

welp . i payed 200 for basically a recomfirmation so i feel kinda cheated abit .....well i have a few more developments . inw hich i have kind of cluster of bumps appearign on my hand . not sure if blisters and i took a picture of my bottom . and it doesnt look smooth ( i know it sounds weird) like what you see on tv . it has bumps and crusts . mind you this is on the buttock not at the anus . and i have no history or anal anything

Expert:  Dr. Rick, MD replied 1 year ago.
Can you upload the picture?

This is one easy way to do this:

Save your picture on your computer, someplace easy to find it such as your desktop.
Go to www.tinypic.com
Upload your picture to the site tinypic.com by browsing for it as directed.
This opens up files on your computer. Double click on the picture you want to upload then hit open (bottom right of the screen). This will take you back to the tinypic page. Hit "upload now" then do the secret code thing and your picture will upload into the system.
Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.
Copy the link from inside this box and then paste it into your justanswer dialog box and send it to your expert
Customer: replied 1 year ago.

ok

Expert:  Dr. Rick, MD replied 1 year ago.
I will standby
Customer: replied 1 year ago.


keep saying axxess denied

Expert:  Dr. Rick, MD replied 1 year ago.
Oh...if it is of your buttocks, the "porn filter" on the site is probably blocking it.....

Perhaps you could just describe it more to me, where exactly it is, how large, color, texture, etc and how long it has been there.
Customer: replied 1 year ago.

well it looks like tiny red bumps . but i really have to jsut show yout he pics . why is the access denied thing ahppening

Expert:  Dr. Rick, MD replied 1 year ago.
I'm not sure.

But,we can get around that block...

Email your pictures to customer service and tell them that it is for Dr Rick.

They will then upload them to me, I'll review them and send you a reply.

This may take up to a day to go through the system but at least we can get it done.
Customer: replied 1 year ago.

lemme try this . dont reply to this msg until mayeb you see pics or 5 mins have passed

Expert:  Dr. Rick, MD replied 1 year ago.
got two pictures.

What are you concerned that they might be a sign of?
Customer: replied 1 year ago.

std or HIV? if not those , what am i doign that are causing these

Expert:  Dr. Rick, MD replied 1 year ago.
That is, for positive, not a sign of HIV or an STD from what you have posted.

One picture is out of focus but in the other the lesions look a lot like furuncles. This is caused by Staph aureus bacteria that normally live on your skin when they infect a hair follicle.

They are treated by washing well with soap and water, using an antibacterial soap you can by over the counter,such as chlorhexidine.

Sometimes topical clindamycin ointment twice a day is needed, but not always. Rarely oral doxycycline or vancomycin is used.

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Sorry about the problems with the pictures....
Customer: replied 1 year ago.

last attempt at the photos

Expert:  Dr. Rick, MD replied 1 year ago.
Got them. Let me have a look...be right back
Expert:  Dr. Rick, MD replied 1 year ago.
yup. That is what it looks like on this side.

Of course, with skin lesions the only way to be 110% sure what it is would be to have a doctor look at you upcloseandpersonal.
Customer: replied 1 year ago.

it looks like what on what side?

Expert:  Dr. Rick, MD replied 1 year ago.
Oops. Sorry about that vague statement :(

On this side of the computer screen the pictures you have provided look like furuncles as we discussed above.
Customer: replied 1 year ago.

on the buttocks? so not HIV or std?

Expert:  Dr. Rick, MD replied 1 year ago.
That is correct. It does not look like it is from a STD or HIV.

Which is a good thing ;)
Customer: replied 1 year ago.
sorry dr rick. just want to comfrim. you can assure more or less guarentee that i dont hiv or std without a dhadow of a doubt??? and also are pore blockage bump common an the buttocks?
Expert:  Dr. Rick, MD replied 1 year ago.
Yes. I can assure you, with as much certainty that is possible in the medical world, that from what you have told me and the pictures we have reviewed together that you are not suffering from HIV or a STD.

I would not say this if I didn't really feel this way :)

Yes. Pore blockage bumps are common the buttocks. I, personally, have suffered with them so I speak not only from my medical training but from my life experiences.

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Thank you for mashing the excellent feedback button for me :)

Have a good evening and I am, of course, available to help you at any time....
Customer: replied 1 year ago.

just to make sure. this is you assesment after reading through all the back and fourth between me and dr pauline? also i have these kind of tiny dots appearing . looks like ppp but they are individual . and i will tip AGAIN after this . the dots are in the middle of the picture

Expert:  Dr. Rick, MD replied 1 year ago.
I have reviewed all your prior conversations with Dr Pauline and I just looked at the pictures..

Those dots are not a sign of a STD, HIV infection or anything to worry about. They are normal.

Does this make sense to you?

Thank you for mashing the positive feedback button.....if you want, I do accept tips too :)

Let me know what I can do to help you again in the future.

Dr. Rick MD FACS
Customer: replied 1 year ago.
i hope you gat that rating and tip i sent . so i ahve this NEW pimple or boil or std at my anus again . again its not at the anus hole its at the buttcheek . its ahrd and kinda big but i cant really get a good picture of it. again i ask can you get std there if youve never had any kind of anal activities. also ive been ahving some stomach problems like diarrea but not really . could this be a sign of anything serious? std or HIV wise
Expert:  Dr. Rick, MD replied 1 year ago.
I'm sorry but the rating and tip you sent did not come through.

Could you mash the positive feedback button again and, if you want, give the tip again? If if doesn't work this time we can contact customer service and see what the issue is.

Sorry about this technical glitch :(
Customer: replied 1 year ago.
there ive sent it again but could you answer this one quick . dont know how long i ahve have access to the internet
Expert:  Dr. Rick, MD replied 1 year ago.
It did not come through. I can send this issue to customer service for you if you like, or you could open a new thread, and request Dr. Rick to help you and we can just continue there.

Let me know what will work best for you.

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