Concerns About STDs After Potential Exposure: What You Need to Know

Concerned about sexually transmitted infections (STIs)?

Hello, Doctor: About four months ago, I met a male friend online and during our encounter, he inserted his finger into my anus while he masturbated and ejaculated (he was wearing a condom; I asked him afterward, and he said he used his other hand to masturbate and ejaculated into the condom).
Since I was facing away from him, I didn't know when he ejaculated; I only realized it when I smelled the semen.
I'm a bit worried that he might have inserted the finger that touched his semen back into my anus (I asked him, and he said he didn't, but I'm still concerned).

About three weeks later, I noticed some itchy bumps on my body, which appeared in areas including near my left armpit, the inner side of my left upper arm near the joint, my lower back, the right side of my waist, and the inner thighs (both legs).
I visited a dermatologist three times (at two different clinics); one diagnosis was bird mite bites, while the other two diagnoses were eczema.
I applied medication for a while, but it hasn't improved much, only alleviating the itching symptoms.
I thought the bumps might resolve on their own over time, but now, about four months later, while they haven't increased in number (some have subsided), they are still present and occasionally itchy (in episodes).

I would like to ask the doctor if these bumps are related to the sexual encounter I mentioned earlier.
Could they be a sexually transmitted infection? If not, what other conditions could they possibly indicate?

Thiem, 30~39 year old female. Ask Date: 2021/09/11

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, acne is usually caused by hot and humid weather leading to folliculitis, which should not be related to sexually transmitted infections.
However, the process you described may indeed indicate unsafe sexual behavior.
It would be advisable to consider visiting a clinic for examination or to undergo anonymous screening to confirm whether there is a sexually transmitted infection.
Thank you for your inquiry.

Reply Date: 2021/09/11

More Info

It’s understandable to have concerns about potential exposure to sexually transmitted diseases (STDs) after engaging in sexual activities, especially when there are uncertainties about the nature of the contact. Based on your description, you had a sexual encounter where your partner used his fingers and a condom during masturbation. You are worried about the possibility of STD transmission, particularly given the subsequent development of skin lesions.

Firstly, it's important to note that STDs are primarily transmitted through direct contact with infected bodily fluids, such as semen, vaginal secretions, or blood. In your case, since your partner used a condom during masturbation, the risk of transmission from semen is significantly reduced. However, if there was any contact with his fingers that had been in contact with his semen and then inserted into your anus, there could be a potential risk, albeit low, for certain infections.

The skin lesions you described, which have persisted for four months and have been diagnosed as either insect bites or eczema, raise some important considerations. While it’s possible that these lesions are unrelated to your sexual encounter, it’s also important to consider the possibility of an STD, especially if the lesions are itchy and have not responded to treatment.

Common STDs that could potentially cause skin lesions include:
1. Herpes Simplex Virus (HSV): This can cause painful blisters or sores, typically around the genital or anal area, but can also appear elsewhere on the body. If you had any lesions in those areas, it would be worth considering.

2. Human Papillomavirus (HPV): Certain strains can cause warts, which may appear as bumps on the skin. These can sometimes be mistaken for other skin conditions.

3. Syphilis: This STD can cause various skin manifestations, including rashes that may appear on different parts of the body.

4. Scabies or other skin infections: These can cause itching and rashes and may be confused with STD-related symptoms.

Given that your symptoms have persisted for several months without improvement, it would be prudent to seek further evaluation from a healthcare provider who specializes in infectious diseases or dermatology. They may recommend specific tests for STDs, including blood tests or swabs of any lesions, to determine the underlying cause of your symptoms.

In the meantime, here are some general recommendations:
- Avoid self-diagnosing: While it’s easy to jump to conclusions based on symptoms, a healthcare professional can provide a more accurate diagnosis.

- Practice safe sex: Always use protection and communicate openly with partners about sexual health.

- Monitor your symptoms: Keep track of any changes in your skin lesions or new symptoms that may arise.

In conclusion, while the risk of STD transmission in your described scenario appears low, it’s essential to have any persistent or concerning symptoms evaluated by a healthcare professional. They can provide the appropriate tests and treatments based on a thorough assessment of your condition.

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