Sexually Transmitted Diseases/Gonorrhea transmission

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Question
Hi Dr.
I'm a gay male and haven't had much experience. I am just starting to experiment now that I have recently outed myself to my family. My question is pertaining to a guy I did not have intercourse or oral with.  I gave him a hand job and also some anal fingering but that was the jist of our encounter. Reason being, I noticed blood in his cum and first thing I thought of was STD.   I have read other posts that gonorrhea is spread via sexual contact/not through the blood but is that in all cases?  My finger that was in his rectum is extremely swollen from the nail bed to the first knuckle, it's red in color, warm to the touch, and it is pretty sore. It may have had a small cut from trimming my finger nails with a clipper but that's about it. Did my finger just catch an STD?
Thanks
j

Answer
Hello Jay,
The most likely problem is what we call a "felon," which is an infection of the tip of the finger, usually caused by germs that may enter through a cut or scratch on the finger around the fingernail.  A herpetic whitlow is an infection by herpes of the finger (usually fingertip at margin of nail; some experts refer to a herpes infection anywhere other than the mouth or anogenital area as a herpetic whitlow).

Gonorrhea usually affects the urethra of the penis, the throat/tonsils, anorectum, and the cervix (in women!). More rarely, it may disseminate to cause a disseminated infection of a joint.  

My guess is that your infection is not an STD, but a staph infection that does require immediate medical attention, with antibiotics and possibly a surgical procedure known as an I&D (incision and drainage).  

Good luck! Go to an urgent care or your doctor immediately!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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