STD or back injury?

Welcome to the forum. Thanks for your question.
But I have to say I’m a bit intrigued by the title. Having not yet read anything else, I’ll comment that no STD is likely to cause back pain as a symptom. So if you’ve had an injury and your back now hurts, no STD seems likely.
Now having read the rest: You describe a low risk exposure, since the overall frequency of STDs by oral to penile contact is very low. And to underscore my comment above, there are no STDs acquired in that manner that would cause back pain. Testicular pain, maybe — but only if there is also painful, tender swelling of a single testicle; and (usually) discharge of pus from the penis. These could indicate epididymitis, especially due to gonorrhea — but even this is very unlikely.
That said, if you have fairly diffuse scrotal pain, and back pain, and with the urinary symptoms you describe, you could have a prostate gland problem. You’re of the right age for it. However, prostititis is not an STD; if that’s what you have, it’s merely a coincidence with the oral sex exposure, not the result of an STD or any other infection from the event.
Those comments cover question 1. Question 2: IF you had acquired gonorrhea or another STD, there is a high risk you have infected your wife and she would need treatment. But don’t assume it. Wait for your test results — and if you were tested on line or without professional guideance, then regardless of the results you need to see a doctor or clinic about your symptoms. Question 3: Chlamydia is rarely if ever acquired by oral sex. If your chlamydia test was a blood test, you are correct that it’s useless, whether positive or negative; only a direct test on urine or a urethral swab is accurate. But if that’s what you had, the result is very reliable.
I hope this helps. I look forward to hearing the outcome after you have been professionally evaluated.
Regards– HHH, MD

Risk of STD?

Welcome back to our Forum. I will try to help. The exposure you describe was low risk and the symptoms you describe are not suggestive on an STI. Most commercial sex workers do not have STIs and even if she did, most exposures to infected partners do not lead to infection. There is certainly no risk to you from participation in condom protected vaginal sex. As long as condoms are worn through the encounter and do not break (and your condom did not obviously break, it did not break, when condoms break they break wide open).
As for your receipt of oral sex, receipt of oral sex is an inefficient way to acquire STIs. Even among persons with many sex partners, oral infections are uncommon and for a number of biological factors too complex to go into here, the efficiency of transmission of infections through oral sex is lower than for penetrative genital-vaginal or –anal sex. Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; for all practical purposes, chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny. If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection) such as burring on urination or a penile discharge by now. As I said above, even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection. In your case, I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time for gonorrhea and NGU. I anticipate the if you do, the tests will be negative and personally, I would not even seek testing. EWH

Dr. Hunter Handsfield wins award for STD prevention


March 3, 2010

Bobbi Nodell

UW Health Sciences/UW Medicine

University of Washington’s Dr. H. Hunter Handsfield, a long-time trailblazer in sexually transmitted diseases (STD) research, will receive the nation’s highest honor in the STD field during the Centers for Disease Control and Prevention’s 2010 National STD Prevention Conference in Atlanta, March 8-11.

Handsfield is the 2010 recipient of the Thomas Parran Award, named for Dr. Thomas Parran, Jr., U.S. Surgeon General from 1936 to 1948 and the chief developer of modern STD prevention strategies. The American Sexually Transmitted Diseases Association bestows the award in recognition of “long and distinguished” contributions to STD research and prevention.

Handsfield has been a leader in STD prevention and research since the early 1970s, when modern scientific investigation in STDs was gaining public and scientific attention and moving beyond what was then believed to be just a national gonorrhea epidemic. Handsfield was selected by unanimous decision of the association’s awards committee, said Dr. Bradley Stoner, committee chair and associate professor of medicine and anthropology at Washington University in St. Louis.

“Over the past 30 years, Dr. Handsfield’s contributions to our field have been enormous,” said Dr. Edward W. Hook III, a professor of medicine and epidemiology at the University of Alabama, Birmingham, in his nominating letter. “Dr. Handsfield is a proven and influential investigator, an innovator in the provision of health services for persons with and at risk for STDs and an effective mentor who has guided several of us forward in our careers within the field of STDs/HIV prevention.”

Handsfield, a clinical professor of medicine at UW, is currently a senior research leader at the Battelle Centers for Public Health Research, where he focuses on domestic and international HIV prevention research especially HIV/STD prevention in Zimbabwe. He got his start in STD research and prevention as an infectious disease fellow at UW between 1971-1973, following his residency there in internal medicine.

Expanding STD Prevention Efforts

From 1978 to 2005, Handsfield was director of the STD Control Program for Public Health Seattle & King County, where he honed his trailblazing skills. Under Handsfield’s leadership, the Seattle/King County STD Control Program was among the first in the nation to expand STD prevention efforts beyond syphilis and gonorrhea to include emerging syndromes like genital herpes, chlamydial infections and the other 20 or so common sexually transmitted infections. Handsfield implemented a comprehensive, holistic style and reliance on physician assistants and nurse practitioners to provide high quality clinical and prevention services—revolutionary at the time but now the national standard.

“As much or more than anyone in the United States, Hunter’s career has really bridged the divide between academic research and the practice of public health,” said Dr. Matthew Golden, the current Director of the Seattle/King County HIV/STD Program. “His career is a model for people who want to integrate research with public health prevention.”

Setting New Standards

Handsfield’s research also established current standards for routine testing of women for chlamydia, the most common STD caused by bacteria.

“We initiated the nation’s first routine chlamydia screening program,” Handsfield said. “We did it first in the STD clinic, quickly expanded to public health family planning clinics, then to the community level—all pretty much before other health departments were testing even in STD clinics.”

Handsfield summarizes his career as one that was broadly based on prevention of all STDs, including HIV/AIDS. The ASTDA awards committee cited his signal contributions to understanding to understanding the epidemiology, clinical manifestations, treatment and prevention of gonorrhea. He first defined the frequency and importance of asymptomatic, silent gonorrhea in men and how gonorrhea spreads in populations. He led the research efforts that established the current first-line gonorrhea treatments with the antibiotics ceftriaxone or cefixime.

In the 1980s, Handsfield was among the first public health experts to promote routine, voluntary HIV testing of persons at risk, a controversial strategy at the time. Two decades later, as a visiting scientist at CDC, he helped develop and promote CDC’s current recommendations for routine HIV testing of all persons seeking health care, now a cornerstone of HIV prevention.

A Wide-Ranging Impact

In selecting Handsfield for the Parran Award, the nominating committee also cited his leadership in research and promotion of expedited partner therapy, whereby the partners of persons with chlamydia or gonorrhea may receive antibiotics without necessarily being examined in person. Under Handsfield’s leadership as visiting scientist, expedited partner therapy became recommended by CDC as a standard prevention strategy.

Other accomplishments cited by the committee include Handsfield’s research on syphilis, in particular the frequency of early invasion of the brain and spinal cord, setting the stage for later complications; policies to prevent genital herpes, especially transmission to newborns; research establishing the importance of sex in transmitting cytomegalovirus; strategies for STD/HIV prevention in men who have sex with men; and three decades of consulting with CDC, the U.S. Food and Drug Administration and other agencies on treatment and prevention of STDs.

“Hunter was perfecting the art of ‘program science’ or ‘implementation research’ well before these terms became fashionable,” said Dr. Jeanne Marrazzo, ASTDA president. “He is an amazing example of someone who has always quickly grasped the implications that cutting-edge scientific discovery could have for enhancing health, both at the community and individual patient levels. His broad intellect and curiosity, deep generosity with trainees and colleagues, and wonderful sense of humor — beyond all of his notable research accomplishments — make him especially deserving of the Parran Award.”

Handsfield has authored or co-authored over 250 research papers, reviews and book chapters in some of the most commonly used medical textbooks. He also wrote his own book, Color Atlas and Synopsis of STDs, published by McGraw-Hill, which has been a standard educational resource for health care providers worldwide since the 1990s. He is working now on the third edition.

See the list of prior Parran Award winners.

Dr h hunter handsfield

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