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STDs  (Expert Forum)
 | 
Hiv or not doc
Answered by
H. Hunter Handsfield, M.D. -
University of Washington Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.

IMPORTANT

This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum

Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
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MedHelp Member's Question

Hiv or not doc

by hypochon, Apr 06, 2006 12:00AM
Hello Dr HHH



Ill keep this as simple as possible



Im a white male living in South Africa



Had a negative elisa test at 8.4 weeks after unprotected vaginal and oral sex but we are more at risk in this country!!!  Although its more prevalent amongst black africans rather than white africans.



I developed what looked like a median rhomboid glossitis on the dorsum of my tongue 5 weeks after the incident.  It sort of cleared up with anti fungal medication. No other symptoms apart from a sharp pain through my right side of my neck which might have been glands. Still get that pain now and again 3 months later.



Bad part is that my tongue has been furry or a little hairy on top(dorsum) for about 3 months now. It gets very white and creamy from the fur holding up debris and bacteria



questions



1.  is this furry tongue which still remains slightly red but not sore indicative of a virus in the body.  



2.  Wouldnt problems with the tongue come much later in hiv than 3 months



3.  I know you say 8 week hiv test is conclusive but thats to americans where hiv is uncommon.  Because Im in S A should I go for another test.



4.  Do my symptoms sound common for Hiv or am I being an idiot.



5.  Anything you can comment will help



thanks

Regards

Doctor's Answer

by H. Hunter Handsfield, M.D., Apr 06, 2006 12:00AM
Question 3 first, because it is central to your other questions:  You are right.  The higher the risk of HIV exposure, the more important it is to be tested later rather than earlier.  Although your negative result 8 weeks after possible exposure is highly (probably almost 99%) reliable, because you are in a country where heterosexual transmission of HIV is very common, you should be tested again at 3 months.  (See other threads on "time to positive HIV test" for information about why the level of risk influences this.)



1 and 2) Having said that, the test result remains infinitely more reliable than symptoms as an indicator of HIV infection.  "Furry" (or coated) tongue has lots of potential causes in addition to HIV.  And yes, tongue abnormalities are much more likely with late than early HIV infection.  4) You aren't being an idiot by any means, but your symptoms do not suggest HIV.



5) Other comments?  First, your 8 week test result makes it extremely unlikely you acquired HIV during the exposure you describe--but get tested again in another month.  Second, for goodness' sake, what the heck are you doing having unprotected sex (assuming this was a non-monogamous context) in South Africa??!!  Don't do it again.



Best wishes.  Get (and stay) safe.   HHH, MD
Member Comments (19)

by ThoughtlessRage, Apr 06, 2006 12:00AM
my mother is a dental hygenist and thats why i am answering your question. she has a book with pictures of different oral problems and hairy tongue was one of them so i found a website that talks about this that you can take a look at.http://www.emedicine.com/derm/topic639.htm

pay attention to section 3 Clinical, while it is seen in patients with HIV it is not a symptom of HIV. it is mostly seen in people who drink a lot of tea or coffee or use tobacco products. also can be in result to poor oral hygiene

by Willl, Apr 06, 2006 12:00AM
I guess down there you should make sure the tests are checking for HIV-1 and HIV-2, I would be surprised if they weren't.

by Willl, Apr 06, 2006 12:00AM
I wonder why it is so prevalent down there, and like you said with black Africans particularly. I don't see how the 1/1000 or 1/2000 average risk for heterosexual contact could apply in that region, it's not enough to sustain that kind of infection percentage. Either everyone is having sex when the viral load is really high or there are a lot of other std's being spread around causing the elevated transmission risk. And why the racial division?

by hellohello, Apr 06, 2006 12:00AM
To: Dr. H
I have a question regarding the regional geography risks involved.  You recommended another test at 3 months due to the persons geographical location, however was this also due to the activity performed?  Lets say a person has protected vaginal sex or protected oral sex in Africa, would your testing recommendations differ if the person was say in North America?

by H. Hunter Handsfield, M.D., Apr 07, 2006 12:00AM
To: Everyone, Willl
Search the threads and archives.  common in some parts of the world than others (i.e., in some populations than others), and the risks of vaginal intercourse higher, has been discussed.  (Try searching old threads for "HIV transmission risk".)  It's quite complex, but the expalanations include circumcision status of men, background STD rates, "dry sex" and other sex practices, average viral load, stage of the HIV epidemic (related to viral load), relative infrequency of antiretroviral therapy, and others.



HHH, MD

by ThoughtlessRage, Apr 07, 2006 12:00AM
i took a geography class the quarter before last and the professor talked about the spread of HIV in africa and he said that just as people are well aware of it was first contracted by monkeys and apparently a bunch of truck drivers delivering various things across africa all had HIV and then gave it to prostitutes in remote areas along their route they know this because right along the route in completely remote tribes there were people with HIV. so the men gave it to the prostitutes and the prostitutes then gave it to the men in these tribes. you have to realise that while you make think "oh just wear a condom" people in different cultures dont think this way. in some cultures sexual protection is seen as being wrong and its not like you can just go to africa and hand out condoms and say hey wear these, it just wont happen.really the reason it is a high amount of exposure across a wide area, and lack of education when it comes to STDs and things like that.

by hypochon, Apr 07, 2006 12:00AM
the reason why hiv is so prevalent in South Africa is due to the fact that most black people live in poverty and are highly un educated.  They drink and have multiple partners every night. In some cases they would sleep with 4 or 5 woman on one night in the locations or poverty stricken areas. There is also a lot of rape. They dont use condoms, many have std's and there sex is much rougher than the white race. It spreads like wild fire amongst them.  Unfortunately it has started to spread amongst the white people too.  I would say that about 15 to 20 percent of black people are infected and possibly somewhere between 1 to 2 percent of white people are infected.  But also remember that the blacks in S.A outnumber the whites about 10 or 20 to 1.  Unfortunately this situation has come about due to poverty and over population.



Thanks Doc now Im shitting myself.

by monkeyflower, Apr 07, 2006 12:00AM
To: hypochon
I find your last comment quite offensive, particularly this sentence: "Unfortunately it has started to spread amongst the white people too."



Hope things work out for you.