Symptoms and overall risk

[Query2011]

Hi Doctor:

I have been worried about this for quite some time. I am 30, hetero male. I have not had an HIV since 2004- it was negative then but since then I have had sex with four women. None of the women were sex workers but like me, they did probably have casual sex. In each instance, I used condoms and cannot recall a break. About one year after the first encounter, around 2005, I got mild Seborrheic Dermatitis. I have had it on the scalp and a little bit around the nose for years, and it is controlled by head and shoulders. I think it may have even come in the armpit a couple of times. The dermatologist told me not to worry but also I have had a few bouts of jock itch over the years too if I ever wear the same underwear more than a day or two. Those are my only symptoms which could point to HIV. I have not done any illegal drugs, no needles, or anything else.

Could you evaluate my risk? I'm with a serious girlfriend now in a monogomous relationship and I'd like to stop using condoms. But i'm afraid to do this in the event I could be infected with something. All other STD tests were negative but I am afraid to do the HIV test which I haven't done in some time.

Could you quantify my risk?

Thanks for your help,
Query

[Edward W Hook, MD]

Welcome to our Forum.  Your risk of HIV from the encounters you mention is low.  Your partners were apparently not high risk and, even more importantly, you regularly used condoms.  Condoms reduce the risk of getting HIV to essentially zero even if you were to have sex with an infected partner.   I see no reason to be worried whatsoever.  Perhaps you are concerned because you have heard that persons with HIV are more likely to be troubled by seborrheic dermatitis than persons who do not.  While this is true, the fact is that despite this, the vast majority of persons with SD do  not have HIV.

The issue is on your mind.  As a result.  I recommend that you get tested, not because I have any concern that you have HIV but because of the peace of mind a negative test will provide.  Please remember, testing does not give a person HIV but it does give them the power to know what is going on and whether or not they have the infection.  Most tests are negative and if you were so unfortunate as to have HIV, the test would allow you to seek treatment sooner.  There is no reason to delay or avoid HIV testing.

I hope these comments are helpful.  EWH

[Edward W Hook, MD]

Thank you for your candor.  I understand how these concerns can weigh on a person.  I hope the consistency of my responses will help you to not worry going forward.  EWH

[Query2011]

Dr. Hook:

Thank you. I must admit, I asked you this question previously a couple of years ago under the name "worried in toronto" and you and Dr. Handsfield both told me that it was exceedingly low risk and not to worry about Seborrhea. I recall you mentioned that the chances of getting struck by lightning were higher. I wanted to come clean with this and let you know that I asked a repeat question so that I won't be allowed to ask one again.

Thank you and sorry,
Alan