A few questions

[Okemos]

Dear Doctor:

Your work on this Forum is great.  I have three questions, and I have numbered them to make them easy to respond:

1.  I became sexually active with my girlfriend in mid-December of 2005.    She has had sex with three men in her life.  None of the men were gay or bi-sexual, slept around, or had any kind of drug problem (aside from pot).

She was married and had a child in July of 2003.   I asked her if she ever had an HIV test.  She is not sure.  Can I assume that she did take an HIV test during pregnancy?  Her primary care doctor works for a major hospital in Seattle (Sw*dish Physicians).

2.  I became concerned with HIV, because a few weeks after sex with her (Jan 1, 2006), I came down with acute bronchitis.  I had all the signs of bronchitis (and the doctor even had to give me an inhaler to open up my lungs passages).

The doctor at the ER (I went to the ER in Baltimore, because I was not at home and it was a Saturday) said that "bronchitis" is not a symptom of HIV.  

In other words, he said that bronchitis is not associated with "ARS" and is not even a flu-like symptom to begin with.  

Is this true or false?  I'm a little freaking out about that.

I'm just a little concerned about testing positive for HIV.  I have been having sex with her for the past 10 month all unprotected.  

3.  Is there an STD that produces sores outside of the anus area (not actually in the anus, but outside because the anus and scrotum)?  I have been having this problem on-and-off for over a year.  

It heals quickly.  It hurts upon touch when it happens.   During that time, I tested NEGATIVE for everything, including herpes.  My doctor thinks that it could be chafing from having gained alot of weight (about 30 pounds).

[H. Hunter Handsfield, M.D.]

I'll try to help.  Your risks for HIV are nil.  To your questions:

1) The odds of HIV in a woman with that sexual history, and assuming the information about her past partners is accurate, is zero or close to it.  Since 2000 or so, in most of the country all pregnant women have been routinely HIV tested, although I don't know the specific policies of the ObGs who practice at Swedish Medical Center or other Seattle hospitals.

2) The ER doc is right; bronchitis is not a symptom of ARS.  Anyway, despite what you might have read online or elsewhere, almost no symptoms of any kind are reliable indicators of new HIV infection, especially in people at such low risk as you are.  (Search the forum for "ARS symptoms".)

3) The suspicion of possible herpes probably was reasonable, because some people with recurrent herpes, including heterosexual men, have recurrences that primarily involve the anal area or perineum, the space between (I'm sure "because" was a typo) the anus and scrotum.  But if you tested negative, that's probably conclusive.  As to other causes, I can't speculate; your own provider's advice is better than any guess by an online expert who can't examine you.  But if you remain concerned about herpes, e.g. if you ever had reason to believe you were exposed, a type-specific blood test could tell if you are infected with HSV-2.

Good luck--  HHH, MD

[Okemos]

Thank you, Doctor.

If I were to test positive for HSV, could I transmit that to someone else?  I have never gotten "sores" on my penis or testes area, ONLY that one sore that I have mentioned in the area between my anus and scrotum.

In other words, would sexual intercourse be a route of me transmitting HSV2 to another woman?

Thanks for everything, doctor.

[H. Hunter Handsfield, M.D.]

I stress that I don't think herpes explains your symptoms.  But if  your blood test is positive, yes you could sexually transmit it to someone else.  You can search this forum for "genital herpes" and "herpes transmission" for more information; and read the herpes article in the link "STD Quick Facts and Articles" on this forum's home page.

HHH, MD