HIV Concern

hello dr,  
i have posted before in the free forums but am still extremely stressed and anxious as i went to the dermatologist because of a persistent rash and was diagnosed with folliculitis with also yeast.  When the dermatologist told me what i had she told me that it was very rare affecting only 5% of people.  My exposure happened in the beginning of august and i had protected sex with a prostitute.  I know what is said about protected sex but now i am having doubts that the condom remained fully intact throughout the whole episode because of the symptoms that i have.  Everything i have read online about folliculitis with yeast talks about hiv and aids.  Also i have read about eosinophilic folliculitis and i am not sure if when my dermatologist read the results from my biopsy said that it was eosinophilic folliculitis with yeast or just folliculitis with yeast.  My questions are 1) if it was eosinophilic folliculitis would a biopsy come back positive for yeast along with it  2) or is folliculitis with yeast something completely different than eosinophilic folliculitis?  3)  If i did have hiv would folliculitis with yeast show up only 4 months after exposure? 4) alos my dermatologist has put me on monodox twice a day, cipro twice a day and fluconazole once a week and the rash has not yet cleared up, could this be because of a weakened immune system cause by hiv? 4) is folliculitis in hiv+ people much worse than normal folliculitis as i have it on my back, chest, and buttocks, but it is not itchy nor are there alot of them rather than just a couple in each area

Thank you for your help and i am very stressed due to the symptoms that i have experienced after possible exposure even though it was protected.  I spend most of my day reading about folliculits and hiv/aids signs and symptoms.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  You have had very reasonable evaluation and advice on the community forum, in two different threads, and from your dermatologist.  The problem here is your unwillingness or inability to understand or believe what you have been told.  And all I can do is repeat the same advice:

First, you had a zero risk exposure for HIV; I'm not going to go into the explanation, which was very clear on the community forum.  Second, you are just wrong in your statements on the other forum about folliculitis and cutaneous yeast infections suggesting HIV; like many anxious people, you are misinterpreting what you have found by searching online.  As your dermatologist told you, the vast majority of people with such problems don't have HIV.   To your specific questions:

1,2) I know nothing about eosinophilic dermatitis.  To my knowledge it is not associated with HIV, but in any case this is a question for your dermatologist.

3) Yeast or folliculitis could show up as soon as 4 months after catching HIV, but not very likely.

4) Folliculitis is not an especially ocmmon problem in HIV infected persons, and to my knowledge would be neither more or less severe than in HIV negative persons.

You don't mention HIV testing.  That suggests it hasn't been done.  Despite your low risk exposure, and despite a skin problem that doesn't suggest HIV, you are fixated on that possibility.  The way to start to get beyond these frankly irrational fears is to have an HIV test.  If you have not tested because you fear a positive results, just suck it up and do it; I have absolutely no patience with that line of thinking.

Feel free to return with a follow-up comment to report your HIV test result if and when it is done.  Until then I will have NO follow-up comments or advice; don't try.  There is no information you can add that would change the opinions and advice I have given so far, so no point in further discussion.

HHH, MD