HIV risk after sex with someone who has another STD

hi doctor! i'm living in the philippines and had unprotected sex with a prostitute about two months ago. i have read several times in this forum that the odds of contracting HIV from a single episode of sexual intercourse is 2 out of 1000. although this is somehow reassuring, i also have to mention that the girl had another std (i'm not sure what, but of the type caused by a bacteria), and I got this from her. this std has since gone away (i've taken anti-bacterial medicine). my question is, does this increase my risk of getting HIV, assuming that the girl is HIV positive?

[stonjambo]

hey why not take a test now, 2 months is enough time, a neg test now is almost conclusive, even by conservative standards...

[john_go]

yeah i'll probably get a test. but for the meantime, i would like to ease my mind a bit. i've read somewhere that if you have another std, your chances of getting hiv is increased. what if it's the hiv carrier that has another std, does the transmission rate go up too?

[stonjambo]

as i understand, for infection, the important factors would be the amount of virus in the fluid of the infected person, the duration of contact and ease of entry into the receptive partner. if you did not have an std, the third factor is not changed. if there is another std, fluids like blood etc could be involved from the girl. this could increase the chances. however even with an unprotected encounter like yours, the chances are higher that you will be ok. after all statistics suggest that it is not that easy to get.

this is all that i have learnt so far. go ahead and take a test, we will keep praying for a good result.

[john_go]

it's always comforting to know that we are not alone in this world. this is a truely remarkable site with wonderful people. i was just wondering, would you happen to know why it's more difficult to get hiv compared to other std's? i think i've mentioned in one of my previous posts that i got another std from this girl on that regrettable sexual encounter. if she has hiv, would this have increased the chances of me getting the hiv or do my odds remain the same?

[stonjambo]

seems the virus needs to many factors to transmit, like temperature, moisture, humidity, openings, etc. it dies quickly when exposed to air unlike some other stds. so the transmission has to occur inside, and occur quickly. i have heard all this from different people including some experts so no reason not to believe it. if you have other stds you have more openings to your blood, that is why odds are increased. i am not sure if odds remain same or are increased if your partner has an std. generally i think people will say odds are somewhat higher. why not test and put this ordeal behind you? if i was at 2 months i would come to this forum after testing, not worrying about what people like me are saying here.

[Teak]

Individuals who are infected with STDs are at least two to five times more likely than uninfected individuals to acquire HIV if they are exposed to the virus through sexual contact. In addition, if an HIV-infected individual is also infected with another STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons (Wasserheit, 1992).

There is substantial biological evidence demonstrating that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV (Fleming, Wasserheit, 1999).

Increased susceptibility. STDs probably increase susceptibility to HIV infection by two mechanisms. Genital ulcers (e.g., syphilis, herpes, or chancroid) result in breaks in the genital tract lining or skin. These breaks create a portal of entry for HIV. Non-ulcerative STDs (e.g., chlamydia, gonorrhea, and trichomoniasis) increase the concentration of cells in genital secretions that can serve as targets for HIV (e.g., CD4+ cells).

Increased infectiousness. Studies have shown that when HIV-infected individuals are also infected with other STDs, they are more likely to have HIV in their genital secretions. For example, men who are infected with both gonorrhea and HIV are more than twice as likely to shed HIV in their genital secretions than are those who are infected only with HIV. Moreover, the median concentration of HIV in semen is as much as 10 times higher in men who are infected with both gonorrhea and HIV than in men infected only with HIV.

[ExtremelyWorried21]

I just noticed you said a 2/1000 (1/500) chance of transmission in your original question. That would be for the female partner. The risk for you would be in the region of 1/1000 - 1/2000

[ExtremelyWorried21]

The reason its believed that there would be an increased risk with a concurrent STD is because the inflamation (inflammation) brings the target cells closer to the surface of of the membrane in the vagina and urethra. In the HIV+ partner with the STD, this would increase the virus concentration in the 2 areas. And if the HIV- partner had an STD, as it brings the target cells to the surface, it would make transmission slightly easier.

Some important factors have been stated above such as viral load, and the main factors with regards to enhancing transmission would be from ulcerative STD's such as Herpes or Syphilis, which produce an open sore on the genitals. This is why its believed that there are much higher rates of heterosexual transmission and Africa (as well as other factors such as drying of the vagina before intercourse and anal sex).

STD's generally can increase your already low risk by about 2-5 fold (the higher end being for ulcerative STD's as mentioned above).

I would imagine the Dr HHH would say that your risk would be negligible, maybe up to a 2-fold increase at best. I have also spoken to a HIV helpline who stated that even if the HIV- male partner did have a NON-ulcerative STD such as Chlamydia, it would not increase the risk significantly. The urethra is a very small opening and sex would have to be very vigorous to have a chance at forcing the infected vaginal fluids down there.

[curious29333]

So are the odds a lot greater that a person infected with another STD will transmit the HIV virus to there partner considering there partner is clean and it was a short 1 time vaginal encounter.

[GOLOKA]

Yea, u need to get  HIV test... Upnrotected sex is high risk... There is no such thing as no risk.

If you have symptoms, you have HIV.

[Xhost]

To the original poster, please do not put any faith in the counsel provided to you by Goloka. There are, indeed, safe activities, and, as you probably may have learned by now, you can place absolutely no credence in symptoms when it comes to determining one's HIV status. None at all. Goloka is a bit mixed up, and, it seems apparent now, cruel in the extreme.

And yes, while it is certainly true that the presence of another venereal disease increases the likelihood of transmitting HIV (or contracting it as the receptive partner), it is by no means certain that:

1. The woman you were with had HIV, or
2. That you actually contracted it from a one time encounter.

Believe it or not, the odds are that you did not. It would be wise of you to go ahead and take an HIV test, but, this is certainly not something to panic about. My guess is you are going to be just fine. In fact, come back here and report the results of your HIV test, which will almost certainly be negative. If you are very worried, you may certainly go ahead and take a test now, as the result will be an excellent indicator as to your status. As others have advised, you will probably want to follow it up with a test at 3 months, just for peace of mind.

And, of course, to avoid this type of anxiety in the future, always wear a condom. Seems an obvious thing to say, I know, but it is decent advice.

Good luck to you.

[allthesigns]

"If you have symptoms, you have HIV"

You are a complete moron who has no idea what you are talking about.  You can't even spell right.  I think you need to stay out of this forum b/c you add no value to it for other users.  

The only way to determine if you are HIV positive is through a blood test.  Even if your partner has HIV and every other STD and even if you show "every" symptom you have come across on the Internet, the only way to be sure is to have a test.  Stop being an a**hole by pretending to know what you're talking about.