High Risk!

Doctors,

I'm a 29 year old  single hetro male who has made a horrible mistake. I have read alot of posts on this forum and think that I might unfortunatley be  on the higher end of risk than most hetro males who post here.  Basically I met a girl at a night club a couple of months ago that I took home for the night. During intercourse the condom broke. When I found out it had broke I turned to her and asked her if she had any STD's (I know i should of done this before) and she said no. However in speaking to some people who know her....they have told me she used to be a "dancer" at strip clubs and used to do other things for money and she also did drugs.  Since our time together  I've had all the classical ARS symptoms (night sweats, gland swelling, rash etc.). From reading prior posts I understand this is non specific but im still extremely worried. It just seems like too much of a coincidence.

What has me worried:

1) I have been tested positive for HSV2 which I did not know I had before this exposure. I've read that this increases risk by 3 times for HIV.

2) I am circumsized but when I look at my penis I think only partially. ie) I still have some foreskin that does not go over the head of my penis but quite a bit and  my frenelum is still there.

My HIV test results come in next week. Considering my hsv2, partial circumcision, symptoms and high risk partner (I know....a perfect combo for male hetro infection)....can you please let me know what kind of risk im looking at.

[H. Hunter Handsfield, M.D.]

Welcome.  This is really more appropriate for the HIV forum; we'll move it there.  (Normally we just delete them without reply.  You caught me in a good Halloween mood, I guess.)

It is true your risk is higher than for many questions on this forum.  On the other hand, that's largely because so many questions here are about very low risk events, like oral sex, condom-protected sex, hand-genital contact, or even contact through clothing!  Your risk is definitely higher that those.  However, it really is not very high risk in the overall scheme of STD risk.

You really shouldn't rely on rumor to judge a partner's risk.  But let's say what you heard is true.  Most people don't lie about their STD status when asked directly, and most women who believe they are not infected truly are not.  And even if she has something, STDs are not transmitted with anywhere near 100% efficiency.  For example, if she happened to have chlamydia, there's probably around 1 chance in 5 you would be infected; if herpes less than 1 in 100; and so on.  And most important, the chance a woman like you describe has HIV is near zero; and if so the average transmission risk less than 1 in 1,000.

1) HSV-2 indeed increases HIV risk if exposed -- maybe closer to double, but that's a hair-split versus a 3-fold risk. First you have to be exposed; and anyway 3 times a near zero risk is still near zero.

2) Being uncircumsized has about the same effect as HSV-2.

You are correct that even classical symptoms of ARS usually don't mean much.  But you don't describe them in detail, so I can't comment further.

You didn't need HIV testing after this sort of exposure except for peace of mind.  But of course it does no harm.  You don't say the time from the exposure event to your HIV test.  If it's 6 weeks or more, you can rely 100% on the negative result -- which is what it will be.  Of course, you could also speak with your partner.  You might find she is just as concerned as you are; after all, much higher risk of catching HIV from their new male partners than vice versa.  Anyway, maybe she would be reassured to hear about your negative test, just as you would feel better if she had been tested recently (or got tested now) with negative results.

Since it's the wrong forum, we won't have any further dicussions.  But don't freak out.  The chance you caught HIV is extremely low.

HHH, MD

[zack678]

Dr. HHH,

I know you didnt want a follow up from me but I just had to say thanks for the long and detailed awnser. I thought I was extremley high risk and you really calmed my nerves with some realistic perspective on my asssociated risks from this encounter.

As you predicted...my test results came back negative. I dont know what caused all those symptoms but it was definelty not HIV.

I encourage anyone thinking they have HIV based on sypmtoms to just get tested and save yourselves a ton of unneeded worry and grief and by all means do not go searching for symptoms on the net!

Thanks again Dr. for being one of the best at what you do. You will not hear from me again.

Cheers.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  You're welcome.  Stay safe.