Need your professional insight an opinion Please..

[moncton100]

I am 39 yr old hetro circumsized male non iv drug user. 2 1\2 yrs ago had vaginal sex for about 1-2 minutes with african american CSW in Montreal massage parlor. I am not sure about condom (was fairly drunk) and this was my only ever experience. Had no ARS symptoms post experience.
My problem arises in May this year my wife came down with a sore throat and bad cough then a few days later had a fever with sweats and chills which lasted a few days. She has since gotten mild Serb Derm within the last 2 months. I realized at this time that although I had gotten 2 full physicals with CBC they do not screen for HIV(my ignorance). Panic set in for me with full blown anxiety and stress.I started having minor sweaty nights immediately.  I went to walk in clinic in June 09 with sore throat and was told I have strep and Dr. also said I had Thrush(now real panic) I received antibiotics for strep and Nystatin for thrush both were gone in a couple of days . He indicated that if thrush was due to HIV it would return and to date it has not but not sure of the timeframe of how often or quickly it comes back. I also started seeing eye floaters (which may have always been there) and got one canker sore and some red spots on my tongue and perhaps minor serb derm which also may have been there pre panic. Lately I have been spitting up more phlegm than ever before.Other than that I have been perfectly healthy since then with no fevers\no diarhea (diarrhea)\very few sweaty nights\no weight loss in fact I have gained weight over the summer. I have scheduled a test.
1. Does my wifes symptoms sound like ARS? I did not think a bad cough was indicative?
2. Would serb derm show up only months after being infected in my wifes case?
3. Could my thrush be misdiagnosed or came as a result of strep? Would it have come back by now if I was hiv pos?
4. Would I have seen more severe symtpoms in my health by now?
5. is phlegm indicative of any hiv symptoms (sinusitis perhaps) ?

Thanks

[Edward W Hook, MD]

Welcome to our Forum.  your risk of HIV from the exposure you describe is statistically tiny.  The odds that your partner had HIV are very low (no greater than 5% and probably more like 1%) and the risk of a single episode of unprotected sex results in HIV transmission only 1 in 1000 times.  Thus, at most, your statistical risk is no greater than 1 in 20,000.

As for your symptoms, there is really  nothing to worry about.  I will address your specific questions below:

1.  It sounds to me as though your wife had a flu-like illness due to either influenza or some other community acquired, non-STD virus.  In general, the symptoms of the ARS/ early HIV are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.
2.  As above, most people with seb derm do not have HIV.   it is a common dermatologic problem in "normals".
3.  Absolutely on both counts.  As above, most peole with thrush do not have HIV.
4.  Not necessarily
5.  No, absolutely not

Bottom line, there is little here to suggest any risk for HIV.  That said, you are clearly concerned. Why not just get an HIV blood test. At this time the result will be totally reliable.  I am also confident that the result would be negative.

Take care.  EWH

[moncton100]

Thank you for your time and response.

[moncton100]

Hopefully you can provide a quick clarification to a couple fo your answers. I did get tested and get my results next week. For your reply on the odds they do seem to differ from other posts on the site was this based on my experience? 1 in 20000 seems lower than usual any specific reason? my symptoms? Also question 4 regarding my health I was speaking that if my immune system was comprised enough to get Thrush 5 months ago would I not see other overt symptoms as well?

[Edward W Hook, MD]

I got to 1 in 20,000 by multiplying the possiblity that your partner had HIV (1 in 5 = 20% ) by your 1 in 1000 chance from a single exposure.  The math comes out to 1 in 20,000.

Regarding question 4, no change in my opinion.  It takes most people up to a decade for HIV to get to the point where their immune function is compromised to the point where they start to get infections because of it.  EWH

[moncton100]

1 in 5 seems really high based on other posts? Usually even CSW are regarded as rarely having HIV what makes this one different in your opinion? your saying that 20% of CSW have HIV?

[Edward W Hook, MD]

I was being conservative in order to try to illustrate for you that there was not a major concern. Instead you seem to be wanting to debate things. Life is just too short for this so instead I will conclude this thread with a single, general statement repeating the conclusion to my original response to you--"Bottom line, there is little here to suggest any risk for HIV.  That said, you are clearly concerned. Why not just get an HIV blood test. At this time the result will be totally reliable.  I am also confident that the result would be negative."

There will be no further replies.  EWH