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HIV Prevention (Expert Forum)
Risk of HIV / HSV2 Simultaneous infection
Answered by
Edward W Hook, MD - HIV Prevention, stds
Risk of HIV / HSV2 Simultaneous infection
by charliesun1980, Oct 03, 2009 10:18AM
I am (was) a very healthy 48 year old heterosexual male, with only one sex partner my entire life until now. On August 25th I had unprotected sexual contact with a CSW in Washington State. No intercourse but there was a couple of minutes overall where my penis was rubbing against her wet vagina. I did enter her vagina almost an inch at one point but immediately pulled back out. Three days later I came down with the symptoms for HSV2, with the tingling in my prostate/groin area, also itching, burning when urinating, light feverish feeling off and on, lack of appetite (never any external blisters). I went to a doctor on Aug. 31st. He did a swab test for clamydia (chlamydia), a urine test for bladder infection, along with blood tests for HSV, HIV and Hepititis. On Sept. 3rd I went in again to get my test results (everything was negitive) and discuss my continuing symptoms. The doctor gave me Vibramycin for what he called a possible non std urethra infection and Cipro for a possible enlarged prostate. These drugs didn't help at all. From my internet research I'm almost positive I have HVS2, and the sypmtoms are still persisting. The symptoms seem to cycle and change but there is definitely something still going on in my genital area and it's been going on way to long for standard 10 to 21 day HSV2. Here is where we go back to the possible HIV risk/concern. If this is protracted HVS2 then from my internet research I understand there may be a good chance I also have HIV. I've read things like "HIV likes to hitch a ride on other stds" and "new studies show that HIV tends to be concentrated at the white blood cells that are fighting off the Herpes virus, therefore creating a much higher chance of contracting HIV along with HSV2". To keep my question with-in the guide lines of this forum I would like to know how much greater is my risk of having HIV if indeed I have contracted HVS2 from her. I lost 10lbs the first two weeks. Please help, I am very concerned! Thank-you!
Doctor's Answer
by Edward W Hook, MD, Oct 03, 2009 05:15PM
, Oct 03, 2009 05:15PM
Welcome to the Forum. In reading your post, I come to very different conclusions than you do. Let me work through them one-by-one.
1. You did have intercourse with here- entering is entering, be it an inch or further. It does however sound as though your duration of intercourse was very brief and logically this is associated with lower risk.
2. Your "herpes" symptoms really do not sound like HSV to me at all. While the sensations may be suggestive, that they have been present for nearly a month now without any lesions is atypical both in terms of duration (initial HSV rarely lasts longer than 2-3 weeks) and in terms of the absence of lesions. there are many other potential causes of abnormal genital sensations including local irrigation, allergy and anxiety which are far more likely causes of the sensations you describe.
3. You seem to think that because she was a CSW she was likely to have HIV. This is not the case. In the Washington State area I would guess that far less than 5% of CSWs have HIV and even if she did, your risk of HIV from a single exposure is less than w in 1000.
4. If you had acquired HSV it would not impact your simultaneous risk for HIV. The 3-fold increment in HIV risk associated with HSV is for persons with established HSV, not HSV acquired simultaneously.
Bottom line. I think you have made a number of incorrect assumptions, perhaps fueled by the considerable misinformation available on the internet. I predict the your future tests for HSV related to this exposure will be negative. Further, I am confident that you did not get HIV- tests at 6-8 weeks will demonstrate this. In the meantime I hope you will be able to get your anxiety under control and hope these comments help you to do so.
EWH
1. You did have intercourse with here- entering is entering, be it an inch or further. It does however sound as though your duration of intercourse was very brief and logically this is associated with lower risk.
2. Your "herpes" symptoms really do not sound like HSV to me at all. While the sensations may be suggestive, that they have been present for nearly a month now without any lesions is atypical both in terms of duration (initial HSV rarely lasts longer than 2-3 weeks) and in terms of the absence of lesions. there are many other potential causes of abnormal genital sensations including local irrigation, allergy and anxiety which are far more likely causes of the sensations you describe.
3. You seem to think that because she was a CSW she was likely to have HIV. This is not the case. In the Washington State area I would guess that far less than 5% of CSWs have HIV and even if she did, your risk of HIV from a single exposure is less than w in 1000.
4. If you had acquired HSV it would not impact your simultaneous risk for HIV. The 3-fold increment in HIV risk associated with HSV is for persons with established HSV, not HSV acquired simultaneously.
Bottom line. I think you have made a number of incorrect assumptions, perhaps fueled by the considerable misinformation available on the internet. I predict the your future tests for HSV related to this exposure will be negative. Further, I am confident that you did not get HIV- tests at 6-8 weeks will demonstrate this. In the meantime I hope you will be able to get your anxiety under control and hope these comments help you to do so.
EWH
Since I'm still feeling prostrate pain and burning and itching of the penis and genitals would you recommend I return to my usual family practice MD or a Doctor at a STD Clinic? And should I return fairly soon to try to figure this out? I understand that to have a conclusive blood test for HIV it should be at 3 months and for HSV it is at 4 months. That is along time to wait with the kind of discomfort I'm experiancing right now but I am not sure if there is any way of figuring it out with no lesions, discharge, etc. Thanks again for your help!
Some family docotrs are more comfortable than others in dealing with possible STDs. In general however, the STD clinic would probably be the best and quickest place to have STDs ruled out. If the symptoms linger beyond that, it's time to torun to your family doctor. EWH