Terrified in Ohio

Hello, Doctor

I have an HIV test scheduled for next week, but I'll have to wait for the results and I'm very anxious.

Three years ago, I had an encounter with a transexual escort.  We performed unprotected oral on each other very briefly (maybe 30 seconds) and then I penetrated her/him anally with a condom, which didn't break.  I lost my erection and the penetration lasted maybe 30 seconds.  This was my only M2M encounter and I didn't enjoy it and wouldn't repeat.  Also my only significant exposure.  I contacted a local HIV group and they said it was very safe with respect to HIV, but to test for gonnorhea (Gonorrhea) and chlamydia, which I did (negative).

About seven months later, I developed angular cheilitis, which was definitely fungally infected since it cleared up with an anti-fungal cream recommended by my doctor.  It hasn't recurred, and at the time I didn't know it could be associated with HIV.

For six months, I've been seeing a woman I care deeply about.  We've had lots of unprotected sex and I'm worried I've infected her with HIV.  A week or two after our first encounter, she developed the first yeast infection of her life, and it seems to come back every month or two, usually after a period when we've had lots of sex.  It's very disturbing.  And now she's developed angular cheilitis, which she has had before, but this is a stubborn case and it hasn't resolved.  Obviously, I'm very worried.  Her sexual history is very mild, and I feel like if she's infected, it must be from me.

Questions:

1 Have you ever seen someone infected from an encounter as low-risk as mine (bried unprotected oral, protected anal)?

2.  Is it a good sign that my cheilitis has not returned?

3. At what stage of HIV disease, would you expect to see vaginal yeast infections?  My partner's started within a few weeks of sleeping with me and I wonder if this is too early in terms of the disease's progression.

4. Do I have a decent shot at negative results?

Thanks

[Edward W Hook, MD]

Welcome to our site.  Your really have no reason to worry and I suspect that the problems you outline represent a combination of coincidental occurrences which occur in the course of everyday life, concern for your partner, and some amount of guilt over the experience you describe. Condom protected sex is safe sex.  Your chances of having HIV from the experience you describe are close to zero.  As for your specific questions:

1.  No.. As I said, your risk is essentially zero.
2. Angular chelitis is not something to focus on.  Most people get if once in a while.
3.  Yeast infections are a fact of life for women. Sometimes sex can precipitate them or make them a bit more likely.  While people who have advanced (i.e. have been infected for years) HIV can be troubled with frequently recurring, sever yeast infections, normal people regularly get yeast infections.  Only a tiny fraction of persons with recurring yeast infections do so because of HIV.  
4.  I am confident your HIV test results will be negative.  I hope that when you get the result they will provide you with peace of mind.  EWH

[ohio1000]

Forgot to mention, doctor, I did have an HIV test four years ago, befor any of this happened.

Thanks again

[ohio1000]

Thanks so much, Doctor.  I feel considerably better.

Could I impose on you with one more question?  Do you think it's possible these are not yeast infections at all, but something else entirely (my gf has not actually been to a doctor regarding them, nor had she ever had one before to compare these to).  They do seem to clear up for at least a little while with OTC remedies (Monistat..etc).

Finally...even stubborn, infected cheilitis is not a concern?

Thanks again.  I promise this will be the end of my questions.

[Edward W Hook, MD]

No, "stubborn" chelitis is not a concern.  There may be things other than HIV which make the chelitis "stubborn".  These include diabetes, unconcious licking of the corner of your lips, etc.  

With regard you your GF's infections, I suggest you leave that up to her. If it recurs soon after treatment it is probably worth a visit to her doctor or another health care provider.  EWH