Herpes, HIV and Vaginal Discharge

[Dyinghere]

Well, I think my life just ended as I know it.

I month or so ago, I had a few sexual encounters with a woman in Brazil.  I am pretty sure I have contracted Herpes.  I used a condom for every encounter, but I had 1 breakage and 1 slippage, I pulled out immediately and washed.  So I would have been  exposed for a very brief time to her.

This woman had what did look something like a burn mark on her bum, she told me that she had sat on a curling iron, retrospectively I think it was herpes lesions.

Anyway, upon returning home from Brazil, I thought all was fine. About 3-4 days later my wife developed a very small lesion on her lower labia.  This cleared up after about a week.  I then came back to Brazil, I work here.  Then she had developed some itchyness and vaginal discharge, clear, thin, odorless.  When the itchyness started, she treated herself for yeast infection and the itchyness disappeared, but she still has the discharge.  Very slight discharge.  

She went and got tested for Gonnorhea, Clamydia (chlamydia) and other things, not sure what.  She didn't ask for these, the doctor just tested her to be safe.  All came back negative.  She then recieved a call from the doctor saying she tested positive for a yeast infection, and prescribed her some sort of anti-fungal.

I have no symptoms to speak of, I think all that has been happening to me is stress(sore stomach, ulcer maybe).

Questions:  

1. What are my chances of cathing HIV along with the herpes, assuming she was HIV positive?

2. How much more infectious HIV-wise is someone with open lesions. ( I say open, they were dry, not weeping or anything.)The lesions were well away from the vagina, well out on one of her cheaks, another reason I believed her burn story.

3. How long does the vaginal discharge associated with herpes usually last, My wife has had it for about 10 days-2 weeks, as far as I can tell?

4. I read some stuff about menningitis (meningitis) and herpes. Is this really common?

5. If the primary breakout is small, does that denote future outbreaks will probably be mild as well?

Anyway, I am going to come clean when I get home, and we are both going for testing... however I doubt we will be going together.

I truely screwed up this time, I just hope someway she can forgive me.  Believe it or not, the terrible thing is this was the first time I ever cheated on her.

Thanks in advance Doc, I apprciate all of your answer on this forum.

[H. Hunter Handsfield, M.D.]

Your wife hasn't had a herpes diagnosis, apparently.  Although yeast occasionally can be misdiagnosed for herpes and vice versa, most women's health care providers are pretty good at reliably diagnosing yeast infection.  And the likelihood you got herpes with that brief exposure, had an asymptomatic infection, then transmitted it to your wife, and then she had a misdiagnosis....  very, very low that all those circumstances would prevail at once.

1) I won't answer it that way, because the odds are your Brazilian partner was not HIV positive; and further the odds are you didn't catch herpes.  But if you are right, the odds you got HIV at the same time as herpes are low.  But if you're worried about HIV, get tested; enough time has passed for a reliable antibody test result.

2) It is higher, but the available research isn't precise enough to give a numerical estimate.  On average, people with genital herpes have about double the risk of getting HIV if exposed. But remember that double a risk of almost zero still is almost zero.

3) Duration of herpes symptoms is highly variable.  Ditto for yeast.  If her discharge persists, she should return to her provider for further evaluation.

4) No, only rare people with initial genital herpes get herpetic meningitis.  Which, by the way, isn't a serious illness--very different from bacterial meningitis of the type that occasionally occurs in school children and so on.

5) In general, mild initial outbreaks are associated with somewhat fewer and somewhat less severe recurrent episodes. But probably not an issue, for the reasons above.

Don't go yammering to your wife about this, at least not yet.  At a minimum, see an STD-knowledgeable health care provider and have a blood test for HSV-2 infection.  (Even if positive, it won't mean you got it during the sexual exposures you describe.)  Don't assume the worst.

Good luck--  HHH, MD

[Dyinghere]

Oh, one other thing, this exposure happened about 5 weeks ago.  I will be going to get tested at the 6 week mark, as I have read in many places on this forum.

[Dyinghere]

Just a a bit more info, on the condom break, we had anal sex, but we switched back to vaginal, using the same condom, this is the condom that condom broke.

Also if I caught the herpes, is it guaranteed that I also got HIV?  If it is not, why not.  If I was exposed to one virus, would not not also be exposed to the other?

[H. Hunter Handsfield, M.D.]

"Exposure" alone is not enough for transmission.  For every 1000 exposures to HIV (e.g., vaginal sex with an infected person, no condom) HIV is transmitted only once.  Herpes is probably more than 100 times more transmissible than HIV.

HHH, MD

[Dyinghere]

My wife did get tested for yeast infection, and the test came back positive, I am just so worked up over this.  There is way too much coincidence.

One thing for sure, I am now 100% monogamous, if I make it out of this.

Thanks for the reply Doc, you have put me somewhat at ease.

Wish me luck.

[yoy]

Calm dwon- take the doctors advice.  Get tested that will tell you if you have to fess up- or you can fess up on your own if you choose, but if not for a medical reason think about why you are fessing up to this.  Is it go get it off your chest and feel good?  What good will come of the confession if you did not need to tell your wife of an infection.  Slow down and think about this.  I don't make any moral judgement here, just raising the concern that a confession, that need not be made, may cause more harm than keeping it to yourself and wqorking through it.