High or Low risk of getting HIV?

HI Doc,
    My wife and I are completely monogamous until  I  did  a one time unprotected sex  (vaginal-penis, and oral)from a prostitute from our vacation from out of the country.  It happened early in June.
     Unfortunately, my wife got Trichomoniasis (she went to std clinic and got signs and symptoms from it.-- they got culture from her discharge) She was treated for it and got syphillis (syphilis) and HIV test --->both came out negative.
     After  our trip, I experienced severe sore throat that lasted about 2 weeks. I also experienced some back pain and fatigue since we went to waterpark for 3 days and also i didnt get enough sleep at the same time i work during the day.
     I went to the clnic and got treated for TRich. at the same time I got tested for syphillis (syphilis) and hiv.(blood test) they also took culture from my throat.
     when i came back for the result,The lady told me i am positive for chlamydia and gonorrhea and not mention syphillis (syphilis) . --negative on hiv. They want me to go back and have syphilis and hiv re test again on OCtober. They gave me 100mg doxycycline for 7 days and  an i.m. shot of penicillin. my wife will be treated and neede to go back also.
    ive been reading about std's and here are my questions...i am so worried about the chance that i might get positive hiv on october. what is the chance or risk?

1. The shot of penicillin is for syphillis (syphilis) ,right? how come the lady only told me  i got chlamydia and gonorreah?or is  shot also for chlamydia and gonorreah?

2. if it is positive? could it be false positive? i read in an article that if it become positive on  syphillis (syphilis) it can be false positive and maybe   due to  viral and bacterial infection like Infectious mononucleosis.


3. is it possible that i could have gotten Infectious mononucleosis (kissing disease) instead of syphillis (syphilis). since the symptoms i got fit it? sore throat  and fatigue  I didnt have any chancre and didnt feel any difficulty urinating or burning.

4. all in all , i got trich,chlamydia,gonorrea. so did get syphillis (syphilis) also?(  Ive learned my lesson and will never do it again. I have caused to much emotional pain to my wife aside from giving her all these std's.

5.  I started the doxyc 4 days ago and last night i feel a little sore throat again (but it is not as bad as before) is it normal? or maybe it is due to fatigue also? i drove for 4 hours yesterday and didnt get enough sleep. is the bacteria fighting against the doxycyline that's why i feel the sore throat?

6. my last question is... PLEAse tell me the risk of catching the hiv virus... hopefully you say the risk is very low. the possibility of becoming positive on October? can u explain the incubation period. is it the so called PRIMARY hiv infection?

7. From describing my situation, 7 years monogamous and one time unprotected sex from prostitute, again the risk of hiv infection? i am sorry if i sounded too paranoid but I really am.
please help to relieve worry.

thanks!
    

[H. Hunter Handsfield, M.D.]

My reponses are going to take your history of mutual mongamy, except for the single prostitute exposure you mention, at face value.  But to be honest, I have to wonder about whether you or your wife in fact have had other partners.  On the other hand, that isn't a necessary explanation.  Whatever else is done, you both need to be treated simultaneously for all infections found in either of you, then have no sex (even with condoms) for at least a week after treatment.

As far as HIV is concerned, you are unlikely to have been infected--but with all those other infections, your risk is higher than that of most of the others on this forum who have asked about the odds of HIV after single exposures.  The best you can do is for both you and your wife to be tested ~6 weeks after your outside exposure, and for good measure, once again at 3 months.  There is no reason to wait until October; 3 months would be early September.

On to your specific questions:

1) Penicillin is active against syphilis but not any of the other infections.

2) False-positive tests for syphilis can occur, but your provider probably did automatic confirmatory testing--in which case the result is reliable.

3) Mono would not cause tests for syphilis or other STDs to be falsely positive.

4) If your blood test was positive for syphilis, you caught syphilis (somewhere).

5) Of all your apparent infections, doxycycline is active only against chlamydia; it does not treat your sore throat.  (I don't know what is causing the sore throat.)

6 and 7) See my comments above about HIV.  You don't need to wait until October.  The follow-up syphilis test is to see how well you responded to the penicillin treatment.

Good luck--  HHH, MD