One More Question

First of all thank you so much for your prompt response on my last question in mid December. I had a couple more follow up questions for clarity. In my last question I was wondering if I should be concerned about HIV from receiving oral sex because I ended up having an infected vaginal gland a couple of days later. You told me I shouldn't really be concerned. Well, a couple days ago I began getting another infected gland, again between the vagina and anal area (not bartholin gland, right?). This is about 3 months after the first one. Now I also have been taking some baths, which even though I don't use bubble bath, seem to always make me sensitive and sometimes give me a yeast infection. Well, I have also had some nausea and break through vaginal bleeding. Does this possibly sound like gonorrea to you? Should I be concerned that the doctor did not take a culture the first time I had the infected gland and simply prescribed me flagyl, (which made it clear up quickly). I have also read on other sites that hiv is found in saliva and if I had cracking in the vaginal area, (which I am sure I did) it could enter my bloodstream, however rare. I also have herpes and I have also read that it is easier to get hiv when you have a previous std. Why is this and does it pertain to a herpes diagnosis that I was given five years ago? Thank you so much for your prompt response. I have been making myself stress like crazy, which I suppose could be the reason for the break through spotting. I look forward to hearing from you.

[H. Hunter Handsfield, M.D.]

There are no prominent glands--i.e., nothing like Bartholin gland--between the vagina and anus.  I wonder whether the "infected gland" is just a herpes recurrence with swelling.  (In any patient with a past history of genital herpes who then has 2 episodes of genital lesion 3 months apart, herpes is the best bet.)  Also, of course I can't rule out gonorrhea or chlamydia, which indeed might cause spotting between periods.

In any case, even with cracking or other genital lesions, HIV is very rarely transmitted by oral sex.  When the virus is in saliva it is in small amounts, and antibodies and other substances in saliva inhibit HIV.  It is likely that most cases of oral-genital transmission in fact result from blood exposure, e.g. in the presence of gum disease.

But the usual advice prevails:  I can't diagnose on line and you need to see a health care provider, ideally while you still ahve the "infected gland".  To set your mind at ease, be tested at the same time for chlamydia, gonorrhea, and HIV.  Also a syphilis blood test, please; I doubt syphilis is causing your problems, but it is possible and the test is easy and cheap.

Good luck-- HHH, MD