Aa
A
A
A
Close
HIV - Prevention Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

Please Help

Here is my situation.  I am in my late twenties and am married.  Recently, I made the biggest mistake in my life when in New York.  I got drunk and hired a csw.  We used a condom (at our mutual insistence), but the condom failed (broke) and I assume that we had unprotected sex vigorously for at least 5 minutes.  There were a few very small cuts (not bleeding or anything, but just minor breaks in the skin) on my penis - I noticed no blood from her vagina.  I am beyond terrified.  8 days after the incident, I had a test for STDs done - all negative.  She insisted that she was totally clean and always used condoms with her clients.  She said that she had been tested about a month prior to the incident and all was negative.  I spoke to her on the phone yesterday (5 weeks post-incident) and she insisted again that she was totally clean (for what it's worth, I know that she's still working because I saw another ad for her services posted yesterday).  She is white in her late twenties.

The reason that I am so terrified right now is that I had unprotected sex with my wife once about 3 weeks ago.  She told me yesterday that she feels like she might be fighting a flu bug and had been for about a week.  She's tired, feels out of it and on one day she felt a little achy (achiness went away after one day).  Also, I noticed a couple of days ago that my tongue was kind of white.  I looked at pictures of thrush online and the online pictures seem to be far more severe than what my tongue looks like.  My tongue looks like the taste buds are whitish all over my tongue, but the whiteness cannot be scaped off easily and does not look like cottage cheese, each of which I understand are hallmarks of thrush.  No other possible HIV symptoms (e.g. no rash).

I am sooooo terrified that I got HIV and passed it on to my wife (knock on wood both times).  I am so worried that the thought consumes me all day every day.

PLEASE help me.  Is it safe to have unprotected sex with my wife?

7 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

When a woman has HIV, the average transmission risk to her male partners, for each epsiode of unprotected vaginal sex, averages around 1 chance in 2,000.  That's equivalent to daily sex with infected women for 5 years before transmission might be expected.  That's why many spouses of HIV infected persons remain free of the virus for years (which you may not have known).  And you describe a partner who almost certainly does not have HIV.  In most population groups in the US, fewer than 1 in 100 CSWs have HIV; and your partner's test history strongly indicates she isn't infected.

So it is exceedingly unlikely you were infected -- and if you were not, of course you could not have infected your wife.  Both your symptoms and and hers suggest you are sharing a garden variety virus.  Coated tongue goes along with many minor infections -- and by the way, thrush is not a common sign of early HIV infection anyway.  Absence of high fever, sore throat, and skin rash are all further evidence that neither of you has a new HIV infection.

If I were in your situation, I would continue unprotected sex with my wife without worry.  I can't give you any kind of absolute guarantee, but all things considered I would estimate the chance you caught HIV as no higher than 1 in several million.  Still, I suggest you be tested for HIV and other common STDs (gonorrhea, chlamydia, syphilis).  The negative results will probably be more reassuring than all the odds and probabilities I can give you.  Accurate gonorrhea/chlamydia testing can be done at any time, and syphilis and HIV testing at 6 weeks after exposure.  (Or 4 weeks for a duo HIV test, for both HIV antibody and p24 antigen.)

I hope this has helped. Best wishes--  HHH, MD
Avatar universal
Thank you very much doctor.  That is extremely reassuring.  I did have the 8-day test so that would deal with gonnorhea/chlamydia (see above - negative).  I will probably do the 6 week test for HIV/Syphillis as soon as I get there.

Quick question - assuming that thrush occurs as a result purely of HIV infection, is it something that doesn't appear for like 6 months?  Just wondering, as you said it was not a common sign of "early" HIV infection - not sure what exactly "early" means.  Thanks so much.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Thrush in HIV is typically a sign of advanced immune deficiency, i.e. overt AIDS -- i.e. several years after catching HIV.  Transient cases can occur in association with the initial infection, but only rarely, and probably never as the main symptom.
Avatar universal
thank you very much.  one more question about this and I promise that I will no longer bother you on this.  with respect to thrush, was my description above accurate as to what it looks like (e.g. pretty obvious raised brocoli-like white material that easily scapes off to expose a very red and irritated area)?

Thanks again.  It's incredibly rare to find a doctor of your/Dr. Hook's caliber willing to provide information to people like this.  Thank you from the bottom of my heart.
239123 tn?1267647614
MEDICAL PROFESSIONAL
This sounds like typical coated tongue, not thrush.

Thanks for the thanks. Try to move on.
Avatar universal
sorry doctor - last question.  Had I come to you asking for PEP following this incident, would you have prescribed it?  or did this incident not warrant that?  thanks.
239123 tn?1267647614
MEDICAL PROFESSIONAL
I would not have advised PEP.

That will end this discussion.  I won't have any further advice.
Didn't find the answer you were looking for?
Ask a question
Popular Resources
These tips can help HIV-positive women live a long, healthy life.
Despite the drop in new infections, black women are still at a high risk for HIV, the virus that causes Aids.
What are your HIV treatment options, and how do you choose the right one? Our panel of experts weighs in.
Learn the truth behind 14 common misconceptions about HIV.
Can HIV be transmitted through this sexual activity? Dr. Jose Gonzalez-Garcia answers this commonly-asked question.
A breakthrough study discovers how to reduce risk of HIV transmission by 95 percent.