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
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.
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.
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.
This sounds like typical coated tongue, not thrush.
Thanks for the thanks. Try to move on.
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.
I would not have advised PEP.
That will end this discussion. I won't have any further advice.