Quite worried

[worried in toronto]

Dear Dr. Handfield or Dr. Hook,

I have had some worries crop up recently about HIV. My sexual history since my last test a few years ago. I am so concerned about my symptoms, that I am petrified to test. I never used to have a problem testing but because of this symptom, I am nervous as I developed seborrheic dermatitis- a bit on my face near my nose and on my scalp. It comes and goes. My dermatologist laughed me off and said it is a common condition among young and old, but I read all these websites saying that people with HIV can develop it.  I do get stressed out a lot and have anxiety so perhaps this could exacerbate it. Also, about a year ago, I had jock itch which never returned (went away quickly with cream). My family doc also said it was "nothing to lose sleep over," but I suspect he doesn't see much std or HIV anyway so I question his expertise on this one (of course he didn't like my prying on his knowledge of HIV).

I have slept with 3 women over the past three years. I am a male hetero. I used condoms every time with the women and cannot recall a break, but one time, a condom was a bit too large and slipped about halfway down my shaft (I am uncircumsized). What do you think the chances are that I will test negative for HIV? I had negative tests for syphillis and the other routine stds. The women were not "escorts" or anything, but I have a feeling they sleep around a bit. The seb derm came after about a year after I slept with the first woman with the condoms.

I appreciate your advice on this. I am sweating it out here worrying.

[Edward W Hook, MD]

Your response is an excellent example of why I suggested that you might benefit from counseling.,   Read my response carefully, in its entirely without taking a phrase or sentence out of context.  It suggests that your anxiety is misdirected and not good for your health.  The reason for you to get counseling is to help you work through the anxxity.  The reason for testing is as a starting point in that process- to demonstrate that there is NO reason for the anxiety which you are experiencing.  EWH

[worried in toronto]

Thanks Dr. Hook. I will take your advice.

[worried in toronto]

Dr. Hook,

I really appreciate your reply. Your last paragraph got me a bit scared though. Are you suggesting testing because you think I need it? Or are you recommending it as a possibly way for me to put the fear to bed?

thanks again for this
Worried in Toronto

[Edward W Hook, MD]

Your post (and review of some of your prior posts)  indicates that you've thought carefully about this and are knowledgeable about HIV risk.  For that reason, I'm quite surprised at your concern over getting tested.  

1.  You are heterosexual.  HIV is relatively rare among heterosexuals.
2.  Your partners may be somewhat risky by virtue of (perhaps) having other partners
        but that too is really not much of a risk factor.
3.  You use condoms, condoms work
4.  You have been assured by two health care professionals that your risk is low and the while SD may occur in person with HIV, the vast majority of persons with the condition are not HIV infected.
5.  You have not gotten other STDS which are more common than HIV.

For a person with such a list of factors in their favor, there is no reason to be concerned at all.  Your chances of HIV infection are vanishingly rare.  If you should happen to have HIV (I suspect your are more likely to be hit by lightening), getting tested would have NO impact on the presence or absence of infection whatsoever but the knowledge would permit you would have the knowledge to do something about it.

My advice - get tested. If you cannot bring yourself to do this, then I suggest you speak with one of your health care providers and get professional assistance on the matter.  I say this because such unwarranted anxiety is not good for your health.  I hope my note is helpful.  EWH