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Avatar universal

Shingles twice...HIV?

Doctor,

I have had a couple of experiences with CSW's in the past. I recently had 2 exposures which are now of concern to me.

The first one was unprotected oral followed by protected vaginal sex. Afterwards the CSW put her fingers in the condom we used for sex to stimulate my anus. There was penetration and I have a history of bleeding when I use the toilet. This exposure was three weeks ago

The second exposure probobly wasent an exposure at all as I dont remember much. Simply I was with a csw and had vaginal sex but I dont remember if a condom was used or if used and broke due to too much alcohol. Common sense tells me a condom was used but I am not 100% sure. This exposure was two weeks ago.

Prior to these two exposures I had a hiv test at 8 weeks which was negative. So if i got hiv it had to be from the exposures above.

Today I was diagnosed with shingles? and given famciclovir and a cream to rub on the rash which started three days ago. The rash is a red band of small sores on my trunk, left hand side only. The doctors english was'nt very good and he called it 'herpes of the skin' When I suggested it was called shingles he said 'not the same'

Im worried because if it is shingles its my second outbreak.Im 32 now and the last outbreak was about 12 years ago although the last time the rash was on my neck and behind my ear.

1. Could this be a sign that I contracted hiv during the exposures above and my immunity has been compromised?
2. Is testing reccommended?







9 Responses
300980 tn?1194929400
MEDICAL PROFESSIONAL
Let's separate the exposures and the possible shingles.  

To deal with the exposures first, the bottom line is that you've had two exposures, one or both of which could possibly have placed you at risk if your partner had HIV.  As you point out, at this time there is really no way to re-construct the situation and be sure about these exposures so most of what we can go with is a matter of probabilities.  The probabilities are in your favor.  Odds are that your partner was not infected.  Most commercial sex workers are not.  Then, what about the risk.  When the CSW used your used condom to stimulate your rectum, you don't know if you were exposured to your secretions (no risk to you) or hers.  If they were hers, they had been outside of the body and if they were infectious at all, they were much less infectious than had you been directly exposed to her.  As for the other, sounds as though you were probably protected but, even if you weren’t, IF SHE WAS INFECTED, your risk of infection is only 1 out of a thousand exposures.  Bottom line - the numbers are very much on your side, statistically.

Shingles.  Many people get shingles and a fair number get it twice.  You do not need to think that two episodes of shingles means you have HIV.

What to do.  There are several unknowns and, as you acknowledge, you are anxious about this.  Get tested at about 8 weeks, A negative result at that time can be taken as solid evidence that you did not get HIV.  No need for earlier testing and no reason to worry much while waiting for the 8 week point to arrive - your risk is very low.  EWH
Avatar universal
I should probobly add that I have been extremely anxious since the second exposure, (even before the shingles showed up)and I have been diagnosed with anxiety disorder in the past. Is this a factor in getting shingles twice?
Avatar universal
Thanks for your advice. I will take the test as recommended...I was going to do it anyway, but you probobly could have guessed that.

Final questions...is shingles a symptom of primary hiv infection or is it something that occurs later on?

I use condoms with my current girlfriend for vaginal sex only, not for oral sex. Should I modify this? Should I avoid contact altogether untilI get the test?
300980 tn?1194929400
MEDICAL PROFESSIONAL
Shingles becomes more frequent in persons with HIV as the infection progresses.  It is not a sign of recently acquired HIV.

Your risk is very low.  I do not think you need to modify your current practices in exposures to your GF.  EWH
Avatar universal
Thanks for your help.  Ive been out and about. I managed to find the girl from the first exposure. She assures me that she  a) is not infected with anything and b) she turned the condom inside out so that I was not exposed to her secretions. Guess there is the possiblilty she got it wrong but its reassuring nonetheless.

That may only leave me the possibility of being infected during the second exposure. I couldnt find that girl (shes gone home) but I found a friend of hers(they hang around in the same bars mostly) who said she wouldnt do 'business' without a condom

I will still get tested, because anxiety will still drive me to do it. It just freakes you out when you develop symptoms 2 or 3 weeks after an exposure, especially shingles for the second time.

Thanks again for your help.
Avatar universal
My shingles has cleared up. It never progressed really beyond what it was like on the third day. Just a three small clusters of spots on my trunk.

Unfortunately anxiety got the better of me and I went for earlier testing. I had a rapid HIV 1 & 2 test today which came out negative . This was exactly 31 days since the most recent exposure and 42 days since the first exposure. I know this test was not part of your recommendation but the wait is torture. I promise I will have follow up testing at the 8 week point.

By my calculations (with all other stats considered) this would put the odds of me being infected into the millions, do you agree?
300980 tn?1194929400
MEDICAL PROFESSIONAL
Yes
Avatar universal
Just a note for completeness...I tested negative again last week...about 10 weeks post exposure.

I havent seen any other posts on this forum where a reasonably young man (32) has had shingles twice in association with a HIV scare so I hope it can help someone in the future.

Thanks again to you Dr. Hook and all at Medhelp..you helped me more than you know.
Avatar universal
A related discussion, Yes it does help! was started.
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