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Doctor H. Hunter Handsfield Please Answer
My possible exposure:
On September 4th, 2008 past midnight I had protected (with a condom) vaginal insertive sex with a woman who works as a stripper and escort. I have no idea how many men she had slept with before me. HIV Status Unknown. She provided the condom. It was a prolonged experience lasting 20-30 minutes, and got vigorous. We made out with deep tongue kissing, no oral sex. I have several symptoms, but the possible OHL scares me the most since it seems fairly specific.
**Note: I went to a walk in clinic on the previous Sunday and was diagnosed by a PA (said I had strep, but I have no fever, or swollen glands, no lab tests) who used a shotgun approach of zithromax, and when I complained about white tongue, nystatin (which doesn’t seem to help), I didn’t start fearing HIV until recently when I looked online.**
Oral Hairy Leukoplakia(OHL) : I have read that this occurs in almost exclusively HIV+ patients. A few weeks after exposure I developed a white coating all over my tongue. It seemed to be avoiding the lateral borders. Now I am experiencing (within the last couple of days) raised ribbed looking white areas on the sides of my tongue as well. These do not scrape off, and Nystatin oral suspension does not seem to affect them (which leads me to believe it is not thrush). It resembles pictures of some (but not most) of the hairy oral leukoplakia pictures online. There are also fin like protrusions on the sides of my tongue.
Today, October 4th, 2008, I got tested for HIV (and other STDs). I should have the results on Wednesday or Thursday. This will be 30 days from my possible exposure. I also intend to get retested in March (6 months).
1.Please assess my risk as of the information I’ve given you now [pre test results], and as of a negative 30 day test result (which I will hopefully get). I know you recommend 6 weeks and then 3 months but I just couldn’t wait. If you can use odds I’d be thankful. 2. Please discuss the possible OHL
On September 4th, 2008 past midnight I had protected (with a condom) vaginal insertive sex with a woman who works as a stripper and escort. I have no idea how many men she had slept with before me. HIV Status Unknown. She provided the condom. It was a prolonged experience lasting 20-30 minutes, and got vigorous. We made out with deep tongue kissing, no oral sex. I have several symptoms, but the possible OHL scares me the most since it seems fairly specific.
**Note: I went to a walk in clinic on the previous Sunday and was diagnosed by a PA (said I had strep, but I have no fever, or swollen glands, no lab tests) who used a shotgun approach of zithromax, and when I complained about white tongue, nystatin (which doesn’t seem to help), I didn’t start fearing HIV until recently when I looked online.**
Oral Hairy Leukoplakia(OHL) : I have read that this occurs in almost exclusively HIV+ patients. A few weeks after exposure I developed a white coating all over my tongue. It seemed to be avoiding the lateral borders. Now I am experiencing (within the last couple of days) raised ribbed looking white areas on the sides of my tongue as well. These do not scrape off, and Nystatin oral suspension does not seem to affect them (which leads me to believe it is not thrush). It resembles pictures of some (but not most) of the hairy oral leukoplakia pictures online. There are also fin like protrusions on the sides of my tongue.
Today, October 4th, 2008, I got tested for HIV (and other STDs). I should have the results on Wednesday or Thursday. This will be 30 days from my possible exposure. I also intend to get retested in March (6 months).
1.Please assess my risk as of the information I’ve given you now [pre test results], and as of a negative 30 day test result (which I will hopefully get). I know you recommend 6 weeks and then 3 months but I just couldn’t wait. If you can use odds I’d be thankful. 2. Please discuss the possible OHL
How on earth can you sit there and tell me its a 1 in a thousand risk for catching HIV during unprotected intercourse with an hiv infected woman? I do not know how you come up with this figure and I think that what you are handing out is a false sense of security.
You can get HIV through one careless lay. I personally know of several people who got it this way, and another guy who from what I understand got it from drinking from the same glass as another fellow who was HIV +. Are you aware that risk goes way up when the viral load present is higher? You have no way of knowing these things so your figures are moot.
You helped someone stop worrying about whether they caught something, but that is dangerous to the rest of us, if people are thinking there is, and I quote you. "virtually no risk..." There is no excuse for this, especially coming from a Doctor.
AE
You can get HIV through one careless lay. I personally know of several people who got it this way, and another guy who from what I understand got it from drinking from the same glass as another fellow who was HIV +. Are you aware that risk goes way up when the viral load present is higher? You have no way of knowing these things so your figures are moot.
You helped someone stop worrying about whether they caught something, but that is dangerous to the rest of us, if people are thinking there is, and I quote you. "virtually no risk..." There is no excuse for this, especially coming from a Doctor.
AE
Thanks Dr. Hook. You made me feel a lot better. I appreciate your knowledge and what you do on this forum.
MEDICAL PROFESSIONAL
Dr. Handsfield and I share the forum. You got me. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
I think you are laboring under several misconceptions. First, the idea that you have OHL is unproven. OHL is not an easy diagnosis to make and many people have white tongues and bumps along the borders of the tongue such as the ones you describe which are not OHL. Thus, thus first thing to do is find out if this is what you have by being examined by a person who is clear on the diagnosis. I regularly find that even some health professional make mis-diagnoses. A dermatologist could help.
Second, OHL is not found only in persons with HIV. It was recognized and described long before the HIV era and occurs regularly in persons other than those with HIV.
Next, as you no doubt know, your exposure was virtually no risk. You do not know that status of your partner. Statistically is most likely that she did not have HIV. If she did, and you had not used a condom your risk of getting HIV would be less than 1 in 1000; you on the other hand used a condom, this would transform your rather low risk exposure (if she was infected which is unlikely) into a virtually no risk exposure. Your statistical odds of having gotten HIV from the exposure you describe are less than 1 in a million.
Finally, you will soon have a negative result from your HIV blood test. At 4 weeks post exposure the tests will have detected 85-90% of infections that are going to occur. The negative result that I am confident you will get thereby will reduce your risk at least 10-fold more, to less than 1 in 10 million.
Bottom line. Your risk if HIV is tiny. As for your possible OHL, don't jump to conclusions. Start by finding out if this is what you have. EWH
I think you are laboring under several misconceptions. First, the idea that you have OHL is unproven. OHL is not an easy diagnosis to make and many people have white tongues and bumps along the borders of the tongue such as the ones you describe which are not OHL. Thus, thus first thing to do is find out if this is what you have by being examined by a person who is clear on the diagnosis. I regularly find that even some health professional make mis-diagnoses. A dermatologist could help.
Second, OHL is not found only in persons with HIV. It was recognized and described long before the HIV era and occurs regularly in persons other than those with HIV.
Next, as you no doubt know, your exposure was virtually no risk. You do not know that status of your partner. Statistically is most likely that she did not have HIV. If she did, and you had not used a condom your risk of getting HIV would be less than 1 in 1000; you on the other hand used a condom, this would transform your rather low risk exposure (if she was infected which is unlikely) into a virtually no risk exposure. Your statistical odds of having gotten HIV from the exposure you describe are less than 1 in a million.
Finally, you will soon have a negative result from your HIV blood test. At 4 weeks post exposure the tests will have detected 85-90% of infections that are going to occur. The negative result that I am confident you will get thereby will reduce your risk at least 10-fold more, to less than 1 in 10 million.
Bottom line. Your risk if HIV is tiny. As for your possible OHL, don't jump to conclusions. Start by finding out if this is what you have. EWH
I'm kind of a hypochondriac too, so if the outlook is good please put me at ease as much as possible and I wont even feel the need for a follow up question. I read the heterosexual insertive sex is low risk, and condoms are low risk. But it really looks like OHL.
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
