All the symptoms in the book - testing tomorrow

[babai123]

After a year of stress I’m testing tomorrow at PP. Here is my story :
Dec 08 – encounter with stripper-she licked my ear and  French kissed briefly
Dec 09 - condom protected vaginal sex with CSW + oral with same condom which I found out she took out from inside her mouth !
March 09 – condom protected sex with a massage parlor girl
April 09 – three incidents of protected felatio with being rimmed in one ocassion..

Symptoms:
May 09 – extreme fatigue , urine infection (found enterococcus in urine) with WBC , weight loss
June 09 – sore throat, white coated tongue, sinus problems, mild folliculitis on arms chest and scalp
July 09 – grayish white patches in foliate papillae area of the tongue (OHL ?), dermatitis with red pimple like rashes on the folds of the skin mainly neck and armpits, also red spots on the penis head (may be fungal infection) and nasty jock itch on groins.The weird thing is that I have never had any condom breakage in the past and I don’t know how it feels.. I have never checked the condoms after sex with the CSWs..which worries me… Also at one time the CSW who put the condom by mouth spit on my glans which was a bit irritated at that time with mild fungal infections…could this be the reason I may have got the disease….?
I am paranoid now and extremely fearful of the test tomorrow….
Questions:
1. Does enterococcus bacteria in urine a sign of suppressed immunity or is it an STD ?
2.  What could be attributed to the grey patches in foliate papillae area of tongue, weight loss (around 5 % of body weight ), white tongue, sore throat and skin rashes - are these not related to early symptotic hiv infection ? Why would I get that so early- I thought these occur years after infection ?
3. I know protected sex is safe sex - but what about the girl spitting on my penis which was a bit red and irritated and applied the condom which was inside  her mouth and may be filled with saliva ? Risk ?
4. Can I expect negative results ?

[Edward W Hook, MD]

The rashes do not sound like HIV.  The scenario you suggest is simply not supported by the facts.  Forget it, you are not at risk for HIV.  This is the last answer. There will be no further answers.  EWH

[babai123]

Dear Doc,

This is my last question I promise -  I still cannot move on.
As mentioned my last exposure was where the CSW put the  condom by her mouth and gave me a handjob 23 days before  I tested negative. The reason I am still in anxiety is because of the rashes I developed in the sides of my neck , armpits and inner elbow 2 weeks after the incident. It lasted for a week That’s it- no where else, no other symptoms.
I continue to think that some blood may have been contaminated with saliva inside the condom(since it was in her mouth before it was applied to my penis) which made some virus come in contact with T cells /langerhans cells on my glans(which was a bit red and irritated with mild fungal infections at that time)  and I got infected.

Do you think can anybody ever be infected like this. I did not notice any visible blood inside the condom.. I had unprotected sex with my girlfriend couple of times after this which makes me even more nervous..

Please let me know if those rashes sound like ARS and does your previous opinion of no need of additional  testing change in this case?

[Edward W Hook, MD]

Still no risk, as explained above.  Believe your test.  There is no need for additional testing. It is time for you to move on.  EWH

[babai123]

Dear Doc,

Thanks .. I did a RAPID blood test yesterday...results were negative !
However I still cannot celebrate since I had missed out on one event in my earlier post...
Around three weeks ago I had gone to one of the CSWs earlier I had vaginal sex with (mainly with the intention to ask her if she was tested, which she said that she does every week)..
But stupid me..! I had a handjob from her ..but the concerning thing is that I had the handjob with a condom on but again she had applied it with her mouth and the condom was also in her mouth before she applied it on my penis...I've already mentioned that I was having mild fungal infection(no visible sore..but redness) on my glans..
This actually happened 23 days before the test...
I know that the condom may have saliva in it before it was applied but there was no visible blood in it...

Now again I am thinking the mild rash(small reddish pimple, bit itchy) I had on the skin folds area of neck and armpits.last week...(mainly skin folds)may not be ARS because of this exposure...once again I am a bit worried...

Please answer the below questions...

1.Is the rapid test conclusive ?
2. Have you ever seen hiv being transmitted in such a way (with respect to the last incident) ?
3. Do you consider the last event  risky enough that I may consider testing after 3 more weeks(its been only 23 days since this exposure)...

Please help

[Edward W Hook, MD]

Welcome to the Forum.  I hope that your concern about HIV has not slowed you from getting tested because your risk from the exposures you describe is close, if not, zero and your symptoms in no way suggest HIV.  To elaborate a bit, chances are that none of the women you report contact with had HIV.  In addition, kissing is no risk, even deep kissing and even with gum or dental disease. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  That someone held a condom in their mouth before putting it on you or spat on your penis for lubrication with masturbation does not change this.  In answer to your specific questions:

1.  No.  Enterococcus is a common cause of urinary tract infections.  That you had a UTI does not suggest you have suppressed immunity.
2.  Anxiety, stress, other but not HIV.  Each of these symptoms is totally non-specific.  If you'd acquired HIV from any of the exposure you report, odds are you'd be asymptomatic.
3.  See above.  No risk.
4.  YES!

Hope this helps.  Take care.  EWH