Exposure while on antiboitic treatment

[mdp07]

Dear Dr. Hansfield and Dr. Hook
First I would like to thank you, for your great work and all the encouraging advices you provide.
I am a 42 year old male, married and have twins (2 years). In July 2006, while very drunk, I was involved in kissing, fingering, protected sex with an Asian csw.

The condom (latex?) was supplied by csw, and some lubricant (not sure if water or oil based) was also used on it.
However, with the same hand used for fingering, I put on the condom. This might have caused the vaginal secretions  transferred to the penis shaft  or may be even to the tip (circumscribed) as I cover the penis. I rubbed my protected penis against the vagina for about 3 minutes and had sex for about 4 minutes. My penis never touched the vagina directly, and the condom was intact.  This is the only event of having sex with someone besides my wife in my whole life.

According to the postings in the forum, I thought I was safe, and did not perform any HIV test, and decided to put this out of mind  
Now, after about a year, I become quite concerned for the following reasons

1) Lately, I am having some pain in the left of my groin, pin/needle and burning pain in the feet/hands that comes and goes, and also could feel some pea-size bilateral lymph node below the jaw and below right ear. Meanwhile I gained about 10 lbs, but I feel loss of muscle in the arms and buttocks. And also I observe easy bruising and infections of skin.
2) I was on treatment for sinusitis with erythromycin for about two months (200mg, 3/day, which I stopped last month) at that time. Is there any possibility that using antibiotic had put me in extra possibility for HIV infection?
3) I am worried that if I am infected, I might have infected my wife and also the children through saliva, sweat etc. Because during seroconversion, the viral load could be very high, and infants (8months) might have weaker immune system. Are these likely?
I would appreciate your expert advice or comments. Best regards.

[Edward W Hook, MD]

I would urge you to put your concerns out of your mind once again.  Your risk is virtually non-existent.  We get many questions about the possibility that contamination of the hands during foreplay might then transmit infection when putting on a condom or after sex, similarly transmit when taking off condoms.  The plain and simple fact however is, there has never been a transmission through this mechanism although minor level contamination has undoubtedly occurred fairly regularly.  In addition, as relates to the condom and lubricant- the major concern about petroleum-based lubricants is that they will lead to breakage.  This did not occur so you can assume (as do I) that your condom did its job.  As for your specific questions:

1.  These are not symptoms which bring HIV to mind.  While it can cause neurological problems (after years of infection) and lymph node swelling, these are incredibly non-specific problems and are almost never related to HIV.  I would suggest that if these are concern to you, you seek evaluation by your primary care provider who can examine you and order tests.  No need to mention your HIV concerns- they are not operative here.
2.  No, antibiotics do not increase one's risk of infection.
3.  There is no reason to worry about infecting your wife if you are not infected.  Nothing you have described suggests that you are.  You can either accept my reassurance or, if your concerns continue, why not get an HIV test and put the matter behind you.  It can be obtained with confidentiality at your local health department. EWH

[mdp07]

Thank you very much for your kind reply. It was really good to know, especially in the context of my exposure, that HIv doest not transmit that way. Your explanation was very reassuring. To put these  thought out of my mind for ever, I will soon take an HIV test.
thank you again,
Best regards

MDP