Hello Doctor. I posted a few weeks ago on an a single episode of brief (less than a minute) unprotected vaginal sex with a friend of unknown status. I am aware of the forum rules and I will not be posting again after this, I just had some follow up questions. To refresh your memory I am a white, male, hetero, non drug user, no STDs. The girl is hetero, non drug user. When I told you of my episode I said that my only symptoms reflected a bronchitis infection I had simultaneously with the episode. Now that I look back I remember that day or two after the episode, I noticed minor nail pitting (several small pin sized indents) on one of my fingernails. I am not sure how long it takes for HIV to infect the fingernails but I heard that nail pitting is a sign of psoriasis which is can be an early indicator of HIV. I have no discoloration or pitting on any other nail, just several small indents on a single nail. I have had minor nail pitting every now and then even way before this episode ever happened, I guess this time just worries me because it happened coincidentally with an unprotected episode.
I have also done some research on HIV transmission among low risk heteros. I found many articles that support the idea that the only risk heteros have is when they put themselves at risk with a member of a high risk group (secondary transmission). Any other transmission following that would be considered tertiary transmission (meaning the infected low risk person passing it on to another low risk heterosexual.) Many people suggest that tertiary transmission simply does not happen and when it does it is due to repeated exposure. A big advocate of this theory is Michael Fumento (author of "Myth of Heterosexual AIDS"). Since authors can write whatever they want it is hard to trust them. I figure since you are a doctor and have an STD clinic, you can answer some follow up questions I have. And then I promise I'll leave you alone.
1) Would HIV cause psoriasis to flare up as quick as two days? And is minor nail pitting alone enough to diagnose psoriasis?
2) Would having bronchitis during my sexual episode increase my vulnerability to HIV?
3) Do you agree with those who say that tertiary transmission, or any heterosexual transmission for that matter, requires repeated exposure to HIV to have a significant chance of infection?
4) Is an episode of vaginal sex lasting less than a minute usually long enough to transmit enough of the virus to the male to become infected? given that she even has HIV.
5) In all your practicing years have you ever handled or heard of a case of a low risk heterosexual male becoming infected after a single episode of vaginal sex with a low risk female. especially a brief one?
Your service is amazing and very helpful. Being a college student, after this experience and seeing doctors like you who care, I am strongly considering going into the medical field. Thank you very much.