HIV possibility??

[NeverAgain]

in mid may i had unprotected sex with a girl i just met for literally about 2 minutes.  Then again a week or two later i had sex with a differnet girl for maybe 1 minute unprotected (both times i wanted to use a condom - and gave in temporarily to the situation and realized it and stopped the sex).  Since then i've experienced no real symptoms of all the HIV symptoms i've been reading about except a few:

1) Weight Loss: I usually hover around 185-195 depending on the year, how work is treating me, etc...  a few years ago i was about 175, but i've been as big as 205 before... i fluctuate worse than a woman.  About 3 months ago i weighed probably ~190... a couple weeks ago i weighed myself and i was 185, and today i'm 182... and it's really starting to worry me.  Because i eat pretty much only fast food and restaurants, and i rarely exercise.  In what stage is 'weight loss' and 'rapid weight loss' considered?

2) In the past i've had a couple white pimple like bumps on my lower abdomen (belt line) that i always thought were nothing, and that they'd go away (i can remember back as far as 6months)  Well recently (over the past few weeks) they've increased in number to about 15 but they're all very small.  I think this is Molluscum.  What worries me though is all the HIV related Molluscum i've read about?  What are the chances that the molloscum is increasing due to HIV related?  I did recently irritate and mess with one that could possibly lead to the formation of new ones.

3) What is tongue thrush?  I've seen some extreme pictures on the internet, and every now and then you'll see a picture that looks almost like a normal tongue just someone needs to use a scraper.  My tongue has always had a little discolor to it as far back as i can remmeber (since i was probably 12) and it doesnt really appear to be any different.  Long story short i was using a differnet toothbrush than i normally use and i iddn't feel like it was doing a good job, and i got a couple canker soars a few weeks ago, i went and bought a new toothbrush and those have gone away, could this be HIV related?  Also, i use a tongue scraper and i still have a little bit of the discolor left, mostly towards the back (gag area) that i can't get to.  Could Tongue Thrush be scraped off? wouldn't it bleed?  i have nothing anywhere else in my mouth.  and my tongue doesnt' really look lke the larger white thick bumps that tongue thrush is.

Finally, what are the chances of a solid HIV transmission with those brief sexual encounters?  And could the molloscum increase be due to those encounters of coming in contact with it again?

I have not experienced any headaches, diarrhea, nausea, fatigue, nothing .. my only main concerns are the weight loss (what is considered 'extreme weight loss' and the increase in molluscum and the oral thrush.

To date it has been just over 8 weeks since the most recent one, and 10 weeks since the furthest sexual encounter.

Please advise.

Thanks

[NeverAgain]

One last question that NOWHERE is there an answer or even an opinion on, and i'm sure people would be curious to know this...  you say that unprotected brief heterosexual sex there is a 1 in 1000 chance of contracting HIV?  So can i assume that if the sex went on all night over a period of hours - that there would be more of a chance for transmission from Female to Male? (along what kind of odds?) If the Male ejaculates inside the woman, that makes her more susceptible if the male is HIV+... on the flipside if hte woman is HIV+ and the male ejaculates inside her, it's still that low risk?  I know a lot of this is clinical opinion - but no one seems to give their opinion on this.

Thanks

[NeverAgain]

one final comment.  I've had a couple girlfriends since those incidents and with them i had always used protection and known their sexual past.  Since i've noticed the bumps in the past and never done anything about htem (always thought they were acne or ingrown hairs since i used to shave my pubic area occasionaly, and even recently (past month) i've used an electric razor to trim the area), wouldn't they be showing signs of MC if what i have is truly MC?  I've read MC is spread on objects too such as sheets, towels, and can even spread in water.  My recent girlfriend we've taken baths together, had sex several times, slept naked in the same bed, etc... and she has 0 signs of MC?  I know you probably can't answer this without actually seeing me, but it's as if 1/2 the signs point to MC the other half point to not MC?  Any final suggestion?

Thanks In Advance.

[NeverAgain]

On the weight loss thing...  i read numerous places that an early sign of HIV would be "exteme weight loss"?  In the past 2 months i've maybe tops lost 10 lbs which isn't uncommon for me - even if it weren't uncommon for me - would this be extreme enough to qualify, and how long after exposure could i expect to see something like this.  You're right on the white tongue - i did some brief research on it - i believe i have that due to the fast food diet for the past 400 years.  (i'm 24yr/male) ... tongue thrush seems to be very excessive:

http://www.ich.ucl.ac.uk/factsheets/families/F040082/tongue-thrush.jpg - tongue thrush

whereas mine has been more like this for several years now (even before sexual encounters) (below link)

http://www.maxillofacialcenter.com/images/geogtongueC4.jpg

And the spots i have appear to look like acne, and they seem to slowly grow... they look like little white heads with a slight red outline when irritated, and as the day goes on it almost looks like they shrink and slightly grow, red outline can go and come...  and mine aren't big enough to see a noticeable dimple?  Any ideas?  THey're so unnoticable that when looking in the mirror you can't see them - but you can under closer inspection.  They don't itch or anything either, however they also do not pop like a normal zit, the one i messed with bled some when i really messed with it.  And one final question - the hiv postings related to MC have all said "extreme cases of MC"...  what is extreme?  if this is MC, i curently have around 15 spots...  what would extreme be and in waht kind of timeframe would it go from normal (zero presumably) to 'extreme' (50+ i'm guessing?) ... is it a day or two, a week, a month?  i've done tons of research and can't find anything...  Also, do you have a picture you can post a link to of what you know as being MC for a comparison?

Thanks

[H. Hunter Handsfield, M.D.]

The symptoms of HIV are very nonspecific; that is, they can be caused by a wide variety of health conditions.  The vast majority of people with such symptoms do not have HIV.  Since heterosexual sex with women is an EXTREMELY low risk activity for HIV, you can be confident you didn't catch HIV during the exposures you describe.  (If you had that sort of sex a 1000 times with women known to be HIV positive, you probably would never be infected.  And it is unlikely either of your partners was infected.)

Looked at another way:  In a person who really is at risk for HIV (most gay men, injection drug users, regular partners of known infected persons who don't use condoms), the symptoms you describe would be of real concern and should lead to HIV testing.  But people without such risks can almost always safely assume they are not due to HIV.

To answer your specific questions:

1) Your weight fluctuations clearly are due to variations in diet and exercise. Weight loss due to illness is associated with loss of appetite.  Weight doesn't go up and down in people with HIV or other chronic illnesses; it just goes down.

2) The "white" bumps don't sound like molluscum contagiosum.  The main sign of MC is pink, shiny bumps, many of which have a dimple in the middle.  But if in doubt, see a health care provider.  In any case, this symptom is completely  unrelated to HIV.

3) You probably are confusing thrush, a yeast infection inside the mouth, with coated tongue, a whitish material on the tongue surface.  Coated tongue happens from time to time in everyone; simply variations in diet, getting a cold, and other normal events can do it.  Your symptoms don't sound like thrush, which is most common in people with immune deficiency; thrush causes white patches, often with soreness and irritation.  But once again, if in doubt, see a health care provider.

4) (Your "finally" questions):  Essentially no risk of HIV.  If you actually have MC, it is conceivable you acquired it from one of the sexual encounters you describe.  But having sex doesn't make preexisting MC any worse than it was.

Good luck--  HHH, MD

[H. Hunter Handsfield, M.D.]

OK, here are some responses your subsequent questions in two "comments".  Note that I cannot and will not try to make a specific diagnosis by online description.

I can say anything more about your weight fluctuation or "tongue thrush" (see my original response about the terms "thrush" and "coated tongue"); I can't tell whether your tongue has an abnormal appearance at all, or if it does, what might be causing it--except it isn't HIV.  And I can't diagnose the skin condition; it still doesn't sound particularly like molluscum.  Regardless what you have read, I am unaware of reliable data that MC is spread by intermediaries like sheets, bathwater, etc.  In adults, genital area MC (e.g., lower abdomen, pubic area, scrotum, etc) is always sexually acquired.  But it likely isn't MC anyway.  You will need to see a health care provider for diagnosis.

The reason you can't get the detailed information you seek about HIV transmission risk (or might find conflicting information) is that the data don't exist.  The best we have are overall rates of HIV acquisition in various populations, correlated with frequency of various sexual practices (vaginal, anal, oral), condom use, circumcision, presence of other STDs, blood levels of HIV in the infected person, and so on.  It stands to reason that more prolonged exposure is higher risk than brief exposure; that traumatic sex is riskier than sex without injury; and so on.  It also is likely that male to female transmission is more likely if he ejaculates in the vagina than if not (indeed, this probably is the main reason transmission is more frequent M to F than F to M.

It works out that in most settings in industrialized countries, when you calculate the rate of HIV acquisition with the frequency of vaginal intercourse without condoms, it works out to an average around 1 in 1000; higher M to F, lower if condoms are used, higher if one partner has an STD (especially herpes), lower if the guy is circumcised, higher for anal sex, lower for oral sex, and so on.  But there simply are no data on the exact risk level at the detail you are looking for.  As a result, individual opinions often dominate the information found on websites, rather than data.  Some of those opinions may be valid, but others are wacko.  Always consider the source.

HHH, MD