[Question #12135] HIV cause vulvar cancer

10 months ago

Last 8/28/24....I had anal sex with a Shemale Escort. Escort was a top only...I believe it was protected but I have anxiety about it. Because I did not see a condom on the escort when it was done but it took 2-3 mins before I can see. It was doggie style so it took me a minute or two to turn around. The Escort pulled out and went into bathroom. When escort came back, I did see a condom on. But I saw two condoms on the floor. One was open with no condom in it. I went into bathroom and saw a condom in the toilet. So, I assume it was protected but I started thinking did she really wear it... I had anxiety about this, but my wife saw the doctor past week because she felt pain/inch in her vagina. She received medication...She just told me that she felt a bump and she think it is Vulvar cancer because she said I have all signs. She is 47 yrs old. She going to call the doctor Tomorow. I looked it up and talks about HIV can cause that. for younger women. We last had sex about 3-4 weeks ago...Only once from my incident. Now I am thinking that I got her HIV from this incident and passed to her.... Can she get this cancer this quick due to this HIV exposure...Did I get HIV for this incident...My anxiety just went through the roof..... She did have genital wart in her college days. That was a long time ago in her early 20's.....I read about HPV too..... Thank you

H. Hunter Handsfield, MD

10 months ago

Welcome. Thanks for your question.

You're the only one who can judge whether a condom was used; you were there and I wasn't. But if she told you a condom was used, I see no reason not to believe it.

HIV has nothing to do with vulvar cancer. That's strictly an HPV problem. In any case, her recent "pain/itch in her vagina" probably has nothing to do with your sexual experience six weeks ago, and certainly is not due to HIV or HPV acquired at that time. It takes months to years for vulvar cancer to develop after acquiring HPV, and it is not a likely cause of genital pain or sore. However, a painful genital area sore is most commonly herpes, or could be syphilis; or maybe just a physical injury? I can't even guess without a lot more information about it. What did her doctor diagnose? If he treated her with some sort of medication, sure he told her what he believes is the cause. What is the medication? If she doesn't yet know or understand, she should be sure to ask when she is in touch with the doctor's office tomorrow.

For your wife's proper care, she needs to know of your non-marital STD risks. I realize this may be difficult to discuss with her, but in view of her genital symptoms, both she and her doctor need to know. You probably can safely wait until she hears from the doctor's office, however.

Receptive anal sex ("bottom") with a male partner is the highest risk of all sexual practices for catching HIV. (Your transgender partner undoubtedly considers herself female, but anatomically she still is male.) However, even that is under a 1% chance, and far lower if indeed a condom was used. And of course only if she is HIV positive, which you do not know -- but probably she does not have HIV (or is likely on treatment if she does). You should be tested for HIV and syphilis, and also have a rectal swab test for gonorrhea and chlamydia. Since a condom probably was used, you can expect negative results, but testing is the only way to know. All these tests will be conclusive at this time.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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10 months ago

On Wednesday she saw the doctor.... They took a swap of her vagina. They called her on Friday and prescribed metronidazole 500 mg...She stated she had it before...She told me her DX but I never heard of it...She stated she had itchy lower buy last night it was higher. So, she felt a Bumb...Never noticed before...But she had this before, several times she said but the bump is new...

H. Hunter Handsfield, MD

10 months ago

Metronidazole usually is prescribed for two similar but separate kinds of vaginal infection -- trichomonas and bacterial vaginosis. Trichomonas is an STD; women only catch it by sex with an infected male partner. Bacterial vaginosis is an overgrowth of mostly normal bacteria and is not usually considered an STD. However, BV is common in women with gonorrhea or chlamydia. In addition, neither trich nor BV typically causes pain or itching, and not any kind of skin "bump". The main symptoms of both are increased vaginal discharge and strong vaginal odor. In any case, your wife definitely needs evaluation for other STDs, especially gonorrhea, chlamydia, syphilis, and maybe herpes. She should confirm with her doctor whether she was tested for them.

Given these issues, it's even more important your wife and your doctor know of your STD risks. This might have nothing to do with your non-marital sexual experiences, but I'm sure you don't want to risk your wife's health by withholding necessary information. Good luck with it.

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10 months ago

I just found this ??? Can tell what it could be ?

H. Hunter Handsfield, MD

10 months ago

I don't know what you mean. If you attempted to post a photo, don't try again. We do not look at clinical photos; it comes too close to practicing medicine from a distance, which we cannot do.---