Hi Dr Handsfield,

I’m a married man , I’ve been with my wife for approx 16 years. Before we met I had unprotected sex with a UK woman in Greece. Not to be rude but I think she was a bit free and easy! Although it was a one night stand and didn’t last long. I haven’t had unprotected sex since except with my wife whom we now have 2 children. 

About 8 years or so I have had what I thought was a bout of thrush (erythematous) kind, I can feel lymph nodes like little peas in the neck. Recently I had a small white mark on the side of my tongue and immediately freaked out thinking it was OHL, I haven’t stopped picking and playing with it which has caused it to come back whiter after being rubbed off! Not sure if this is normal or from constant friction and picking?!? Does this sound like OHL or frictional keratosis which ive read about?

Also I am getting some buzzing and heat in the bottom of my left foot which has led to me to think it’s Peripheral neuropathy, but it go for about a month or so but it has stated up again on and off especially after I exercise . Does this sound like peripheral neuropathy in HIV? 

Last year I had a couple of bouts of herpes in the mouth on my roof. They were little ulcers that lasted a couple of days, they always followed a food burn. I keep reading you can’t get canker sores here so I’m presuming it was herpes brought on by the traumatic food burn?? As an expert in Herpes is this typical Dr? 

I’m also getting stomach cramps. Apart from this I feel fine.

Am I overreacting here considering it’s been 16 years? Have you ever experienced anyone going this long without treatment? I know I’ve read about it as those who are elite controllers etc. I know I can’t base it on my wives two tests done at pregnancy. 

Many thanks for your work.

Welcome to ur Forum.  The short answer is that the odds of you having acquired HIV and being an elite controller who is now manifesting signs of HIV is incalculable but must be in the range of 1 in trillions.  To break this down, the odds that your partner had HIV is low, certainly far less than 1%, the odd of of you acquiring HIV if she was infected   is less than a fraction of 1%, and the odds of you  being an elite controller if you acquired HIV is similarly a small fraction of 1%.  The symptoms you describe are the sort of things that all of us accumulate as we age but NOTHING you describe suggests HIV in any way. 

My sense is that the odds of you having HIV from your pre-marital dalliance in the distant past approaches zero and is not a concern.  If it will be helpful to you, I suggest you seek testing- everyone needs to be tested once,  OTOH, I would bet a huge amount that you do not have HIV and I am not a betting person.  This is simply not something for you to be concerned about. I hope this perspective is helpful t you.  EWH

I have some follow up questions if that’s ok?

In your experience what is the typical course of HIV in the absence of treatment? I know it can vary based on many things. But in your experience of working with this disease for so many years.

In terms of your experience how rare is it to have acquired hiv from a single act of unprotected heterosexual sex? Do you or Dr handsfield often see it?

Many thanks 

Persons who have untreated HIV have a progressive loss of immunity which leads to repeated infections and cancer.  Typically people who have HIV and are untreated have AIDS by year 10 or 11 (sometimes sooner) and die within a year of reaching this stage. 

The risk of acquiring HIV from a singe unprotected sex act is one infection for every 1000-2000 sex acts (less than 1.10th of 1%).  It is quite uncommon.  EWH

Typically 16 years after seroconversion what would you expect of a patient on no treatment.

Many thanks 

Have you ever experienced anyone going out as long as 16 years on no treatment? 

I can see my anxiety is letting loose here but apologies I just need to ask. 

I think your anxiety over this long past event is getting the best of you.  I have never seen a person surive for 16 years without treatment. 

As this is my 3rd response to your questions, as per Forum Guidelines this thread will be closed later today without further responses.  Given your level of concern, I suggest you get tested and when you received your negative test result (as I'm sure you will), hope that you will move forward without further concern.  EWH