[Question #810] HIV Risk And Chicken Pox Rash

51 months ago
Hi Experts..

Let me start by thanking you for an amazing and selfless service that you all are giving here.

I will keep my stint as crisp as possible. I am 25 year old healthy male. And i have  only had 3 sexual exp in my entire life. 2 of which were in nov last year which were random hook ups when curiocity got best of me, after which i had 2 hiv test of which the lastest one was a oraquick swab test 4 months out, which was neg. then my 3ed and latest sexual exp was last week with my fiancĂ©. None of my exp were penitrative sex as far as i can tell.it was unprotected oral both ways.now comes the twist of my life. I came down with very mild chicken pox 4 days back and it was confirmed by my dermitologist,he just looked at it for asec and said its chicken pox.It was a very low grade fever with max of 22 red bumps on my body which are already going away in its 3ed day and fever gone the same day. I am now worried if i have aquired hiv for any of my 3 sexual scenes..So my questions:

1:By any chance can som one misdiagnose ars rash as chicken pox? Do they look the same? Single red bumps with fuids that burst when u scratch.
2:the rash came 5days after my make out session with my fiance,is it possible that ars starts that early
3:i understand that chicken pox is not a thing that adults get, hence does me getting chicken pox by any chance mean that hiv from my first two exp has effected my immune system and my tests have missed them out.
4:how common is chicken pox in hiv patients 

You reply is appriciated
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
51 months ago
Welcome to the forum. Thanks for your question.

While chickenpox is most common in children, cases occur in adults. In fact, adults cases have incrased greatly in recent years. It used to be everyone got chickenpox in childhood and as adults were immune to reinfection. Today, however, everyone is supposed to be vaccinated in childhood, but many do not, so the proportion of adults who are still susceptible to the infection are more common in the population.

That said, if you WERE immunized as a child, then your current rash isn't chickenpox. Also, chickenpox in adults is almost entirely limited to persons who have known exposure to a child with chickenpox or, less commonly, someone with herpes zoster (shingles), which is caused by the same virus (called varicella zoster virus, or VZV). If the dermatologist really suspected chickenpox, you should have had a swab test from one of your skin lesions to test for the virus. Something to discuss with the dermatologist.

As for sexual risks, you are at the extreme low end of the risk spectrum for HIV. Almost nobody in the US or other western countries with your sort of sexual history has HIV. In any case, your negative HIV tests prove you weren't infected before your most recent sexual exposure with your finace. What in heaven's name makes you think she could have HIV? If she's not an injection drug user, the chance is nil for practical purposes. And oral sex is zero risk for HIV, or close to it.

To your specific questions:

1) The rash of ARS is entirely different from chickenpox. ARS rash doesn't cause lesions that blister and can be broken with scratching.

2) ARS symptoms cannot start sooner than 8-10 days after exposure.

3) No, having chickenpox does not suggest an underlying HIV infection. HIV does not predispose to chickenpox. Your previous testing proved you don't have HIV anyway.

4) I've never heard of chickenpox occuring in people with HIV. Surely it can happen, but probably no more common than in people without HIV.

So no worries at all about HIV. However, since you're obviously concerned about it, I suggest you and your fiance both get tested for HIV. Maybe you'll find she is just as paranoid about it as you seem to be. Your mutually negative HIV test results would prove neither of you can infect the other. In the meantime, I also suggest you do some online research on HIV. In the US, it is far less common in heterosexual settings than you might think based on health education you may have had or from the news media. It simply is not a realistic concern in your situation.

I hope these comments have been reassuring and otherwise helpful. Best wishes--

HHH, MD
---
51 months ago
Dear Doc

Your patience in replying to my question is commendable...

I would say that you sir had a right choice of word "paranoid". the dermitologist said that my rash was typical of chicken pox and he mentioned somthing about different stages of each bump etc so he is confident that its chicken pox and his treatment is working as the bumps are drying out, he also confirmed that ars rash does not form such bump and also dont dry out spl not with in days is that true??. Unfortunatly i am not aware of comming in contact with any one with pox that i can recall but i do travel to middle eastern countries and i visit crowded places/souqs so i might have caught it there. In any case i take your advice on testing along with my fiancĂ© as its the right thing to do. but i do need to understand if performing oral on a female is risky for hiv specially with an open cavity due to failed filling back of my mouth which bleeds a little every once in a month. And is one oraquick test self swab @ 4 months enough to establish hiv status. I think i will book a session or two with the "head doctor" so that he can help me sort my thoughts, but you are helping me greatly sir. Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
51 months ago
Your dermatologist is absolutely correct. And in the 30 years of the worldwide AIDS pandemic, nobody has been known to acquire HIV by performing oral sex on an infected woman -- and of course millions if not billions of such exposures must have occurred in the presence of oral sores, dental problems, etc.

I also agree that professional counseling might be hellpful. All signs suggest you have some rather deep conflicts about sex, which are manifesting themselves as disease risk. (Any chance you were raised in a politically or religiously conservative environment, with biased attitudes toward sex and and sex education?)

In the meantime, thanks for the thanks. I hope these additional comments also are helpful.

---