[Question #8148] Herpes Zoster, HIV

48 months ago

Dear Dr. Handsfield and Dr. Hook,

Let me first of all express my great gratitute for your commitment to providing science-based, accurate information about HIV and other STI's through this forum. I wish I would have found it earlier, that would for sure have saved me reading a lot of inaccurate, freightening info online.

Now about my 'exposure'. 31 days ago I visited a strip club in Prague with two friends. Just to have a drink. We were soon accompanied by two strippers (one Czech Roma, one from Jamaica), who proposed to take us to a separate room for sex. I didn't think it was such a club / brothel initially, and declined the offer. The strippers did a lap dance on us, while we remained fully clothed. ThI didn't touch either strippers genitals, but there may have been secretions on their bodies - I don't know. After this, I went home (20 minutes), and touched my penis when going to the toilet. Although I regretted the event, I didn't worry about it, as I guessed HIV / STI's are unually not transmitted this way. However, the second morning after the event (24-30 hours later), I noticed a painful rash on the left side of my body, which my GP diagnosed as Herpes Zoster. I did some internet research into the condition, and this is where I got freaked out, as many sources associate it with a early HIV-infection. Then I went on to make the mistake of doing further internet research, and found articles like these https://www.healthline.com/health/healthy-sex/frottage-hiv-risk who claim dry humping presents a risk for HIV and othSTD's. 1. Having read similar responses from your side, you would probably say that I had a no/theoretical exposure. Correct? Nevertheless;2. Does Herpes Zoster present as a symptom of early HIV infection, and could it be at such an early stage?3. In case the HZ was already there on the described evening, and either stripper touched it with contaminated hands, would that be a possibe route of infection for any STI?Many thanks for answering my questio

H. Hunter Handsfield, MD

48 months ago

Greetings and apologies: I replied to this yesterday, only now seeing that for some reason that response didn't get posted. Here we go again:

Welcome to the forum and thanks for your kind words and your confidence in our services.

1) Thanks also for reviewing our replies other questions similar to your own. As a result, you have correctly predicted my reply: all aspects of the events described carried no risk of HIV or any other STI. The information you found at the other website is mistaken: there has never been a proved (or to my knowledge, even a strongly suspected) transmission of HIV by frottage or by hand-genital contact or fingering. The same is true for other STIs. This is true even when genital fluids are used for lubrication. I will also point out that the large majority of female sex workers or strippers, in Czech or anywhere else in western Europe, do not have HIV; but even if one of them was infected, you were not at risk.

2) Herpes zoster (shingles) is a localized recurrence of varicella zoster virus (VZV) infection -- the virus that causes chickenpox, usually in childhood, which resides for life in spinal nerves. Shingles occurs when the virus reactivates in a particular nerve root, with symptoms in the area of skin served by that nerve. It occurs with increased frequency in people with advanced HIV, i.e. overt AIDS, but rarely in association with a new HIV infection. And it certainly cannot occur within a day of exposure to HIV -- 10-14 days would be the absolute earliest. So this medical problem has absolutely nothing to do with HIV or with the semi-sexual events the day before your symptoms started. The doctor treating your herpes zoster may suggest HIV testing, because of the potential association with longstanding HIV, but not because of the events in one the strip club. Also, I hope your doctor prescribed valacyclovir or acyclovir, which will speed healing of the outbreak.

I hope this information is helpful, but let me know if anything isn't clear. I apologize again for the delayed reply.

HHH, MD

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48 months ago

Dear Dr. Handsfield,

Thank you very much for your quick and detailed reply, for which I am very grateful. No apologies needed whatsoever.

It is a relief to hear that there could not possibly be a connection between the strip club visit and the outbreak of HZ the day after.

My doctor did indeed prescribe acyclovir (5x 800 mg daily for 7 days). The HZ is healing well.

Many thanks again for providing this great service to all the anxious souls out here, and the very best wishes to you and the team!

H. Hunter Handsfield, MD

48 months ago

Thanks for the thanks; I'm glad to have helped. That's why we're here!---