[Question #8271] Posted question 8156

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46 months ago
Thanks very much for having this form available to ask questions - so as you say - I do not know the cause of the rash but with certainty it is not related to any STI-  Is that correct - because  it has  healed with triamcinolone acetonide a steroid ? Also since it reacted to this form of treatment and is  not a form of a nystatin would it also not be from a yeast infection?  Finally - as I indicated the first time we had oral - my skin became dry and i had red spots that seem to be like erupted blood capillaries at the surface - could this be related to my use of viagra (increased nitrates) as well as the intensified suction that she applied ? Makes sense due to what occurs when one gets a hicky
Also I understand that I need to go to the dermatalogist when I have symptoms so I can get eyes on the rash if it comes back

Thanks

Patrick



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H. Hunter Handsfield, MD
46 months ago
Welcome back, but I'm afraid I can't help much. As discussed previously, I agree that no STI causes a rash like you describe. And your speculation about vigorous oral sex might be reasonable, although I don't see how oral sex could cause "dry skin" or how viagra could be responsible.

That's about as far as I can go. The forum is a resource for STIs and HIV, but not for other genital conditions and symptoms. As we have discussed previously, it indeed makes sense to see a dermatologist if the problems persist or recur, or perhaps a urologist.

Sorry I can't do more. Best wishes--   HHH, MD
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46 months ago
Dear Dr Hansfield

So my only unprotected exposure happened over 2 years ago - it was question 6030 - which Dr Hook answered and you looked at and responded as well in question number 6237 - ( it was unprotected insertive sex and oral cunnilingus with a female) you also answered a question which was number 8156. I had a skin bump that was due to over exposure to the sun - so went to dermotalogist and a biopsy was done. It came back pre cancer and will go back in 5 weeks to have it frozen. I also had some sort of rash - which we have discussed in 8156 - and saw individual who was a FNP-BC , DNCP - with a master of science in nursing who works in the field of dermatology over 20 years - so she looked at rash and gave me ketoconazole - 2x day for 14 days i go back in on 10/14/21. She did not do a scraping or any test. But I assume that she felt it was yeast related - she said she did not think it was autoimmune. Looks to be clearing up. Unfortunately - with my obsession about HIV - I went on the net to figure it out.  So in 8156 I had gingivitus and was prescribed amoxacillin - (reading on the internet - I see yeast infection and gingivitus as Opportunistic infections of HIV - since covid has started - I know I have been drinking way to much beer - and not drinking my usual in take of water - or exercising as I usually do -could these two amoxicillin and alcohol along with stress be a cuplprit of a yeast overgrowth - Since that event I have practiced safe sex - condom remained on protective insertive vaginal and have performed unprotected cunnilingus and had fellatio performed on me - no anal and I am heterosexual. Have not had any pain or discharge on urination - and have not been sick in the least - You told me no matter how expert we are that a negative HIV test will be more assuring - So knowing about the gingivtitus and yeast would you still be confident that a test would be negative - I do plan to test - what test do I need to take for HIV and I will also do a syphiliis test - cause as I indicated I have had no painful urination nor any symptoms - and when they talk of a yeast infection and HIV - is it more related to inside the mouth - and also wouldnt 2 years be awful early for OI's?

Thanks for your time 

Patrick








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H. Hunter Handsfield, MD
46 months ago
Persons anxious about any particular health problem need to be very careful in web searching that problem. In this case, you have way over-interpreted something you read. There are at least 100 symptoms or health problems that can occur in HIV infected persons, and almost all of them also are common -- in most cases FAR more common -- in people without HIV than those with it. Reading lists of symptoms and going "Aha!" for each one that occurs with HIV is exactly the wrong way to go about it. In judging possible HIV, the pattern and timing of symptoms is much more important than any single one. In this case, there is simply no way that gingivitis and superficial fungal dermatitis could ever be the only symptoms of HIV. That you "have not been sick in the least" is a far more reliable indicator that you do not have HIV, than are gingivitis and fungal dermatitis indicators of possible HIV.

Not all fungal infections are yeast, and most likely your skin problem was a non-yeast fungus, e.g. tinea -- the same sort of fungus responsible for athlete's foot and jock itch. Indeed it is true that most yeast infections involve moist surfaces, like oral cavity, vaginal area in women, etc.

I haven't looked at your previous thread(s). But now learning you apparently have not been tested for HIV despite worrying about it a) makes no sense and b) makes me simply reiterate the advice I or Dr. Hook apparently gave previously. Have an HIV test for reassurance. The standard and best option is a lab-based antigen-antibody (AgAb) blood test -- i.e. a "4th generation" test. I am 100% confident it will be negative. Ditto for syphilis testing. 

I'll be happy to comment one last time if you are tested for HIV and syphilis and would like to tell me the results. If so, do it within the next 2 weeks, i.e. before this thread is closed. But I will have no further comments of any kind until and unless you return with your test results. OK? In the meantime, stay mellow. There is no realistic chance you have either infection. 
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45 months ago
Dear Dr.  Handsfield:

As you said with a 100% certainty both test were negative. I do feel better that I tested - of course a negative test is always a good thing. I have read many post and as you say less than 1 % of the sexually active heterosexual women are infected with HIV - and the chances of getting HIV from a infected female if it is vaginal sex is 1 in 2500 - so (.01x.0004) = .000004= 1 in 250000 - and even more closer to 1 in 1 million- if 30% of the 1.2 million Americans infected are female. So if a condom is worn then the odds become - dramatically lower that an exposure can occur and no symptoms - then even much lower . Being sexual active in the 80's when we first realized about this disease - the misinformation and fear from the media was off the charts . So for the cdc to state that there is little to no risk of HIV through oral sex  - is quite profound - so for a sexual transmission of HIV it is penile to anal or vaginal sex where this happens - there has been no documented cases for cunnilingus and getting syphilis from oral sex from a female is uncommon - and regardless if you have multiple sex partners then you should randomly test - no matter what I have and plan to use condoms as a sexual practice

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H. Hunter Handsfield, MD
45 months ago
I'm glad to hear of your negative test results -- but of course not surprised. You have also nicely summarized current understandings about HIV transmission risk as well as your own risk calculation, and our consistent advice on this forum. I also agree that people who came of sexual age early in the HIV/AIDS era tended to get a more worrisome picture of risks than now exist.

That completes the two follow-up exchanges included with each question and so concludes this thread. I'm glad it has been helpful. Best wishes and stay safe!
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