I recently was diagnosed with Trich after having unprotected vaginal sex with my long time sex partner. All other blood and culture tests were negative but I was tested only 1 week following the exposure. Naturally I'm not worried about possible HIV infection. He said he was recently tested negative in the last 2 months and hasn't had unprotected sex with anyone else. I want to believe him but the trich diagnosis says he's lying and IF he's lied about that he could be lying about his status. It's been about 5 weeks now and I never had any symptoms of ars but I've felt some slight itching and soreness in my vaginal area as if a herpes outbreak was coming but no blisters ever developed. Is it possible that a new HIV infection could be a trigger for dormant hsv2? Need advice. My doctors office is requiring me to wait another 3 weeks for an appointment to come in for follow up labs and my mind is racing in the meantime. Thoughts?

I think the most important advice I can give is that you're probably on the wrong track in blaming your partner or believing he is being untruthful. Trichomonas often is carried for months or even years in either men or women before being diagnosed. In other words, your recent diagnosis does not necessarily mean you were infected during your most recent sexual exposure. Or perhaps that is when you caught it -- but your partner might have had it for a long time, and it was only recently transmitted to you. Of course you know him and I do not -- you're in a much better position to judge his truthfulness. But if have trusted him before, probably you should do so now.

As for HIV risk, that's really not a likely issue. Although any STI, including trichomonas, indicates possible risk for HIV, the vast majority of women with trich do not also become infected with HIV. And if your partner is being truthful about his negative HIV test 2 months ago, and you have not had sex with anyone else, you cannot possibly have it. (Assuming no other HIV risks, like sharing drug injection equipment.) Vaginal "itching and soreness" is not a symptom of ARS. That said, if any doubt remains, both you and your partner should be tested for HIV at this time -- as well as for gonorrhea, chlamydia, and syphilis, any of which can accompany trichomonas.

You say nothing about treatment, which should be with metronidazole twice daily for a week; the formerly recommended single dose treatment is now known to be unreliable. Your partner also needs to be treated, although in males the recommended treatment remains single dose metronidazole. Test of cure normally isn't recommended or necessary -- although it does make sense if you were given only a single dose of metronidazole. If test of cure is done, it's probably best to wait until 3 weeks after finishing treatment, as your doctor has recommended. This avoids the possibility of a falsely positive result because of persistent trich DNA even though the organism has been eradicated.

All of which should be discussed with the doctor treating you. In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

The genital irritation you described above really doesn't suggest (to me) an atypical herpes outbreak, but even if it was, it doesn't imply HIV or ARS.

That completes three follow-up exchanges so concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.