I am a male 33 years age from India. I am married and having kid of 7years old. Hear is my story

I have had around  80 - 90 encounters with CSW in this past 7 - 8 years.  For 2 to 4 times I had Protected sex , condom did not break and sex lasted for not more than a minute as I have problem of Premature ejaculation. But apart from that I always wore condom and didn't even removed my pants. Only performed breast sucking and few times neck kissing. There was no visible sore , blood from nipples, nor anyone of them anytime were lactating . Lately I am having this hiv phobia . On Dec 2020 I had fungal infection which I caught it from my wife, as she was as well having it. She got cured but I am still struggling it having re-occurance of fungal on groin area as soon as I leave treatment. on Nov 2021 I had mulluscom outbreak in my private part (Diagnosed by doctor). I believe it was around 20 - 25 bumps which I removed it by myself. I believe I caught it from my wife . My wife was having few bumps on her back, which got disappeared after 2 months. But never clinically diagnosed with mulloscum.  After removing post 7 months I did not got any new bumps. I am also suffering from IBS and bloating from last 5 years.  I have developed an phobia of this reading posts from medhelp website and scanning Internet but dying afraid of hiv and hiv testing. Please help me . 

I do not entirely understand your CSW exposures. If you have had vaginal or anal sex only 2-4 times, all with proper condom use, you are at little risk of HIV or other STDs. But if you're having intercourse, i.e. your penis in vagina (even with condom) most of the time, there is at least some STD risk over the last 7-8 years, averaging CSW contacts roughly once a month. Condoms markedly reduce the risk of STIs, but are less effective against the ones transmitted by skin-to-skin contact. That includes molluscum contagiosum:  you're kidding yourself if you really believe your wife was the source of your infection; it is far more likely you acquired it during one of your CSW encounters. "Bumps" on your wife's back probably were not molluscum; that would be a very peculiar location. However, you are never at any risk for HIV or other STDs from mouth contact with your CSW partners' breasts or neck. 

Your genital area fungal infection probably is tinea cruris (jock itch), which is not an STD; you did not catch it from your wife, even if she also has had it, or if she had a vaginal yeast infection (a kind of fungus), which also is not sexually transmitted.

Statistically it is unlikely you have HIV, having had only safe sex when it comes to intercourse -- and perhaps only a few such exposures. However, the risk is not zero, and anyone with a sexual lifestyle like yours should have periodic testing for common and potentially severe STDs. Specifically, you should have urine tests for gonorrhea and chlamydia and blood tests for syphilis and HIV every few months, or perhaps once a year. These are not necessary specifically because of the particular recent exposures you mention, but because of your ongoing risks.

I have no patience with not being tested for HIV (or other STDs) because you are afraid of testing. That is nonsense:  it isn't the test that gives someone an infection; you have it or you don't. If you do, you have an absolute practical and ethical responsibility -- to your wife, your CSW partners, and to yourself -- to know whether or not you are infected. And someone who has delayed testing for HIV almost always has REDUCED anxiety after they finally are tested, even if the result is positive. The stress and anxiety of not knowing is worse than knowing the answer, even if it's the answer you do not want. (Same thing for other tests for serious health problems, like people at risk of colon cancer who fear colonoscopy, or women with breast lumps who delay having mammograms.)  And anyway, it is much more likely your test will be negative, not positive. So just do it -- and also a syphilis blood test and a urine test for gonorrhea and chlamydia.

Let me know if anything isn't clear; and feel free to clarify your sexual history if you would like my additional evaluation of your risks.

HHH, MD

Hello Doc,

Thank you for your response. I completely agree with you that I need to get tested and I will. I have few more questions.

1. As mentioned I had 2 - 4 times only protected intercourse which lasted for a minute of so . This happened 4 years back. Leaving apart from those,  I have not engage in high risk behavior and only practiced safe sex (Breast sucking)  and nothing else. Entire time my cloths used to be on . Is testing required even for these activities ? 

2. What if there was few drops of blood/breast milk (which was not the case) involved. Even if we consider this hypothetical situation does this puts me in risk ?

3. Regarding the molluscum , I have read the incubation period is from 2 weeks to 6 months. In that period I only had 1 encounter with the CSW which was only breast sucking. I wore a condom also my cloths were on entire time. No body fluid exchange anytime.

4. Is IBS and fungal infection an symptom of HIV as I have read on many sites, it occurs due to week immune system.

5. Statistically if we consider all of the CSW were HIV positive , what will be my changes with these behavior.

2. A few drops of blood are not a significant risks, a few drops of breast milk probably zero risk. (Babies nursed by HIV infected moms, swallowing a few ounces of HIV-infected breast milk per day, have only a 15% chance of infection after 6 months.)

3. Molluscum contagious transmission is mysterious; the origin of many infections is unknown. The incubation period probably is in the range you suggest, but there are almost no data:  these figures are educated guesses, not based on any objective data. But in spite of your precautions, sexual acquisition from one of your CSW partners probably remains more likely than from your wife. But if your molluscum has cleared up and your wife hasn't had any genital area lesions, probably it's a done deal; no further worries about it.

4. Irritable bowel syndrome and skin fungal infections are totally unrelated to "weak" immune system. Fungal infections are a bit more common in people with HIV, but the vast majority of affected patients do not have HIV or any immune system problem. (Be careful what you learn on the internet! Anxious persons tend to be attracted to information that maintains their fears, without seeing the reassuring information that also is present. Probably it's best for you to avoid any online searching about any of this.)

5. Near zero risk, even if all your CSW partners had HIV -- which almost certainly is not the case anyway. Still, was implied above, you might consider testing anyway -- strictly for the reassurance you would experience from the negative result, not because of any significant risk.

Thank you Doc for your response. I have few more doughts.

1. You mentioned Molluscum , may be I must have contacted from CSW , but I only performed breast sucking and the affected area was by private part (penis shaft and scrotom) . Could this be due to low immunity

2. As mentioned by you , my risk is very low but not zero. But as far as I remember I have not engaged in any risky behaviour. In fact I lied you , I am having this Hiv phobia since the begining . This is the reason I was involved only in breast suck and neck kissing/ licking activity. And the 3 - 4 times which I had protected sex, it was the CSW denied me for the breast sucking. So what exactly had put me in risk . I know abstinence is only the 100 % full proof way to avoid any exposure.

3. Is breast sucking also considered as oral sex. The reason I am asking is coz oral sex is considered a risk and in case while breast sucking there was any exposure with milk / blood wouldn't that be considered the same risk level.

5. I am having all these symptoms IBS , fungal infection , sometimes fever , could this be symptoms of later HIV stage . 

6.  Lastly this is not a question . But I want to thank you for your amazing work . 

2. Your risk indeed is exceedingly low.

3. I would not consider oral-breast contact as oral sex. There is zero STI/HIV risk from oral-breast contact.

5. HIV does not cause such health problems, whether late or early stage.

6. Thanks for the thanks. I'm glad to have helped.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.