[Question #9973] Anxious from poor decision

27 months ago

Hello Doctors, sorry for my English is not my first language. I am a 25 years old heterosexual male living in Spain. I was not very sexual active since 2 years ago, that i went to 2 differents appointment CSW (women), with this two persons i engaged in protected vaginal sex (im 100% sure the condom didnt broke) and we ve done unprotected oral in both sides (giving cunnilingus and reciving oral). Im no really concerned about this ones cause i think it was safe sex. My concerns are from a girl i was dating 3 months ago (she is a friend of one of my college friends) (we met in December and we stoped in January), the first time we ve done it was protected sex but since that time we engaged in unprotected intercouse like 4 - 5 times. In that time i wasnt worried, but now that we "broke" i started to think if she has done this with a lot of people and if she can have HIV (she is 22 years old). I sais this because i did the stupid thing for looking on internet about i think is called angular quelitis (and some white transparent membrane near my lips (i think it is just i have my mouth dry)) and on internet they say is because of HIV. My questions are:

1. Im not worried about my CSW exposures or should i be?

2. Is reasonable to be this worried with the unprotected sex with this girl i met? Should i test for something?

3. Now has been 3 months since we have done the unprotected sex, are this symptoms related to HIV since only 3 months have passed, i know AIDS take longer to appear, but this might be some symptoms of chronic HIV?

27 months ago

To clarify, no ITS symptons in all this time. I tested negative before all this (blood analisis in my healthcare center). I have this "angular quelitis" since a month ago and the white transparent thing near my lips since 5 days ago. I know i should be no worried but the symptoms are making me anxious. Thanks again.

H. Hunter Handsfield, MD

27 months ago

Bienvenido al foro. No hay problema entender su ingles, que probablemente es mucho mejor que mi español.

It seems like your partners all have been pretty low risk for active STDs. Escorts -- expensive female sex workers by appointment -- generally are low risk. They care about their health, take precautions, usually have low risk male clients (men like you), and get tested frequently. And I see no reason to be concerned about sexual safety in your more regular partner. You are at especially low risk for HIV, which seems to be your main concern.

Angular cheilitis is more frequent in people with HIV or other immunodeficiencies, but also in entirely healthy persons; and it never would be the only sign of an HIV infection. The same is true of white coated tongue, which is very common with very minor health issues, like the common cold; and in healthy persons. Neither of these raises any concern at all about HIV infection. Finally, 3 months is much too soon for "chronic" HIV. To your specific questions:

1,2. I see no reason for worry about any of the sexual partners or exposure that you describe. From a medical or risk perspective, I see no need for testing. However, since you obviously are worried, I recommend you be tested anyway, simply for reassurance. But the only tests I would advise are blood tests for HIV and syphilis, and a urine test for gonorrhea and chlamydia. You can expect negative results for all of them.

3. As discussed above, your symptoms are not suggestive of HIV (either acute or chronic). If you decide to be tested, I am very confident of a negative result.

I hope these comments are helpful. Dejame saber si algo no esta claro.

HHH, MD

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27 months ago

Thanks Doctor for your quick response, you write very well in spanish :)

On this time i read a lot of the forum questions and i worried a lot less, before i read it i thought the HIV was very easy to infect, now i know that the exposures with the CSWs were practically zero risk (no cases of cunnilingus and receipt) and with my exgirlfriend the risk was minimal since is rare that she has HIV and with unprotected vaginal u can get infected but is hard. Even so im a minuscule worried since i think this girl has done unprotected sex before with other partners. (i do the math and still is really hard that she infected me, like more than 99,6% even she is HIV + that she could not pass it to me(if its 5/1250 since we have done it 5 times unprotected and im uncircumsiced)). Probably i will do a rapid test for HIV even if there is no medical perspective or high risk since the white dots started to appear at the back of my throat. I want to know if this type of test are reliable, i will buy it in a pharmacy. And i want to know if my assumptions are correct from what i understood from your response and from what i read here on the forum.

And again thanks a lot. You have helped me a lot only with the answer you provided.

H. Hunter Handsfield, MD

27 months ago

Thank you for these comments. I'm glad to have helped you understand the situation about HIV risks.

However, even when every individual exposure is low risk, over time the risks of HIV and other STDs rise. We almost always advise against testing after any single exposure of average or low risk. Instead, we advise persons with sexual lifestyles like yours to get tested on a regular schedule, such as every 6 to 12 months, depending on the frequency of non-committed sexual events. Normally that testing can safely be limited to blood tests for HIV and syphilis and a urine test for gonorrhea and chlamydia.

Therefore, if you go ahead with such testing now -- as I suggested above, for reassurance -- you might consider it the first of what will become regular testing every 6-12 months, assuming your sexual lifestyle continues as it has been.

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27 months ago

Thanks for everything doctor. After reading all, my worries from these exposures have disappeared. I will delay the test to when i have to do a general blood test in some months (here in spain with the normal blood test u can have a serology on the same blood sample), and only for ressurance. I will not maintain this type of sexual lifestyle, i dont want to go to any other CSW (i didnt feel moraly good) and i will not do it unprotected again (unless we tested both before).

H. Hunter Handsfield, MD

27 months ago

Thanks for the thanks; I'm glad to have helped. My final thought is that if those sexual lifestyle choices are right for you, I endorse them. But do be aware that such intentions often are challenged by time and circumstances; sexual gratification is a powerful human drive. Just be prepared in case temptation wins: condoms; and thoughtful about setting, type of partner, and the influence of alcohol or drugs. Best wishes.---