Mr. Sowadsky-- About six months ago, I had sex with an old boyfriend, and
although I do remember using
condoms with him, I'm not sure because I was extremely intoxicated. At any
rate, this summer I had an
outbreak of cold sores on my nose after a sunburn. I didn't get concerned
about the outbreak because I
attributed it to the sunburn, but about three months later I had another
outbreak of cold sores on my nose.
Both outbreaks lasted about three days and then cleared up. In this last
outbreak, I was extremely stressed
out over school related activities, and my doctor told me this might be the
cause. But as I read through the
long list of HIV symptoms, I find that herpes simplex outbreaks are one of
them. I've had cold sores in the
past, but only during colds or flus. Should I be tested again for HIV? I was
tested before the unfortunate
night with my old boyfriend, and the test came back negative (yes, I did wait
the appropriate 6 months
between sexual encounters to make sure I was indeed safe from all previous
sex acts), so the only person
who could have infected me is my old boyfriend. What do you think? --Stressed
Hi. Thank you for your question.
Cold sores are due to the Herpes Simplex viruses. A person can have the
herpes viruses and NOT have HIV. They are two seperate infections.
Stress (both physical and emotional), can activate the herpes viruses, and
lead to the characteristic lesions that the Herpes Simplex Viruses can cause.
This is true in persons with or without HIV infection. If your body has
been under stress (which can include sunburns, lack of sleep, drug/alcohol
abuse, and emotional stress), this can certainly lead to a symptomatic
outbreak of herpes infection. In all persons with herpes infection (whether
it be oral herpes, genital herpes, or rectal herpes), the best advice we
could give would be to reduce physical and emotional stress as much as
possible. If you have recurrent outbreaks on a regular basis, check with
your physician to see if you should start on medications. There are now
several prescription medications for use against Herpes Simplex infections.
In persons who get outbreaks often, a physician may prescribe a drug to
reduce the occurences of symptomatic herpes outbreaks.
Having recurrent herpes outbreaks by itself doesn't necessarily indicate HIV
infection, especially if you have been undergoing physical or emotional
stress. However in persons who have HIV and herpes, they can have outbreaks
occur more often. If you are concerned about having HIV from your encounter
with your old boyfriend, then you may want to consider getting tested again
for HIV. If you had sex while intoxicated (drunk), you may unknowingly have
put yourself at risk for HIV. This is because when a person is drunk, they
are more likely to have unprotected sex, and if they are using condoms, drunk
persons are less likely to use condoms correctly. So you may want to get
tested again (at 6 months post-exposure) to see if you were exposed to HIV.
Overall, since you mentioned that you were under a lot of stress, it would
not be unusual for you to be having recurrent herpes outbreaks. This alone
would not indicate HIV infection. But since you may have put yourself at
risk while you were drunk, it may not be a bad idea to get tested again, to
rule out HIV infection.
If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).
Rick Sowadsky MSPH CDS