Expert: Terry B - 4/28/2009

Question
I have a long question. Back on August 19, 2007 I began dating my partner. On Oct 7, 2007, we both got tested for HIV and were negative. We then began having unprotected sex, but were completely monogamous, and still are. But in Feb. 2008, I got a mild fever and an ulcer in my mouth. The fever only lasted maybe a day or two and the ulcer lasted a few days, definitely not a week or more. I didn't have any other symptoms. I didn't think twice about it at the time, but lately really started worrying because I read stuff about mouth ulcers being an early symptom of HIV infection. Some sites say ulcers can show up early, while others say not until years later, and ulcers in HIV patients last a long time. I know there are many causes of ulcers, but do you think what I describe sounds like infection? Please let me know, I'm really worried. Thank you!

Answer
Dear Mike:

Peace.  First, there are lots of causes of fever and infections, and the symptoms you describe are not dissimilar to acute viral reproduction in early HIV, but based on your report of testing and results and mutual monogamy, unlikely to be HIV.  

The discussion of long-term (chronic, AIDS) and mouth ulcerations is not helpful, as the infections are not necessarily HIV symptoms but rather, an inability of a compromised immune system to fight off common infections.  You might have the same oral infection as someone with HIV/AIDS - the difference being that you can suppress the pathogen that causes the infection more effectively.

Simply, an oral infection should be seen by a provider and treated.  It is unlikely that it is HIV from what you describe, and whether it is or isn't won't be determined by anything but a blood test.  If you are HIV negative, you would still benefit from an oral exam and treatment, just as you would if you were HIV positive.

Get an appointment, have your mouth examined, and if you need peace of mind, get tested for HIV again.  IF you and your partner are mutually monogamous and neither infected, outside of injection drug use or occupational exposure, I don't see you as being at risk.

I will note that there's a reason that abstaining is more effective than mutual monogamy, in part because a break from that isn't always the first thing a partner shares.  Using condoms reduces the risk of HIV as well as other shared infections - and this might be a consideration if all you had was HIV testing.  A good workup might be in order for your both to assess any other infections (herpes, etc) and develop strategies to reduce risk.

More at www.thebody.com on a variety of issues, and the very best to you and yours.  I hope your mouth feels better soon, and please see a doctor.

Thanks for asking,

Terry