Expert: Terry B - 11/14/2006

Question
Hi Terry B,

I had unprotected sex 9 months ago in an out door hot tub and have been suffering with vaginal burning, swelling and on/off discharge since. I have tested negative for chlymadia, gonnoreah, herpes, etc. Howerver I have been diagnosed with 3 vaginal yeast infections in the past 6 months (swabs done). I have been treated with Diflucan. I have read that chronic yeast can be an early sign of hiv in women. Is this true? I thought it was a later symptom (CD4 Count less then 100). I have no reason to believe this person is hiv positive. Also, it seems that my yeast infections occur directly after my period. Could it be due to the hot tub, or stress, or do you think I could have transmitted hiv?

Thank you for your help

Answer
Dear Melanie:

Peace and all good things to you.  It seems that you are already accessing health care professionals for your testing and treatment; my opinions regarding your case are not meant in any way to interrupt or supplant the information you are already receiving; I would strongly urge you to go to your health professional with your concerns.

Speaking more generally, recurrent and stubborn yeast infections have long been a symptom we targeted for women and their primary care providers as a reason to "raise the index of suspicion" and urge HIV testing.  They can be a manifestation of chronic HIV symptoms prior to an AIDS diagnosis, and/or may persist throughout CD4 decline.  

The symptoms you describe, as I said, should be brought to the attention of your health care provider, and you should be aware also that the chemicals which circulate in the hot tub may impact the chemistry within your vagina and make you more susceptible to yeast infection.  

Lastly, from a prevention standpoint, sex in a hot tub isn't preventative against HIV; as with douching prior to and/or after receptive sex, the action of the water spreads potentially infectious fluids over a greater area and can reduce the amount of mucous protecting the mucousal lining.

I hope this is somewhat helpful; it may be that your yeast infection is resistant to your medications.  Inform your prescriber and follow her/his advice.  As I do routinely here, I would recommend you find a counseling and testing center to learn your HIV status.  It does wonders for peace of mind and responsible fluid exchange in the future.

Blessings on you and yours.

Terry