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HIV Prevention (Expert Forum)
HIV Exposure?
Answered by
University of Washington
Seattle - WA
This forum is limited to prevention of HIV and to safe sex in general. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, this is the site for you.
IMPORTANT
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
HIV Exposure?
by MMM1111, Oct 28, 2006 12:00AM
Dear Dr.
Thanks you for taking the time to read and respond to my post.
I am a 38 yr old Bi-Male. I keep myself in very good condition by weight training and cardio exercise and I eat very wll.
I also take vitamins. Multi Vitamin as well as Omega 3/6/9 and flaxseedoil.etc.
On Sept 30 I engaged in unprotected receptive oral without ejaculation receptive protected anal sex with a partner that I have no knowledge of their sexual history. I kept checking the condom to make sure it didn’t slip etc. When we were finished. I saw him take it off and I also saw that it did not have any tears in it. Yet, It seemed that I had some fluid inside of me. Which totally flabbergasted me. When I checked some fluid leaked out. I was unable to determine what the fluid was weather it was lube/or for him.
In any event, everyone around me has been ill and I too felt very ill about 1 week after the episode. Extreme fatigue, swollen glands in the back of my throat, sore throat and some slight difficulty swallowing yet I have had no temperature. I also have had a very bad flare up of Geographic tongue (which I have had all my life, some small cankers sores in my mouth and the back of my throat and tongue feel like they are burning at times. (After week one-I had a lot of white paste in the back of my tongue that is more prevalent in the morning. It lasted for about 10 days and has improved a bit, but the Geographic Tongue and burning tongue and throat is still and issue). I also have had general itching for about three weeks; sometimes it gets worse then others. Also have some slight itching in my groan areas and near my anus, yet dont see any rash or bumps. I sprayed some antifungal spray(Jock itch spray on groan, inner thigh area to hlp this)
This morning 10/28 on top of the itching I now notice for the first time a blotchy rash on my abdomen and chest that that seems to bother me more when I wear clothes.
I tested negative for Elisa HIV on 10/10
I also when to my doctor and they did blood work on 10/20 as well Mono, EBV for STD's and throat culture for Gonorrhea and and also the Elisa and the HIV Proviral DNA by PCR and everything came back neg.
Question:
I do plan on testing with the Elisa again at week 12 and week 24(based on the indow period) But do you think the HIV Proviral DNA by PCR is a good indicator even at 21days that my present symptoms are not HIV related as viral loads would be indicated with the symptoms I’m describing (If they were HIV related?)
All these strange uncomfortable symptoms Mouth/Tounge Burning, Fatigue and inconclusive tests on top of the itching and rash now have me stumped. Could I have a fungal/bacterial infection,Candida, scabies? Any thoughts/Suggestions steps and direction I should take to figure this out?
Thanks again.
Thanks you for taking the time to read and respond to my post.
I am a 38 yr old Bi-Male. I keep myself in very good condition by weight training and cardio exercise and I eat very wll.
I also take vitamins. Multi Vitamin as well as Omega 3/6/9 and flaxseedoil.etc.
On Sept 30 I engaged in unprotected receptive oral without ejaculation receptive protected anal sex with a partner that I have no knowledge of their sexual history. I kept checking the condom to make sure it didn’t slip etc. When we were finished. I saw him take it off and I also saw that it did not have any tears in it. Yet, It seemed that I had some fluid inside of me. Which totally flabbergasted me. When I checked some fluid leaked out. I was unable to determine what the fluid was weather it was lube/or for him.
In any event, everyone around me has been ill and I too felt very ill about 1 week after the episode. Extreme fatigue, swollen glands in the back of my throat, sore throat and some slight difficulty swallowing yet I have had no temperature. I also have had a very bad flare up of Geographic tongue (which I have had all my life, some small cankers sores in my mouth and the back of my throat and tongue feel like they are burning at times. (After week one-I had a lot of white paste in the back of my tongue that is more prevalent in the morning. It lasted for about 10 days and has improved a bit, but the Geographic Tongue and burning tongue and throat is still and issue). I also have had general itching for about three weeks; sometimes it gets worse then others. Also have some slight itching in my groan areas and near my anus, yet dont see any rash or bumps. I sprayed some antifungal spray(Jock itch spray on groan, inner thigh area to hlp this)
This morning 10/28 on top of the itching I now notice for the first time a blotchy rash on my abdomen and chest that that seems to bother me more when I wear clothes.
I tested negative for Elisa HIV on 10/10
I also when to my doctor and they did blood work on 10/20 as well Mono, EBV for STD's and throat culture for Gonorrhea and and also the Elisa and the HIV Proviral DNA by PCR and everything came back neg.
Question:
I do plan on testing with the Elisa again at week 12 and week 24(based on the indow period) But do you think the HIV Proviral DNA by PCR is a good indicator even at 21days that my present symptoms are not HIV related as viral loads would be indicated with the symptoms I’m describing (If they were HIV related?)
All these strange uncomfortable symptoms Mouth/Tounge Burning, Fatigue and inconclusive tests on top of the itching and rash now have me stumped. Could I have a fungal/bacterial infection,Candida, scabies? Any thoughts/Suggestions steps and direction I should take to figure this out?
Thanks again.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 28, 2006 12:00AM
, Oct 28, 2006 12:00AM
You had safe sex. If the condom indeed remained intact, you could not have acquired HIV from the exposure you describe. Therefore, your symptoms cannot be due to HIV, unless you have had other risk exposures; and in any case, they don't particularly sound like HIV anyway. You do not need HIV testing at 12 and 24 weeks; a single test at 6-8 weeks would be sufficient. (And I would have recommended against the PCR test, but since it was negative, that also is highly reassuring. And I can't imagine why you were tested for mono and EBV.)
I imagine the fluid from your rectum after sex was your own mucus, or lubricant.
How to "figure this out"? Follow up with your doctor if your concerns persist. Whateverr is going on, it isn't HIV--and it doesn't sound serious in any case.
And now back to the most basic issue of all: What in heaven's name were you doing having sex with a partner you don't know without asking his HIV status and sharing your own? That is the single most important element of safe sex for gay men, especially for anal sex. Condoms break, and intention for safe sex sometimes go out the window in the heat of the moment.
Good luck-- HHH, MD
I imagine the fluid from your rectum after sex was your own mucus, or lubricant.
How to "figure this out"? Follow up with your doctor if your concerns persist. Whateverr is going on, it isn't HIV--and it doesn't sound serious in any case.
And now back to the most basic issue of all: What in heaven's name were you doing having sex with a partner you don't know without asking his HIV status and sharing your own? That is the single most important element of safe sex for gay men, especially for anal sex. Condoms break, and intention for safe sex sometimes go out the window in the heat of the moment.
Good luck-- HHH, MD
Thanks for the quick reply and detailed reply. I am going to follow up with Primary Care doctor on Nov 8th to explore what can be going on. I just was curious to why you wouldnt reccomend the PCR Test? Do you think it can be used as a tool to find out within the window period if one has been infected?
Thanks for the reassurance.
The PCR test has a relatively high rate of false positive results, much higher than with the antibody tests. It's main use is to monitor viral load in people with known infection. For diagnosis in the window perriod, the test is recommended when the risk of new infection is especially high, e.g. if a person has had unprotected receptive anal sex with a known infected person. But in low risk situations, many or most positive results are false. Such persons then go through an agonizing several days thinking they have HIV when they do not. It isn't a pleasant experience. And if the test is negative, as in your case, it still doesn't prove anything; it is only partly reassuring without giving a definitive answer.
So many experts agree it is a misuse of the test in situations like yours. Admittedly, your situation is borderline, because bottomed with a high risk partner, and there might have been some doubt whether the condom remained. So although I would not have recommended you have a PCR test, some experts might disagree with me. But there would be no disagreement in the more common stories on this forum, after (say) oral sex, or sex with women at low risk for HIV.
And to repeat my closing comment above: Think how much less anxious you would be about all this if you knew your partner didn't have HIV!
HHH, MD