Possible exposure, extremely nervous

[Erica100]

I am a male and I recently(about 17 days ago) had anal sex as the bottom with a transexual Escort and am not sure of his hiv status but I know he is very sexually active with many different partners both male and female. Of course I used a condom but when we were going to switch positions and he withdrew the condom stayed inside of me completely (not hanging out of me at all) and I had to reach in and pull it out with my finger, he did not get to ejaculate and the encounter ended here but we had been having anal sex for at least ten minutes or so at this point and he was fairly large so it was a bit painful at first and I was soar for about three days, not sure if this increases the risk or not but I want to be as forthcoming as possible. I did not go to the doctor yet nor did I take pep. Also for the last two days I've have had diarrhea and in the mornings I wake up with a soar throat and some yellow mucus, but after I get up and spit the soar throat goes away and the mucus is clear, just a feeling of something in my throat. No fever at all but I have some acne on my forehead that I usually dont have and my nipples are very sensitive to a point where its painful to touch. Not sure if these can be symptoms of seroconversion. What is my risk of hiv infection? I asked of his status and he assured me he was negative but one never knows and now I can't sleep or think of anything else. The anxiety is driving me crazy and I can barely function. Also in this same encounter I gave and recieved oral without a condom but I didn't have any cuts or soars in my mouth,this was before the anal and he also did not ejaculate from the oral. I know it was stupid and this is absolutely a wake up call for me but I hope and pray it is not too late. What do you think my chances are? Should I be worried? Should I have gone on pep? Is this just the anxiety giving me symptoms? How soon can I test and what test should I take?

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post.
Because the condom came off during the anal penetration, there would have been a potential risk of HIV infection.  However I would possibly estimate this to be relatively low:  there was no ejaculation, and a condom was used for most of the penetration.  In any case, the estimated risk of receptive unprotected anal intercourse with a HIV positive individual is around 3% per sexual encounter.   In your case, this would be less due to the factors mentioned above.  Therefore it was probably the right decision not to have taken PEP.  
Your symptoms are not all consistent with acute HIV sero-conversion, as they are not specific and one cannot rely on these.  A lot of it, it is most likely to be related to your worries and anxieties.
You could have a PCR RNA test now, which has a very high level of reliability after 10 days.  Subsequently a HIV Duo or Combo after 4 weeks will be totally conclusive.  I would also advise you to get tested for all other STDs.
Best wishes,
Dr José

[Erica100]

Just wanted to add that I had diarreah today again but not yesterday. Also my mild cold symptoms come and go mostly feel the effects in the mornings but today I had a dry cough for part of the day. Very nervous are these symptoms a bad sign? Im feeling very scared and depressed and just need some advice.