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What is my risk given the circumstances?
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What is my risk given the circumstances?

Hi, Doctor.

I read a lot of other peoples` questions first to make sure I wasn`t going to be asking similar questions, but I will feel better if I just go ahead and ask.

Here are the facts:

I have had a lot of sists on my scrotum since I was very young.  Some of them are opened due to itching or careless picking.  

I had sex with an escort.  I recieved oral sex without a condom.  We performed missionary and girl-on-top (excuse the terminology) with a condom.  At one point during missionary the condom popped. We noticed right away and I pulled out and replaced it.  Another thing maybe worth mentioning is the condom was small and didn`t go as far down my penis as far as I am assuming it should, according to what is considered proper usage.  Also, I have no doubt my soars on my scrotum were hitting against her genital area, esspecially during missionary.

It`s been just a little under a month since, and I have experienced light off-and-on aches in my neck, lower back pain and sore abdominals (lymph nodes?), plus a random ache in my left bicep.  The ache in my lower back was steady, not on-and-off, and lasted for about two days. The aches in my abdominals felt like I had done sit ups the day before, even though I did not, and the aching only lasted a day. The right side of my neck started to ache (very sore and tender to the touch) to the point where it resembled the common cold, but only lasted a day. Then, the lymph node of the left side of my neck seemed a bit enlarged and tight but not tender to the touch.  I have not experienced any fever within the last month, or any other common cold-like symptoms as far as I can tell. At least not anything worth missing work or cancelling plans for.

I know it isn`t really worth my time to go and get tested for at least another month or so.. What do you think my risk is? Thank you for your time.
Thank you very much for your post.
Symptoms are not specific of HIV sero-conversion and therefore not relevant.  Your symptoms could be related to many other conditions, much more common tha HIV.
It is more important to be able to estimate the possible risk from the sexual encounter and get tested accordingly.  Your sexual encounter would have involved STI risks, because the condom failed.  However the risk of HIV infection would be estimated in less than 0.1%, assuming the lady was positive and had a high viral load.  The risk of transmission through one of your scrotal cysts would be negligible.  I do not believe that there would be any significnat risk of HIV infection that way.
For your full peace of mind, I would recommend that you get a full STD screening after 4 weeks of the encounter.  Test results would be conclusive, provided they include a HIV Duo test of 4th generation, which includes the p24 antigen.
Best wishes,
Dr José
Follow up:

Neck and back pains continue. Lymph nodes in neck a bit swollen.
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