HIV - Prevention Expert Forum
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Any Ideas


I have had about a year of health problems following 3 unwise encounters with sex workers - protected sex and oral both ways unprotected.  Tested at a UK GUM clinic 9 weeks following last encounter and all tests returned negative.   Currently, I am about 8/9 weeks into something resembling polyarticular arthritis. No real movement problems with joints although a bit stiff if sitting too long.  If I do too much exercise can be painful next day.  Knees and hips are painful when standing still - better to move about. No visible signs of swelling, redness or heat in affected joints.  Joints pop and click noticeably until 'released' but not painful when they click. History of events after last encounter:  Week 4: stinging pain tip of penis migrating back and forward to perineum anus including swelling in vas deferens from time to time also  This continued for about 3 months. Week 7: tested for UTI at docs came back clear. also prostate ok.  Given 1 week course of cipro to no effect. Wk 9: tested at GUM clinic.  Wk 11:1 month course of cipro.  Around this time a couple of molluscum appeared on shaft of penis  Wk16: genital problem cleared up shortly after completion of cipro course but occasional perineum tingling continues to this day. Wk 17:  4/5 weeks neuropathic symptoms - parathesia feet legs hands arms face etc  Also affected some muscles and tendons with minor balance problems.  Neurologist diagnosed as Guillaine Barre Syndrome and believed it would clear up completely.   A couple of minor flares since.  Wk 31:  2 weeks flu type respiratory illness - lost voice, swallowing saliva difficult, confined to bed.  Doc prescribed 2 types of antibiotic to clear. Wk 36:joint pain - fingers, toes.  doc performed several blood tests which ruled out RA, gout etc. Wk 37: spread to knees. Wk 39: spread to hips - doc gave cocodamol. Wk  44: saw another doc - gave me ibuprofen.
Is all this down to an std or even HIV. Could they be related to the GB episode?
239123_tn?1267651214
Welcome to the forum.

You had accurate replies to a briefer version of this question on the HIV prevention community forum a few months ago.  As you were told, you had an essentially zero risk exposure with regard to HIV, in a country where well under 1 in 100 sex workers have HIV (probably closer to 1 in 1,000).  And as we have said innumerable times on this forum, HIV test results always overrule symptoms and exposure history in judging whether or not someone has HIV, as long as testing is done sufficiently long after exposure.  There are no exceptions, and there are no extenuating circumstances that change it -- no matter how typical the symptoms are (yours are not, since HIV rarely if ever causes neuropathy or polyarthritis as the main or only symptom), no matter how high risk the exposure (yours was zero), and regardless of other illnesses, antibiotic treatment, or anything else.  So for certain you don't have HIV.

As for other STDs, no STD is a likely cause of arthritis, Guilliain Barre syndrome, or the other symptoms you describe.  I am confident your symptoms are unrelated to the sexual exposures you have mentioned -- just a coincidence of timing.  It is possible you indeed acquired your molluscum contagiosum at that time, but i'm inclined to doubt it, given the nature of the exposure and the apparent time (6 months or more?) after the event.

Beyond that, I have no thoughts about other causes.  We avoid speculating on this forum about causes of symptoms other than HIV or other STDs.  If they continue, I would advise you to continue to work with your doctor on it.  I also encourage you to pick one physician and stick with him or her, or whatever consultants he or she may recommend.

Good luck with it--  HHH, MD
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