Concerned.. Please Help Dr HHH!

I was tested for HIV in 2007; it was 7 weeks after exposure, I was negative.  Since then I've protected sex with 3 partners; except Oral was not protected.  In January I had unprotected sex with a man who did not *** inside of me; in fact I'm not sure he came at all.  In March same thing.  I also had protected sex with a gentlemen last week.  But Oral was unprotected.  I got tested for Gon/Clyamdia/Hep B and C/Herpes/and Spyhllis; all came back negative today.  However I've been experiencing loopiness; joint/muscle pain; nausea; and extreme fatigue.  My jaw is also tight.  I don't think these are symptoms of Acute HIV?  Also I do take Antibotics on a regular basis so I'm not sure if I could have caught something and it was cleared due to the Antibotics?  I take 600-1000 Miligrams per day.  I'm positive that neither of the men I had unprotected sex with are IV drug users, or have sex with men.  I do plan to get HIV tests but wanted to wait for the proper amount of time.  I guess I just need to ease my mind.  

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

As far as your exposures, you have had several unprotected exposures to men who you presume are not high risk but want to be sure.  Your last unprotected exposure was last week and you were negative, telling you that you do not have those infections.  Syphilis and hepatitis B could take longer to give a positive test but both are quite rare and the antibiotics you take make it very unlikely you would get syphilis.  So, the major question is, are you at risk for HIV?  The answer is that your risk is very low but, given unprotected sex with multiple partners, whether or not they ejaculated, you should get an HIV test.  AT 6 weeks a negative test will confirm that you did not get HIV from any of these exposures.  The chance that you did is very low but it will be best to get tested.  EWH

[unsure1997]

Thanks so much for your answer.  I thought Syphilis was more common.  Also can you tell me about the Oral Sex?  It was unprotected, I'm not extremely concerned about that, but there is a bit of concern there.  And my symptoms do they sound like Acute HIV?  I can tell you do I not have a fever.  I checked my temperature both yesterday and today, and it went from 98.3 to 98.8 today.  Which is still good?

Thanks again!

[Edward W Hook, MD]

The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  This includes by all of the people who had gum disease, etc.

You symptoms are not suggestive of the ARS.  In addition, even if they were, the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  In addition, it is also important to realize that many persons who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

Your risk is very, low.  EWH

[unsure1997]

Thanks Doc!  I'll go get tested in 6 weeks time!

[unsure1997]

One last thing doc, I forgot to mention that my exposure in January was a one time thing, that may have lasted at the most 5 minutes (not even), so that even lowers my risks?  As it was just 1 time?

[unsure1997]

Great news doc!  I tested today Oraquick, that's 12 weeks after the exposure I was most worried about and am Negative!

Thanks for all your help!