Concerned About HIV Symptoms

[smiths]

Facts:
1. May 15th: had protected vaginal sex and protected anal sex with a sex worker in Dubai.
2. Performed unprotected oral sex on her.
3. May 17th developed swollen lymph glands in neck and sore throat.  Sore throat got progressively worse over the next 3 days.  No fever, no headaches.
4. May 18th noticed a white spot on back-center of roof of mouth.  White spot turned to a red spot the next day.  Red spot continues to expand on roof of mouth.  Currently the size of a dime.
5. May 21st took an HIV-1 DNA PCR.  Result was negative.
6. May 23rd, went to doctor for sore throat.  He saw white spots on throat and prescribed me Axonel antibiotics.  
7. May 25, throat pain has gone, but lymph glands still seem slightly enlarged (no pain).
8. Red spot on roof of mouth is still there.  Looks very similar to internet photos I have seen of HIV symptoms.

Questions:
1. Should I be concerned?!  I certainly am worried.
2. I plan on taking an HIV-1 DNA PCR and HIV-2 DNA PCR at the 4 week point.  Thoughts on that approach?  I can't wait the 3 months.  I'm very worried.

Thank you.

[H. Hunter Handsfield, M.D.]

The correct name is Avelox.  That information doesn't change my opinion or advice.

[H. Hunter Handsfield, M.D.]

Protected vaginal and anal sex = no risk.  Remember that even without a condom, and even if the CSW had HIV, the risk you caught HIV was only 1 per 2,000 episodes of vaginal sex and 1 per 500 or so for anal sex.  And the odds are she didn't have HIV anyway.  And nobody has ever been known to catch HIV by performing oral sex on a woman.  And your symptoms are typical for a strep throat or viral infection, and are not typical of ARS.  Had you been my patient, I would not have done a PCR for HIV, and the negative result at 6 days doesn't mean anything; it often takes longer than that to become positive.  Still, there is almost no chance you have HIV.  To the specific questions:

1) No, you should not be concerned or worried. Your doc and I agree you have a garden variety respiratory infection, nothing more.

2) Do not have any more PCR tests.  The odds of a falsely positive result are much higher than the chance you caught HIV.  Think what you'll go through if you have a positive result, while you then wait another 7-10 days for confirmatory testing to show you don't have HIV after all.  There is no need to wait 3 months; a standard antibody test at 6 weeks is all you need.  (Read innumerable threads on this forum about time to reliable antibody test results.  It is almost never necessary to wait 3 months.)

It sounds like you have a competent doctor.  Follow his advice.  Don't worry about HIV; there is almost no chance you ahve it.  From a risk assessment or medical perspective, you don't even need testing for it.  The only reason for testing is for anxiety relief when the results are negative.

Good luck--  HHH, MD

[smiths]

Correction: antibiotic that I was given was Avolex.  Doctor suspected some type of respitorary infection (due to white spots).  Thanks again.