Dr. Handsfield, please help.

[michael415805]

Hi Dr.,

I posted a question in regards to a possible exposure. please see below.

24 gay male. I normally am the receptive partner when i meet other guys. I met this other guy off of the internet. He began jacking off and touched his penis to do it for him. I then touched my rectum afterwards. I have a small lump which my doctor said it was a small vain. I dont recall sticking my finger inside of me. I was lying flat on the bed and he decided to climb on top of me. His butt hit my dick and i felt pressure so i immediately moved it away. His goal was to have me suck his penis as I was laying flat on the bed.  I can guarantee that my penis was never completely inside of him. I am having trouble recalling whether the pressure was felt on the buttocks or the rectum and whether it went in a little. I know for a fact that my ENTIRE penis was never in him, but hard to remember if the head went in. He didn't react or anything so i assume i didnt go in..i also asked him afterwards through text to see if it had gone in and he said no. I  am a bit paranoid over the situation. After i moved my penis from contact with his buttock that lasted 2-3sec, 10sec max.happened on may 7.

1. I tested 2 wks with a rapid antibody and also did an rna which I will get back this Fri. The antibody was neg. How reliable is this?

2. I now have maybe a lymph node?I felt some pain in my mouth with one of my tooths..it lasted a day or two, but, I still feel my right side is bigger than the left. the pressure is felt right underneath the ear lobe. at certain points, I cant feel anything different, but I can feel tenderness.is this a common location for lymph nodes to appear when going through ars?.I don't really have a sore throat, just some scratchiness (probably from the leftover phlegm)...

[Edward W Hook, MD]

Last answer.  As stated above, the combination of tests you list would be definitive at 4 weeks, not 2.  Repeating the same question again and again will not change the answer which was given in response to your original question.

Further repetitive, anxiety-driven questions will be deleted without comment.  EWH

[michael415805]

Can i move on with my 2 week rna and 3 week oral swab?
Thanks

[Edward W Hook, MD]

Nothing to add to prior posts.  See above.  EWH

[michael415805]

??

[michael415805]

Hi,
I received a 2 week rna result = neg
3 week oral swab = neg

Conclusive?

[michael415805]

Thanks doc will keep you posted

[Edward W Hook, MD]

I said I would not comment further.  I will....once!  Correct- I expect a negative result.

No further comments.  EWH

[michael415805]

Which you expect neg correct? ...her diagnosis was lymphadenopathy

[Edward W Hook, MD]

No change in my answer or recommendations.  No further comments until you have a test result to report. EWH

[michael415805]

Whew. Thanks doc. I get the rna exam result on thursday kinda scared.....so the 3 week test was pretty reliable based on my symptoms? I went to an urgent care and the doctor there prescribed me ibuprofen twice a day. She said everything checked normal....

[Edward W Hook, MD]

Yes.  Relax.  EWH

[michael415805]

Dr.,
I just tested with a rapid oral swab test at 3 weeks today and it was negative. The tenderness started i believe fri....if those symptoms were ars, would this test have picked it up?

[Edward W Hook, MD]

I agree with Dr. handsfield and see little to nothing in the way of medical reasons for testing.  

Also, like my colleague, I am not going to play the "what if" came- it does no one any good. EWH

[michael415805]

Thanks Dr. Do you agree that this didnt warrant testing? If i did go in, have you ever seen anyone get positive from a 10sec insert?
Thanks

[Edward W Hook, MD]

Welcome back to the Forum.  As you probably know, Dr. Handsfield and I share the forum.  This time 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.

Its clear that you are nervous after this exposure.  35 posts in two weeks proves this.  I have reviewed your earlier posts and agree with all that Dr. Handsfield said.  From there I will go straight to your questions.

1. I tested 2 wks with a rapid antibody and also did an rna which I will get back this Fri. The antibody was neg. How reliable is this?
The combination of a standard HIV antibody test and an RNA PCR is highly reliable and equivalent to a DUO test at 4 weeks.  While at two weeks the antibody test would detect only about half of persons with recent infection, at two weeks the combination of tests is strong but not absolute evidence that you were not infected.

2. I now have maybe a lymph node?...
What you describe may or may not be a lymph node.  If it is there are many other illnesses which can cause lymph node swelling.  Swollen lymph nodes are a non-specific response to any number of stimuli including infections due to bacteria and viruses, allergic reactions and autoimmune disease.  Trauma due to repetitive searching for nodes can also cause local swelling.  Of all persons with swollen lymph nodes only a tiny proportion of them have HIV  

I hope this helps.  You need to address your anxiety.  Wait for your test results.  I anticipate they will be negative.  EWH

[michael415805]

I am really scared. I know that you said this was considered a very low risk that didn't 'warrant' testing, but the weird feeling under/side of my ear is getting me worried. I sometimes get hot and touch my forehead, but usually goes away minutes later.