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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General Question

Dear Dr's,

17 days ago I made a horrible mistake and had a 1 night tryst with a random bar hookup.  I had unprotected vaginal and oral sex with her.  3 days later I woke up and had an unexplained severly swollen knee. (little to nopain front of knee cap) Dr identified it as possible prepatellar bursitis. Could this be a swollen lymph node instead after 3 days since exposure???  Since than I have had minor sore throat, and splottchy rashes on stomach and chest that last for 30-45 min and go away.  I have also had what maybe oral thrush the last few days. I did start taking some doxycycline mono for 10 days that i had laying around from and old acne perscripton that was not expired. Could this be tha cause of the rashes & thrush. I plan on getting tested for STD's tomorrow.  Do you recommend also having an HIV  andtibody test at this time or wait until 6 weeks.

Thanks so much!
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Welcome to the forum.  The bottom line is that you should be having no worries about HIV of other STDs.  Here is why:

First, in the US and other industrialized countries, the chance any particular woman has HIV -- including those willing to be picked up in bars -- is very low, probably under 1 chance in 1,000.  Second, even if she had HIV, the chance of transmission for any single episode of unprotected vainal sex is around 1 in 2,000.  (So on those two issues alone, the chance you caught HIV would be around 1 in 2 million, i.e. virtually zero.)  Third, HIV symptoms cannot start in less than 7 days and it's usually 10-20 days.  Fourth, your symptoms don't sound like acute HIV infection or those of any other STD.  Fifth, no doctor is going to confuse a prepatellar bursitis with an enlarged lymph node. The two conditions aren't similar in any way.

Thrush is not a diagnosis a lay person can make without professional advice.  Most white coated tongues, for example, are not thrush.  I can't judge whether or not the changes in your mouth might be related to doxycycline, but it sounds like a possibility.  Also, I can't judge the splotchy rash either.  But neither of these problems is likely to be due to a new HIV infection or STD.

From a medical or risk assessment perspective, you don't need HIV testing at all.  But assuming you remain nervous despite my reassurance, have an HIV test.  If you don't mind the wait, a single test at 6-8 weeks is fine.  If you can't wait, have an initial test at 4 weeks (highly reassuring) and a follow-up test at 8 weeks or so.

In the meantime, I see no serious concerns here about either HIV or other STDs.  Follow through with your plan for STD testing, but don't lose a lot of sleep over it.  It is unlikely you caught any infection of any kind from your bar pick-up.

Regards--  HHH, MD

If you remain concerned about your symptoms, return to your doctor for professional re-evaluation.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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