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HIV Risk - Stomach Flu and Lower Back Pain?
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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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HIV Risk - Stomach Flu and Lower Back Pain?

About six weeks ago, I had sex with a sex worker while I was in a drunken state - big regret.  I used a condom for oral sex and then had protected vaginal sex with her but got very stressed out about STDs so only had sex for about two mins. Got a HJ to finish.

Two days after this sex, I noticed urine in my blood and freaked out.  After that I have checked my urine every time I pee'd and I have not had blood again.  Early sign of HIV infection?

Then, four weeks after sex, I developed stomach pain after a meal.  I had a bit of diarrhea (for two days), complete lack of appetite and thought I had a fever because I felt so hot but whenever I checked my temperature, I have normal temp.  My stomach continued to bother me for a week after that, so I went to the doctor, they did blood tests and checked me and diagnosed me with stomach flu which they said has been going around.  Since then my stomach is okay but still kind of uncomfortable but I think that is stress related - constantly worrying that I have HIV.  No fever, no nightsweats, no sore throat though.    

I also noticed my tongue is white-ish - it may be its always been like that though.  I asked the doctor when I went if it was Thrush - they said not Thrush and probably dehydration from the stomach flu.  Also, I have noticed pain in my lower back that comes and goes in the past few weeks. I had some weight loss (about 3% of my body weight but could be from stomach flu and no appetite for a week).

Finally, I talked to the sex worker yesterday, she said that she was tested for HIV two weeks ago and was clean (although why would she admit she had HIV if she did).

What are my risks for STDs and particularly HIV and what could explain that blood two days after the sexual encounter and the on and off lower back pain and abdominal discomfort (could it be stress)?  Am I just crazy and should I be seeing a doctor about anxiety? I tend to stress out over small things and they consume my thoughts 24/7 sometimes.

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239123_tn?1267651214
Welcome to the forum.

First, your "why would she admit" comment:  in fact, it is rare for people to lie about their HIV status when asked directly -- and that includes sex workers.  And in the US and other industrialized, it is the rare sex worker who has HIV -- despite what you might assume.  Second, with condom-protected vaginal and oral sex, you were not at risk; even if your partner were infected, you definitely could not have caught HIV and probably no other STD.

Third, your symptoms do not suggest a new HIV infection.  The symptoms themselves are wrong, since back pain, stomach pain and other gastrointestinal symptoms usually are not part of the picture, and acute HIV infection almost always has significant fever.  The timing also is wrong; 4 weeks is too late for HIV (generally 10-20 days).  There are several potential causes for blood in urine, but STDs and HIV are not among them.  

Clearly you are stressed and anxious, but that wouldn't cause most of the symptoms you describe.  However, the symptoms clearly have nothing to do with the sexual exposure 6 weeks ago.  If they persist, or if bloody urine recurs, return to your doctor for reevaluation.  But you should not be at all worried about HIV or other STDs.

As for the stress/anxiety, if this persists, also discuss this with your doctor then follow his or her advice if s/he suggests professional counseling.

I hope this helps.  Best wishes--  HHH, MD
3 Comments
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Avatar_n_tn
Hi, thank you for the quick response, very helpful to me.  I just have a couple of quick follow up questions.

1) Everything you said makes sense to me.  I thought that the 4 week symptoms after was not related to HIV either but I saw websites that refer to the acute period as being between 3-6 weeks?  Are those websites incorrect?  

2) Also, after my my first symptom after four weeks (the stomach pain), I may have had a fever the first few days as I did not start taking my temperature until 3 days after the initial stomach pain - I did feel hot. Would that change your risk analysis?

3) Would your opinion change at all if the condom broke during sex?  I don't think it did but I've never experienced a broken condom so I don't know what to look out for - how would you know, would it be completely exposed or could there be unexpected holes in the condom or an expired condom?

4) With the white tongue, it is whiter in the back of my tongue and the whiteness scrapes off if I use a brush - no blood.  There are however tiny red dots on the back of the tongue like someone took a red pen and dotted my tongue a bunch of times (I am not referring to the normal big taste buds in a V shape).  Is that a sign of any STD or may be late stage HIV that I got years ago?

Thank you again, I really appreciate this forum and your assistance.
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239123_tn?1267651214
1) Acute HIV symptoms can last that long, but onset is rarely if ever longer than 20 days.

2) No, this doesn't change anything.

3) Why are you speculating about something that didn't happen?  Unnoticed condom breakage isn't realistic.  In any case, this wouldn't make any difference, since she average risk of HIV transmission for any single episode of unprotected vaginal sex has been calculated at 1 in 2,000 (which is why many spouses of HIV infected people never catch HIV).  Adding the low chance your partner had HIV, the chance of transmission would still be in the range of 1 in a million, tops.

4) You're over-thinking it.  The details of what your tongue looks like make no difference, and the description does not suggest HIV or any STD.

These comments suggest that my reassurance alone isn't going to make you stop worrying.  For that reason, you should have an HIV test.  Enough time has passed for accurate testing (no, you don't need to wait 3 months).  This doesn't mean I really believe there was a risk; I do not.  Your test result will be negative.  Feel free to return with that result, but let's hold off on further discussion until then.
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