HIV - Prevention Expert Forum
HIV Scare!
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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 Scare!

Doctors,
Please help me! I am a generally healthy bisexual male, and on January 7th I participated in insertive  anal sex with another male using a condom. I am certain there was no condom failure. So, what is the worry you ask?  Several years ago I acquired HSV-2 (non-sexually) and I am frequent to breakouts; however at the time of this event I had no apparent breakouts. During intercourse my (partner?) started to bleed and I noticed a few drops of blood on the areas of my skin when breakouts would normal occur. I have read on some websites that HIV can be transmitted through “breaks or tears in the skin”. Immediately after I noticed the blood I ran to the shower and rinsed it off. After that episode I left. He did not ejaculate.  
For weeks I felt absolutely fine...until...right at 6 weeks post potential exposure I began to have muscle aches/twitches in my neck, followed by head and ear pressure, generalized muscle aches, and bilateral swelling of my occipital lymph nodes. All I could think about was HIV. I began to Goggle symptoms and saw that swelling of the occipital lymph nodes suggest HIV infection.
I have gone to two different doctors for my symptoms. One doctor confirmed my swollen nodes, while the other claims it looks more like an inflamed muscle. This confused me even more.  Also, a CBC was done which revealed no abnormalities. During and acute HIV infection would there be CBC abnormalities?
I was given antibiotic and pain meds and told to go on my way. At 6.5 weeks, 7 weeks, and 9 weeks post potential exposure I did the OraQuick In-Home-Test. All were negative. These test calmed my nerves until I started reading about how it takes longer to develop antibodies in oral fluids. Today I noticed a post from Dr. Hook that states oral fluids test wont become definitive until the 8-week mark versus the 6-week mark. Does this mean I can rest assured with my 9-week test results?  Any feedback is appreciated!
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Welcome to the Forum. It will be my pleasure to help you sort through your concerns.  The first bit of good news is that the exposure was no risk.  Even with HSV, if there was no penetration, there is no known risk to you of surface exposure to blood or genital secretions.  Thus, at least from a medical perspective, there was no reason even for testing (although I certainly understand how you could worry, given the timing and nature of your symptoms).  (BTW, congratulations on your commitment to safe sex. Properly used condoms will keep you healthy).

The second piece of good news is that you can be completely confident that you did not get HIV from the exposure you mentioned.  While the timing was (coincidentally) right for the ARS, the fact is that if this were the ARS your subsequent tests for HIV would have been positive and without a doubt your OraQuick test would
have been positive.  While we have recently had to re-evaluate the accuracy of the OraQuick test soon (i.e. in the first 6-8 weeks) after infection, you can be completely confident that your 9 week test results- you did not get HIV.

I hope this comment clarifies things. EWH
5 Comments
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Thank you for the speedy response doctor!

I have three more quick questions, just to ease my mind.

1. Have you ever heard of occipital lymph node swelling being linked to acute HIV?

2. Theoretically, If my symptoms were due to ARS wouldn't there be a fever, etc present?

3. Would CBC abnormalities be present during the acute stage of HIV?

Again, thank you for your response. This ordeal has seriously been affecting me for the past couple of months and your response has certainly put me at ease.    
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300980_tn?1194933000
Your anxiety is getting the best of you and "what if" questions will not help.  Believe your test results.  

1. Have you ever heard of occipital lymph node swelling being linked to acute HIV?
Persons with HIV may have generalized lymph node swelling, including the occipital nodes, however when symptoms and test results differ, the test results are always right. Many things can cause occipital node swelling.

2. Theoretically, If my symptoms were due to ARS wouldn't there be a fever, etc present?
No always.

3. Would CBC abnormalities be present during the acute stage of HIV?
Not always.
EWH

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Avatar_n_tn
Dr Hook,

Firstly, I apologize for the "what if questions", sever anxiety has got the best of me and can't seem to move on from this episode.

Secondly, I have two FINAL questions for you- they will close out this thread.

1. Today I woke up with a sharp pain in my right armpit that has lasted all day. I'm not sure if it's a swollen node or not. Would lymphadenopathy related to acute HIV cause swelling in the neck at 6 weeks post potential exposure then 4 weeks later cause swelling in the armpit?

2. I have heard multiple times that the rash associated with acute HIV is diffuse and red. In person with a darker complexion what would the rash look like (specifically the color)?

Thanks in advance for answering these questions,

Worried Well
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300980_tn?1194933000
Last answers. Further questions will be deleted without comment.

1.  No.
2.  The rash is variable and not present in all persons with recently qcquired HIV.  It is part of the ARS and not all persons who acquire HIV get the ARS.

You need to believe your negative tests.  End of thread. EWH
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