HIV tests and Medications - is my test accurate

[Tiredmidwestern]

Dr.

11 weeks ago I was in Germany and went to a strip club where a dancer came up to me in the NUDE and sat on my lap and then my left knee. probably no more than 3-4 minutes if that, no grinding no lap dance, just sitting. I rubbed her hips, thighs shoulders and breasts only. It was when she propositioned me with sex that I got nervous and left. I walked back to my hotel only around the block, maybe 5-10 minutes away tops. There I masturbated and became nervous she had left her vaginal fluid on my pants in some location, I got it on my hand while masturbating and now I have HIV. Below are my questions.

1.)Does male foreskin increase or decrease the succeptability for HIV infection? I have read in South Africa, they believe this is the case. So much so that they publish papers on the fact that it increases risk by 50%. I was unaware that the foreskin on a male was a "Mucus Membrane" or at least the CDC makes no mention of it. Or is it because during intercourse or masturbation, the foreskin moves fluid toward the urethra? I am extremely worried about this. Would I be considered a low risk for HIV infection based on this scenario?

2.) Two weeks following exposure I had jock itch which made me very concerned as it is a type of yeast infection, though it was not Oral Thrush. I applied triamcinolone acetonide cream (60mg) for two weeks following this and it dissappeared. Would the daily application of this medicine affect a Clearview HIV 1/2 test? which was negative at the 6 week mark?

3.) Six weeks following exposure I get very congested and had a significant cough that produced a great deal of phlegm from both my coughing and nose. I took a Depo Medrol Shot 80mg on April 22nd and the symptoms subsided in one week, though I still cough. I took a unigold recomigen test at 11 weeks and it was negative

Would any of these drugs at these doses cause a false negative? Would any of this warrent a followup test at 13 weeks? Am I HIV NEGATIVE?

[Edward W Hook, MD]

Welcome to our Forum. It will be my pleasure to answer your questions which are quite similar to questions others have asked of us in the past.  Let me start however by pointing out that no one has ever gotten HIV from the sort of exposure you describe - i.e. touching, direct, non-penetrative contact or exposure to genital secretions transferred on hands or clothing- not ever.  The HIV virus is a fragile virus which dies quickly outside of the boy and is transmitted only be penetrative ano-genital or genital sexual contact an through injection of infected material deep into tissue.  

Lets now work through your questions:

1.  Being uncircumcised does increase risl of getting HIV among expose person by about 50%. This has been proven repeatedly in carefully conducted clinical studies.  When a man is not circumcised, the skin under the foreskin is different, and more susceptible to HIV infection, than when the covering skin has been removed by circumcision.

2.  Use of topical triamcinalone cream will have  no effect on antibody formation and therefore would not change or delay your test results in any way.

3.  A shot of depo medrol would not meaningfully change your antibody response either.

Bottom line- your exposure i not put you at risk an your test results do accurately reflect the fact that you did not get HIV from this exposure. You do not need to worry and do not need further testing.  EWH

[Edward W Hook, MD]

As i said, this is not HIV.  as to what it might be, I cannot say.  you should speak with your doctor to sort this out. That your son is also suffering with this may be a clue as well and you need to make sure the doctor knows this is the case. EWH

[Tiredmidwestern]

Doctor,

Since I am not experiencing HIV symptoms can you tell me what is associated with pins and needles in hands and feet, combined with Chills and 96 degree body temperature, diarhrreah and excessive acne for two weeks. I just want to look in the right direction. I have been battling this for weeks. I have written off HIV in search of what could be wrong. Whats even more concerning is that my son is suffering from the exact same ailment.

Please give me some direction on what to look for from here.

[Edward W Hook, MD]

See my original answer.  Each of the answers you mentioned says essentially the same things.

This ends this thread.  EWH

[Tiredmidwestern]

The questions was essentially was there any one specific way that the virus was inactivated. The inactivation of the shell of the virus was mostly my question, i.e. the last part. your statement that all of these factors contribute to its death which is more encompassing and complete.

Other websites conflicting with eachother was my question. Why isn't there one answer versus many sites stating that their answer is right over others. Thats all.

I got a warning email for excessive posting - I'm sorry, there just aren't any HIV specialists where I live who know about this.

[Edward W Hook, MD]

I am not sure what your question about the virus is.  The fact is that environmental exposure, which exposes the virus to drying and other changes which are very different from the environment when the virus is inside the body, all damage and thus kill the virus outside of the body. Each of the statements you refer to above means about the same thing, thus these answers are essentially consistent with each other.  EWH

[Tiredmidwestern]

This brings a great deal of relief, thank you Dr. I will voice my other concerns to a healthcare professional. I have only one last question in regards to the stability of the virus itself which I haven't been able to find a concrete answer to. I hope that posting different questions about the virus itself on this site is acceptable?

The CDC states that outside its host, HIV is unable to reproduce or infect. In other website they have stated "air" kills HIV, yet others state the drying of the fluid is what kills it. Moreover, yet another site states that the shell in which HIV is housed becomes damaged once in contact with the environment (oxygen and nitrogen) which then renders it unable to infect.

Can you be very specific with this question. I can't find a consistent answer? Thank you for your help and patience.

[Edward W Hook, MD]

I will repeat- your conrcerns are unwarranted. This was a no risk event which later was confirmed (not that it needed to be confirmed) by a reliable negative test.  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.  Of all persons with swollen lymph nodes only a tiny proportion of them have HIV.  If you are concerned about swollen lymph nodes, the proper place to get evaluated is with a good internal medicine physician but don't worry about HIV as a cause.  

If you are concerned about your symptoms see a physician regarding what might be causing them but I assure you, it is not HIV.  EWH

[Tiredmidwestern]

This was helpful Dr.

I thank you for the response. I do have some followup concerns. Yesterday I began to experience painful lymph nodes in the groin especially in the neck. I also had a great deal of itching all over, though no noticeable rash presented. This was accompanied by chest pain and excessive acne on neck and knees. I have also have gotten a number of new red moles on my arms over the last two months alone. My lower abdomen has been the source of great pain in the last two days. These "liver spots" have me concerned about my liver being attacked. Should a White Blood Cell count be taken in lieu of a HIV test post 11 weeks?

Though these medications will not effect the result of the HIV test, is it possible for these same medications to mask the development of HIV seroconversion or progression? Could I be experiencing prolonged symptoms? Has this been observed? Is there a reason to be concerned about these later symptoms? I could have put this behind me except for the intense pain that is now in my neck, groin, and left side of body.  

Thank you for your help