Mistake

I’m 27 male. My partner is 36 years old, Malaysian CSW, Shemale (male with breast). He had anal sex with another guy in Sep 2012.  My exposure date:  Oct 28, 2012 (5 weeks ago).  We did:   1) Unprotected oral sex (both give and receive).  2) I vomited during the act. 3) Protected anal (me insertive). (Not sure if condom was latex). tried to penetrate but I couldn’t then he used some lubricants (oil based). I didn’t do any in-out action. just penetrated him. 4)I removed the condom with my hand. It was in place but covering 2/3 up of my penis. 5) I took off the condom and came in his mouth 6) his semen came on my hand.  The day after i felt uncomfortable in my penis and i got a very mild fever for almost a week (37.4 cc). I did urine test and doctor said : “your urine  is very dirty”. I took anti biotic and did another test 3-4 days after that and it was all ok. Exactly 14 days after exposure i felt the following symptoms: Throat inflammation which lasted for 2 weeks (No pain or irritation), Runny and stuffy nose (sever) lasted only 2 days , Sneezing (1 day), Feeling not comfortable in stomach (gas coming up) for almost 1week, fatigue.  My voice has changed from the day after exposure till now. Now I feel better but from week 2 to 4 after exposures it was more obvious. During the first 2 weeks after exposure I lost aptitude. The CSW tested negative on OCT 30.
1-Does ARS include my symptoms?  2- Can voice-change be a symptom for hiv? 3 - Why dirty urine? 4- What is my risk? 5- Should I get tested for HIV? 6- In the blood test results of CSW the following comment appears: “peripheral blood films shows a normochromic picture with mild eosinophilia and adequate platelets probably due to  1) allergy 2) reactive  3) parasitic infection“. What does it mean? Can it be related to recent HIV infection? It is also mentioned: “white cells show a mild eosinophilia, otherwise the cells are well differentiated and mature”.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.  You had accurate replies to the same questions on the community forum.  You had a low risk exposure to a partner known to not have HIV, so it is impossible you were infected.

1) Some of your symptoms could occur with ARS, but also with innumerable other medical conditions; and most of your symptoms are not typical.  For example, ARS doesn't cause runny/stuffy nose or abdominal discomfort.

2) ARS doesn't cause voice change.

3) "Dirty" urine often means the specimen wasn't collected properly.  You'll have to speak with that doctor for more information about what it meant in your case.  This certainly has nothing to do with HIV or other STDs.

4) Based on your exposure, your symptoms, and your partner's negative HIV test, you don't need to be tested.  However, you of course could do so if you would gain additional reassurance from the negative result.  If I were in your situation, I wouldn't get tested, but it's up to you.

5) As the report says, your partner may have been suffering an allergic reaction to something -- e.g. hay fever or other minor allergy. It has nothing to do with HIV.

I hope this has helped.  Best wishes--  HHH, MD

[sadboyam]

Dear Dr Handsfield,

Thank you very much for you fast reply. I just needed more clarification regarding the question 1. As I understood you believe from  my symptoms only throat inflammation could be sign of ARS.Am I right? I would like to ask if it is possible that  ARS happens with only throat inflammation? have you ever had such a patient before? I also want to mention i didn't experience such no pain inflammation before. It was the first time in my life. it didn't feel it in the morning but in the evening it was annoying. Can it be psychological? I know it is not possible to diagnose over the web but I'm just trying to get as much info as I can. I met 3 different doctors regarding my throat before. and 2 of them prescribed antibiotic while the 3d one just gave me something for gurgling. I can say the inflammation started at day 14 and  went away  by  day 25 by itself.   Thank you very much for your help

[H. Hunter Handsfield, M.D.]

"...[is it] possible that  ARS happens with only throat inflammation?"  Possible?  Sure.  Likely?  Definitely not. Almost zero chance.

"have you ever had such a patient before?"  No.

"Can it be psychological?"  Indeed it can. In fact, whenever a person suggests his or her own symptoms have a psychological origin, that usually is exactly right.

Based on the information you have provided, it is extraordinarily unlikely you have HIV.  But the question now is why you are stewing about it and trying to figure it out by online searching and forums like this one.  Just go get tested.  I'm sure the result will be negative.

Feel free to return to report your test result if you decide to be tested.  But until then I will not participate in speculation.  I will have no further comments or advice until then.

[sadboyam]

Dear Dr Handsfield,

Sorry i tired so much not to care my symptoms till the time i can test but I am so scared today I decided to post this. today, 38 days after exposure, I have a tinny swollen node under my jaw (left side). it doesn't pain. it can be seen my eye but very small I also have a very mild irritation in my throat. Although now i'm in week 6 after exposure but is it possible this can be related to hiv? there is no other swollen node. just this one on my left side. B.T.W if I test after week 6, which test is more accurate at this time? I have two options: 1) Rapid test  (I dont know which type)   2) CMIA

Sorry again for re discussing my symptoms

[sadboyam]

I forgot to say Thank you. sorry.  I forgot. I appreciate your help and wish you the best.

[H. Hunter Handsfield, M.D.]

The lab based tests are always preferred to the rapid tests when there is no special hurry.  Have the CMIA test.  Stay mellow while you await the result.  You can count on a negative result.

Thanks for the thanks.

[sadboyam]

Dear Dr Hunter,
Thank you very much for your help. I tested NEGATIVE for HIV using CIMA test at 43 days post exposure. my exposure was OCT 28 and I tested at Dec 11. Can I be sure I'm negative? Do I need more tests ? If it is not required, I really dont test again for the rest of my life unless some one force me. (and of course i never expose myself again).

I wanted to propose to a nice girl before I did that stupid mistake. I just wanna make sure i'm safe before doing that. I know she loves me but I don't wanna put her future life in risk and hurt her emotions (in case i'm infected).

Yours Faithfully,

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  I'm glad to have helped.

Your test result is defintive. For more information about time to reliable HIV test results, see the thread linked below:

http://www.medhelp.org/posts/show/1704700

[sadboyam]

Sorry doctor but I'm not sure if the test they performed is CIMA. in the result paper it is just mentioned ELISA. So i don't know which generation of test they have used (I tested in Malaysia).  

1) Is my test result after 43 days still definitive?

2) I also tested for other STDs and all negative. With respect to the fact that other STDs are more likely to be transmitted than hiv, can I include I defiantly have not been exposed to hiv ?

3) Should I forget about this incident and believe my current results?

4) I still have swollen nodes under my chin can they be related to generating hiv antibody ? I've had them for almost 2 weeks now.

Thanks for your reply

[H. Hunter Handsfield, M.D.]

1) If you read the thread I linked above, you would know the answer.  All antibody tests are equally definitive.

2,3) Redundant, already answered.

4) HIV and STDs don't cause enlarged nodes in such a limited location.

You came here for reassurance and I gave it.  Do your best to accept it at face value.  That's all for this thread; further comments will be deleted without reply.