One time vaginal and the anxiety monster

Hello,
I had a one time vaginal exposure with a coworker and have been scared out of my mind since. This happened on dec 29 2010. The woman is a 41yo hetero, non IDU, never done anal, only dates cauc men, was in a monotonous relationship til august 2010 with a man non IDU non incarcerated. She has told me she has not been with anyone sexually at all since her relationship ended in august. Due to my obsessing over this she tested one week AFTER our brief sex (2 mins tops) via oraquick which was negative. I tested at 10 days via oraquick and negative. She then agreed to have another test via blood draw at 4 weeks after our exposure and her then test was negative as well. I also had a 4 week test done via clearview finger prick and it was negative. I have not had any fever or rash but did have a very very slight sore throat and can feel some tenderness in my groin area and under one arm. I have had bad headaches though which may be due to stress and I have not been eating Or drinking very well. So my questions are.
1i know u sometimes put women in 1/1000 and sometimes say 1/10,000 what would u say her odds were given her bio?
2 do my symptoms sound concerning even in the absence of fever?
3 would u recommend furthe testing or should I just move on with my life ( I am worried about another test due to possibility of false positive and I can no do a blood draw as I will faint)
4i was tested also for chly and ghon which both came negative at 4 weeks after and I don't think I have hsv because I have never had sores or anything other than a single pimple on my penis before (single bumP no pus when squeezed a white head cane out like a pimple then went away.
5 I have searched the Internet on lymPh nodes and do have some discomfort in one side of neck under one arm and inside of thigh but no noticeable nodes or lumps that I can see or feel.
Thank you for  your assessment doc!

[Edward W Hook, MD]

Stop obsessing- you do not have HIV and were not exposed!!!  Period.  Now, let me explain.

Your exposure was low risk.   Base on what you tell me of your partner, her characteristics are such that the chance of her having HIV is less than 1 in 10,000, at most.  Then, you had a single act of unprotected vaginal intercourse.  The risk of this, IF she was infected, is no more than 1 in 1,000 an probably less.  Thus, simply by the numbers, your mathematical risk of infection is 1 in 10 million, but that is not all, after all, you could be the one, right? Wrong!

Your partner was tested 4 weeks after your exposure and found to be negative.  She could not have infected you therefore.  Even if she had been in the window period prior to seroconversion at the time you had sex, her test would be positive 4 weeks later.  There is simply NO WAY that you could get HIV from the exposure you describe.  

Lymph node.  Please stop looking/worrying.  Detection of swollen glands is a medical "art form".  Clinicians train hard to detect subtle abnormalities and to try to detect them in yourself is fraught with error, both because you might miss them and, if they are present, interpretation of why they are present is difficult.  This is because "glands" are lymph nodes which can swell due to any of a large number of infections both viral and bacterial, as well as due to allergic reactions, due to autoimmune disorders and other problems.  For this reason we encourage clients who are concerned about swollen glands to check with their own health care providers rather than try to diagnose themselves and, if swollen lymph nodes are present, not to worry about them in relationship to HIV because they are such a non-specific problem.  

Finally, your symptoms- they are not due to HIV- your tests prove this.  If they are troubling you, you should see your doctor to get his/her help in sorting things out but do not worry about HIV, it is not a consideration based on what you've told me.

I hope my answers are calming.  You have no reason to worry about HIV from the experience you describe.  EWH

[Obsessing2011]

I forgot to add that I AM circumcised and the woman doesn't drink or do any sort Of drugs and is a single parent of a 15yo girl. The pain in my inner thighs and arm pit just started a few days ago. The sore throat was from about 6 days after til recently but I do not take meds of any kind and it felt more like a lump from anxiety. I have a burning in my neck that I believe is stress and imProper diet as I only eat a single sandwich or crackers a day because I'm soo worried. I did have bouts with bad nausea for about two weeks but that started right when we had sex and I got freaked out.

Thank you

[Obsessing2011]

Thank you for your reassurance. I thought that she could have been in the window period at the time we had sex as it takes 8 weeks to be conclusive and she was tested 4 weeks after our sex as was I right? Also the last comment about my symptoms not being due to HIV "based on what I have told you" does this mean they sound like primary infection even in the absence of fever and rash? I think guilt and anxiety are overwhelming me to the point of madness. Do you think I could continue unprotected sex with my wife without worry?
Thank you again Dr Hook

[Edward W Hook, MD]

Nope. If she had been in the window period, as I said, her 4 week test would have been positive.  

Sigh.  No your symptoms are not suggestive of HIV. Perhaps you should re-read my comment.  

Yes, you can have sex wsith your wife without concern.  You need to focus on measures to overcome your guilt and resulting anxiety.  EWH

[Obsessing2011]

So in summary of odds. Chance she had it. 1 In 10,000, chance it was transmitted via single vaginal 1 in 1000, chance her 4 week test AFTER me and her 95% and chance my 4 week test wouldn't pick up 95% that's .0001 X .001 X .05 X .05=my calculator doesn't go that high. I also know the odds of being the ONE person either of you have seen in 30 years become infected from a single vaginal exposure and also being the ONE first person in 7 years on  this forum that came back to be positive is factored in and it does seem kinda like it would be a ZERO chance. Am I correct or off in ky calculations?

Last question and I'm done as I don't want my thread deleted.
Thank you fOr everything Dr Hook!!

[Edward W Hook, MD]

You are correct.  EWH

[Obsessing2011]

I guess what I'm not understanding Dr is how there is no way I could've been infected when my partner tested 4 weeks, AFTER our 1 time unprotected , via standard AB test. I thought that IF she acquired the infection herself ( and was untruthful about her not being with anyone since august) in December then wouldn't that equate to 8 weeks she would need to be confirmed negative? Does the mechanics of that sound even plausible? Could you please explain that final thought for me.

Ps: please don't delete the thread as it DOES help to reread.
Thank you Dr Hook!

[Edward W Hook, MD]

the mechanics you suggest are not plausible and do not reflect the biology o f HIV infection.  Rather than continue to argue with you, I will provide a sinlge brief explanation which will be the end of this thread.  There will be no further answers.

In HIV infection, the presence of circulating virus, which is required for infection to occur, typically precedes detectable antibody production by periods of weeks.  If your partner had been HIV infected at the time of your exposure, virus would have to be circulating and would have elicited an antibody response well before 4 weeks folloiwing exposure had passed.   Thus, biologically you should be able to see that your guilt and anxiety-driven concerns which have lead you to assume your partner was not only infected but lied to you (both of which seem quite unlikely) simply do not match up with the facts.

This thread is now over.  EWH

[Obsessing2011]

Thank you. I do believe a light just came on for me.  You provide a great service to all of us who are WW!!

[micheal021]

Wait dr hook has neve seen hiv from a single unprotected vaginal sex.......

[Obsessing2011]

I wanted to follow up with you as I have done another test at 5 weeks as well as the woman I cheated with had another test too. We had these done at 5 weeks AFTER our one time vaginal brief exposure and they both came negative. I am in the 7th week now and still having bad headaches and neck pain. My wife is now having some minor fatigue but does not know about my affair so I hope it's just work stress on her. I can't helP but feel as if the brief one time encounter with the coworker has infected me and she didn't test positive 5 weeks AFTER. I know that sounds crazy but why am I still having all these symptoms and feel doomed to have hurt my family. I know u said that she would've tested positive by 4 weeks after but we have now had 4 tests each all AB and all clearly negative up to 5 weeks out  has a metior hit me? What are the odds??? Please help me one last time.

[Edward W Hook, MD]

The odds are essentially zero.  Your psueonym says it all- you are obsessing.  Look for another reason for your symptoms and assume that whatever symptoms you are having are being amplified by your guilt over this exposure.  EWH