HIV - Prevention Expert Forum
Possible exposure to HIV
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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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Possible exposure to HIV

5 Weeks ago while in another country I engaged in unprotected vaginal and Oral sex with two different women on two separate nights (both women were from Europe). About 3 days later I started to experience a tingling/ burning sensation in my groin region and phlegm in my throat.. at 8 days I also started to feel a slight burn after urination along with the itchy burning sensation on my genitals and returned to Australia and went straight to the doctor. The doctor took a full STD test with urine and blood and the results came back negative for everything.

I've been to 3 different doctors taken courses of Zythromax, doxi and now am on Cipro for 10 days.

My symptoms started as an itchy burning sensation in my groin with an irritated throat and over the past 30+ days I have gotten other symptoms like soar throat (no swollen glands) soar testicles which I had an ultrasound on and came back all clear. Nausea and headaches which I got about 5 days ago straight after taking Cipro. I feel lathargic and run down.

Could this be HIV... How accurate would my symptoms be 8 days after exposure? Also how accurate would my results be at 5 weeks with the symptoms I currently have.

Any advice you can give me would be much appreciated.
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

Having scanned your personal profile and your long discussion on the herpes community forum, I see you're in Melbourne and that apparently at least one of the health professionals you have seen is at the Melbourne Sexual Health Centre.  Collectively, Australia's SHCs comprise, hands down, the world's very best network of STD/HIV clinics and prevention services.  And among them, the Melbourne and Sydney SHCs are the best of the best.

Presumably you have discussed your concerns about HIV with your doctors, whether at the SHC or elsewhere.  If you have, I'm confident they reassured you that individual heterosexual exposures rarely result in HIV transmission, even if the woman is infected; that your symptoms are not particularly suggestive of HIV; and that you can be tested to be sure.  Often a negative test result is a lot more reassuring than any advice based on statistics and epidemiology.  If you have not been tested, I suggest you return to the SHC and request it.

I'll be happy to comment further if you would like to say what advice and testing you have already had, especially from the SHC -- or if not yet tested, I'll comment if and when you do that.  You definitely can expect a negative result.

Best wishes--  HHH, MD
16 Comments
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Avatar_m_tn
Thanks for your quick and reassuring response Dr. I actually live in Brisbane but you weren't to far off. I went to the STD Clinic here after an in satisfied visit to my local GP. But on the grounds that I had already had a HIV test the day before at my local GP which would have been at around 8 days after my last exposure they said there's no point in taking another. That test and both my urine tests came back negative. I'm currently at 5 weeks to my last exposure and my symptoms and my mind are getting the better of me... I could go back to the clinic Monday and get another test and if it did come back negative do you think I could be happy with that result and move on with my life?
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239123_tn?1267651214
Sorry about the geographical error -- your profile says your from Melbourne.  I haven't been to the Brisbane SHC, but they're all good.

I suggest you just follow the SHC recommendations about which HIV test to have and when.  I believe the duo tests (for both HIV antibody and antigen) are the norm in most clinics in Australia.  They are 100% reliable any time 4 weeks or more after the last possible exposure.
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Avatar_m_tn
I went back to my GP today and asked him to take a test for everything via blood. I also advised him that I was talking to another Dr. who mentioned that at 4-6 weeks the duo test for antibody and antigen is 100% conclusive. He told me that he believes this is true and that in the medical field things are often overestimated to avoid any legal repercussions...  He also mentioned that his statement was between me and him. I couldn't imagine waiting the 3 months or worse 6 months to find out if you had contracted anything.... I get the results back in three days! Fingers crossed for myself.

I really appreciate what your doing with this forum! The internet is a very deceiving source of information. To have a medical expert like yourself who has specialized in an area that dew doctors know to much about dedicate his time to the general public is admirable.

I will post my results when I get them.

Thanks for all your work Dr.H
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239123_tn?1267651214
Feel free to post the test result; I'm sure it will be negative.  Thanks for the thanks.  Take care.
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Avatar_m_tn
Hello Doctor

One quick question. I get my results back tomorrow for my blood test. I asked the doctor to also test for herpes. In your opinion if someone has no lesions or outbreaks would you consider a 5 week negative result conclusive? I should tell you that I already know that I am HSV1 +. I've been getting cold sores on my lips my whole life.  
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Avatar_m_tn
6 week blood test results are in.

HIV: Negative
Syphilis: Negative
Herpes 1: Positive - Which I already knew
Herpes 2: Negative
Hep: Negative

Obviously I'm pretty happy with my results!

If you could answer my question about retesting for herpes at 3 months & the likelihood of that negative turning to positive in the next 6 weeks that would be much appreciated.

With my HIV being negative do you think it's worth testing at 3 months again or just put it to bed?

Thanks Dr H.

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Avatar_f_tn
Your tests came back quickly, thats good to hear.
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Avatar_m_tn
My test results did come back quickly Gulley. I ended going to my local GP who was very reassuring. Hope you found the clinic ok and I hope all is well.
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239123_tn?1267651214
The risk of HSV-2 from any single unprotected vaginal sex exposure is very low (one in several thousand events, probably), and it's virtually zero for oral sex.  In the absence of symptoms suggestive of herpes -- which you didn't have -- I would have not recommended testing for HSV at all.  But if you want a 100% reliable blood test, 6 weeks is too soon -- probably about 80% reliable -- and you'll need another HSV-2 test at 3-4 months.  In my view, there is virtually no chance it will turn positive.  (In fact, the chance of a FALSE positive result probably is higher than a true positive -- so you might want to quit while you're ahead!)

Your negative HIV duo test result at 6 weeks is 100% reliable.

That will end this thread.  Take care and stop worrying about this exposure.  If you have a regular partner, you should be resuming unprotected sex, if you have not already done so.
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Avatar_m_tn
done and dusted! Moving on with my life.

Thanks Doctor.
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Avatar_m_tn
Hello Dr.

I know I said I would move on. But I just wanted to run something by you.

This morning I woke up with Diarreah (diarrhea) and the for the whole day my genitals have been burning along with tip of my penis and anus.. My penis was wrinkly and red and tonight when I went to take a shower I have noticed about 6 red spots with yellow heads clustered along the base of my penis... I ignored the symptoms today but after tonight and these spots i'm not to sure.

These are the same symptoms I've been having all month but it's only just now I've noticed the bumps...

Is it possible I could be having an outbreak at six weeks?

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Avatar_m_tn
Went to see a urologist earlier in the week and he diagnosed me with acute prostatitus.

Just wanted to let you know you were right! and leave one final message of thanks!
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239123_tn?1267651214
You're welcome.  Take care.
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Avatar_m_tn
Hello Dr H.

I wanted to ask a prostatitus question if I can. If it's against rules to post an answer than that's ok.

My urologist diagnosed me with prostatitus and put me on a 14 day course of Doxy and Cipro. My symptoms got a lot better however I still have a red irritated penis and groin. The irritation lasts all day and is itchy sometimes...

The urologist seems to think that the irritation is caused by the prostatitus and is not a dermatology issue. I've read on the internet that fungal infections actually worsen when taking Cipro and Doxy. If I were your patient would you send to a dermatologist just to be sure.

I've had this for 10 weeks now and I really don't want to do another month of drugs only to be sent to a dermatologist to fix with some magic cream...

As I said earlier if you can't answer the question then that's ok. Your help so far has been more than enough.
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239123_tn?1267651214
Prostatitis isn't an STD, and it is clear you have no STD.  I'm glad to have helped so far, but I have no further comments or advice.  You don't need to start a new thread on this forum -- we only deal with STDs.  Good luck.
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