Possible symptoms, or overwhelming guilt

[nobeno]

Hi doc,

I saw a Korean SW here in Los Angeles at one of the local parlors. She gave me oral sex with condom, she climbed on top of me and as I entered her I ejaculated into the condom, we continued for about 10 seconds. Prior to, we had a little foreplay, during which I bit one of her nipples softly, she moved at the wrong moment and I guess I scratched her with my teeth. I didn't see or taste any blood or anything. But she acted like it hurt quite a bit

In the days and weeks after I continued to have normal sex with my girlfriend, unprotected. About 2 weeks after She developed small painful cuts in her vagina akin to herpes or a yeast infection we were told. As well as swollen lymph nodes and what looked like herpes on the side of her mouth which has all cleared up at this point as a result of herpes and yeast infection medication.

About 3 weeks after the incident I saw my doctor for a full physical and ordered a full blood work-up, HSV, HIV, etc... All came back negative. Doc said I was in good health. Although my white blood cell count was a little high. But she said it looked fine.

It's now a week or so later and my girlfriend and I have both gotten sick with symptoms that I've read as early signs of HIV.

It's been going on for about 4 to 5 days.

The first night I got a slight fever, over the last 4 days I've consistently had a cold, congested sinus, sore throat, 3 little sores on the inside of my lips (2 on my top lip, 1 below), upset stomach, diarrhea, muscles soreness, fatigue.

I've also developed a rash under my right armpit and in the crease on the back of my head...? The one on the back of my head was itchy, the one under my armpit not. Both red and solid sort of like heat rash. I applied a cream a dermatologist gave me awhile back for eczema and there improving.

I feel immense paranoia and guilt, and have quite a bit of stress currently so I don't know if that might factor in...

Thanks in advance.

[nobeno]

Thanks Dr. Hook, it's a relief to hear that. I guess with the timing and overwhelming amount of symptoms all at the same time it just had me over thinking the situation.

Thanks again.

[Edward W Hook, MD]

This is most likely a manifestation of your guilt over this exposure rather than HIV.  Here is why I say this:

1.  Your encounter was safe.  You used a condom for all sex and condoms work.  There is no risk from you having bitten her nipple.
2.  Even if she was infected, and if you had not used a condom, your risk from a single episode of vaginal sex is less than 1 in 1000 exposures and even lower for receipt of oral sex.
3.  The symptoms of early HIV infection, sometimes referred to as the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  In addition, it is also important to realize that many persons who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

You have not risk.  You do not have HIV.  Given the zero risk nature of your experience, youo do not need further testing.  I hope you and your GF feel better soon - it is not HIV or any other STD  that is making you ill.   EWH