Scared and Worried

[sammy341]

Hello Doctor, on 6th of Feb I made a drunken mistake. I visited a Ladies Serice bar in India. The CSW sat on top of me (Lap dance position) and tried inserting my penis in from behind. I was very drunk and have no clue if she inserted it into her vagina/anus or it was just between the buttock chicks. I don't think I had full erection but not sure. I had two or three thrusts and pulled out. There was no fluid on my penis head which makes me worried if it was inserted in anus which is more high risk exposure. But when I explained it to my expert doctor in UK he said it is a very low risk exposure and said to have hiv duo test which will be conclusive. It was 34 day past exposure when I had my duo and the result was negative.
Later I got more worried reading on internet about 3months window period and I had HIV Insti test at 73 days and 86 days past exposure. My doctor said that duo was conclusive and Insti he will do is just for peace of my mind and Insti is conclusive at 10 weeks in parallel with Duo I had on 34 day. I had one more test at 86 days just to follow guidelines at 12 weeks and it was negative. I also tested for Chalymadia and Gonorrea and result were negative.
Also, I sometimes have a burning sensation while ejaculating and while passing urine do you think it might be a NSU ? I plan to take NSU test. I am worried though as if I have NSU I might have higher risk of HIV ?
Does it need large amount of fluid to transmit hiv ?
I don't have skin cover on my penis head hence sometime i notice a slight bruise on my penis head which is red. Could this put me on risk of exposure?Do you think I need to worry about HIV any more or do you think my tests are 100% conclusive ? I get more worried reading the forums where doc has asked someone to retest because they had highest risk exposure and had negative duo at 7 weeks but now after a year have oral thrush. I feel I might have same situation and get worried and panic even if I have slightest of issue with my health

[Edward W Hook, MD]

Welcome to our Forum. You've asked a number of questions. I'll try to address them.

let's start with whether or not you got HIV.  No, you did not. This is now proven.  Concerns about penetration or not are irrelevant when your test results are conclusive. You have conclusive results that you do not have HIV.  The DUO test at 34 days was conclusive, as were your additional test at 86 days.  There is absolutely no need for further testing or for concern related to the exposure you describe.

As for the possibility of NSU, here whether or not there was penetration is more relevant.  The occasional burning you experience are not typical of NSU as the discomfort of NSU typically does not come and go but it may be worth testing just to put the possibility behind you. My suspicion is that your test will be negative but only testing can be definitive.  

Your red spot/bruise does not put you at higher risk for STD.

I hope my comments are helpful.  Forget about HIV, you don't have it.  I doubt that you have NSU ether but testing will give you the answer you seek.  EWH

[Edward W Hook, MD]

This will be the last answer.

1.  There are many things which can be felt in the neck.  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.  When a person has swollen lymph nodes, the chance that they are due to HIV can be measured as a fraction of 1%.  Many things clients think are swollen lymph nodes are totally normal.

2.  Correct

This thread is now over.  EWH

[sammy341]

Thank you once again for your reply. This has helped me a lot and I slept well for last two night. Only concern that I had this morning was while reading a book lying on the bed this time I touched below my new and I could feel something which I think was a lymph node.

1. Is it normal to feel lymph node below the neck even if it is not swollen?

2. My doctor says that ARS never happens after 12 weeks. Is that right ?

Apologies for being so pessimistic.

[Edward W Hook, MD]

1.  Yes, these tests would have covered all subtypes.  The concerns about missing subtypes from one place or another are out of date and no longer applicable.

2.  If you develop sympotms in the future, they will not be due to HIV from the exposure you described.  Remember, STD symptoms are very non-specific and when person have symptoms "typical of early HIV" less than 1% turn out to be due to HIV, the remainder being due to the sorts of every day viral illnesses that peole geet all the time in the course of normal, day-to-day activities.  

My advice is to put your concerns about HIV behind you.  You did not get HIV. Take care. EWH

[sammy341]

Thank you doctor. Your response did reassure me. Just a two doubts I would like to clear.

1. The HIV Duo and Rapid Insti test I had would it have tested for HIV subtypes ? As the exposure I had was in India and there is a South Asian Subtype I heard about.

2. I fear that I might get symptoms later and my doctor might ask me to take a test again. Do you think that could be possible in my case? Have u seen any one with negative duo after 4 weeks and negative Rapid Insti test after 12 weeks gone on to become positive with the same incident?