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Student Worries
Hi Doctor,
I was in Brazil last month and had sex with 4 prostitutes on May 12,14 and 24.
I used protection all of those time, and after removing, checked for any tears too, and found none, no slippage as well.
1 week after sex, I had this weird tingling sensation in my throat and acid re fluxes starting from June 1.
I immediately saw a doctor who said its just an infection and gave me Hexamedine oral spray. Did not make a lot of difference.
I got tested on June 3 (7 days after the last sex encounter and 18 days the first sex encounter).
All that exists in STD, from gonoreha to HIV 1/2, and used the 4th gen test methods. Everything was negative.
I was not satisfied with my throat condition, so I saw another doctor (General Physician), he noticed white discoloration of my tongue and said it was tonsillitis, and said I was not drinking enough water, which was true at that moment.
I am a 27 yr old man, now I am not sure whether there are tonsil issues at my age. He did another test on June 10, for fungal infection in blood and that too was negative.
As of now that white tongue issue still exists, with little swelling exactly under the ears, no pain, no fever, no flu and no other gland swollen, just dry throat and tongue.
I am not sure whether, this is a cause of worry for me, I did had oral sex, licked the Vagina, but the girls looked clean.
My question is should i be worried about my throat issue, or its just another normal/regular infection, because the timing of the infection seems to be off and I am worried that this might be oral thrush or something like that.
Also I wanted to ask how accurate these results are for STDs between when I had sex (May 24) and got tested (June 3).
Please advise.
I was in Brazil last month and had sex with 4 prostitutes on May 12,14 and 24.
I used protection all of those time, and after removing, checked for any tears too, and found none, no slippage as well.
1 week after sex, I had this weird tingling sensation in my throat and acid re fluxes starting from June 1.
I immediately saw a doctor who said its just an infection and gave me Hexamedine oral spray. Did not make a lot of difference.
I got tested on June 3 (7 days after the last sex encounter and 18 days the first sex encounter).
All that exists in STD, from gonoreha to HIV 1/2, and used the 4th gen test methods. Everything was negative.
I was not satisfied with my throat condition, so I saw another doctor (General Physician), he noticed white discoloration of my tongue and said it was tonsillitis, and said I was not drinking enough water, which was true at that moment.
I am a 27 yr old man, now I am not sure whether there are tonsil issues at my age. He did another test on June 10, for fungal infection in blood and that too was negative.
As of now that white tongue issue still exists, with little swelling exactly under the ears, no pain, no fever, no flu and no other gland swollen, just dry throat and tongue.
I am not sure whether, this is a cause of worry for me, I did had oral sex, licked the Vagina, but the girls looked clean.
My question is should i be worried about my throat issue, or its just another normal/regular infection, because the timing of the infection seems to be off and I am worried that this might be oral thrush or something like that.
Also I wanted to ask how accurate these results are for STDs between when I had sex (May 24) and got tested (June 3).
Please advise.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
You really needn't worry at all about HIV. First, the statistical odds any of your Brazilian partners had HIV is low; heterosexual HIV transmission is more common in Brazil than in North America, but still the large majority of female sex workers in that country don't have HIV. Second, you used condoms, which didn't fail.
Third, your symptoms are meaningless in regard to. They aren't typical for HIV (or for any STD) -- almost certainly your doctor was right, just a minor viral infection. (Viruses don't respond to any treatment -- they just have to clear up on their own -- which is why the oral spray didn't help.) White tongue can accompany just about any minor viral infection, allergy, etc. And neither HIV nor any other STD causes acid reflux symptoms.
And then we have your test results. The negtaive gonorrhea and chlamydia tests are conclusive. The negative 4th generation HIV blood tests also are very reassuring; they clear you from HIV infection during the first of your 4 exposures, and the June 10 result is probably 70-80% reliable for the most recent event.
My advice is to sit tight and not worry about HIV; it is exceedingly unlikely. To be maximally safe, have another 4th generation blood test when 4 weeks have passed since the last exposure. You definitely can expect it to remain negative.
I hope this has helped. Best wishes-- HHH, MD
You really needn't worry at all about HIV. First, the statistical odds any of your Brazilian partners had HIV is low; heterosexual HIV transmission is more common in Brazil than in North America, but still the large majority of female sex workers in that country don't have HIV. Second, you used condoms, which didn't fail.
Third, your symptoms are meaningless in regard to. They aren't typical for HIV (or for any STD) -- almost certainly your doctor was right, just a minor viral infection. (Viruses don't respond to any treatment -- they just have to clear up on their own -- which is why the oral spray didn't help.) White tongue can accompany just about any minor viral infection, allergy, etc. And neither HIV nor any other STD causes acid reflux symptoms.
And then we have your test results. The negtaive gonorrhea and chlamydia tests are conclusive. The negative 4th generation HIV blood tests also are very reassuring; they clear you from HIV infection during the first of your 4 exposures, and the June 10 result is probably 70-80% reliable for the most recent event.
My advice is to sit tight and not worry about HIV; it is exceedingly unlikely. To be maximally safe, have another 4th generation blood test when 4 weeks have passed since the last exposure. You definitely can expect it to remain negative.
I hope this has helped. Best wishes-- HHH, MD
A related discussion, Freaking out... was started.
I got it in Indianapolis, but any major hospital/clinic/lab should offer it. You font need to get a doctor's prescription for it, just take an appointment and walk, the cost depends on your health insurance, mine was covered by that.
Hey AG 188, can I ask you where you received your 4th generation HIV test and how much it cost you? I am interested in getting one when my 4 week window opens up. I had an encounter that I wish to obtain piece of mind for.
I visited the doctor today for the throat issue and the swollen lump, infront of my right ear, he confirmed it was a swollen lymph node, he assured me it wasn't related but when I told him about the 4 prostitutes and me licking their vagina, he was concerned, he said that its rare but its not like that it can never happen. I got a panic attack right then. But he told me that symptom like swollen nodes take years, at least 6 months to appear and there should be other signs too such as mouth sores, rashes, fever and cold(I do have a slight flu/cold that he admitted), but nothing else.
He was saying that its probably allergy but his facial expression were clearly stressed and concerned, I could see that he was himself very suspicious. Now when I asked him to check rest of my nodes, he went through the entire neck, everything else (Other lymph nodes) were normal. After that when he saw that I was very worked up, he gave me an injection of Steroid to bring down the allergy, so that I don't feel stressed anymore.
I requested a full STD panel, he took all the samples and told that at 4 weeks (May 25 - June 24) the results are 90% conclusive, but suggested another test after 6 months.
Question: What could cause isolated swollen lymph node with sore throat and slight cold, no fever, no body ache, no rash? Do I need to worry?
Problem: I am an indian by ethnicity and came to US just last year, my immune system considering indian standards is very good, I never had any allergies in life, certainly not a one with one swollen lymph node. And I would forget all that, just that timing is so off. Its just keeping me from sleeping in night.
He was saying that its probably allergy but his facial expression were clearly stressed and concerned, I could see that he was himself very suspicious. Now when I asked him to check rest of my nodes, he went through the entire neck, everything else (Other lymph nodes) were normal. After that when he saw that I was very worked up, he gave me an injection of Steroid to bring down the allergy, so that I don't feel stressed anymore.
I requested a full STD panel, he took all the samples and told that at 4 weeks (May 25 - June 24) the results are 90% conclusive, but suggested another test after 6 months.
Question: What could cause isolated swollen lymph node with sore throat and slight cold, no fever, no body ache, no rash? Do I need to worry?
Problem: I am an indian by ethnicity and came to US just last year, my immune system considering indian standards is very good, I never had any allergies in life, certainly not a one with one swollen lymph node. And I would forget all that, just that timing is so off. Its just keeping me from sleeping in night.
Once again your reply is very assuring, thank you for being very prompt in replying too.
You last statement suggestion was just what I needed.
You last statement suggestion was just what I needed.
MEDICAL PROFESSIONAL
These details do not change my opinion or advice. HIV never causes one or two scattered enlarged lymph nodes. That the tonsils are lymphoid tissue is irrelevant; the tonsils are involved in virtually any viral infection of the throat.
I'll bet not one person in the past 10 years in all of North America had exposures like yours, plus symptoms like yours, and turned out to have caught HIV. And in the 10+ years of this forum, nobody has actually been found to have caught HIV after a heterosexual exposure they were worried about. You aren't going to be the first.
Odds of HIV from oral to penile exposure? If the oral partner has HIV, the standard estimate is one infection for every 20,000 exposures. That's equivalent to receiving oral sex by infected partners once daily for 55 years before transmission might be likely.
H. pylori is the bacteria that causes many cases of peptic ulcer and some cases of acid reflux.
Your oral/throat symptoms are trivial issues, not at all likely to be due to anything serious and certainly not HIV. This simply doesn't happen! You cannot read lists of HIV symptoms and draw conclusions because you have one or two of them. It isn't the individual symptoms that suggest HIV, but the pattern and combination of symptoms. And you don't have any of the suggestive patterns or combinations.
Your negative 7 day 4th generation test is meaningless; it would pick up less than 10% of infections by that time. But that doesn't mean you have any significant chance of having HIV.
My advice remains that you trust the science, and the reasoned reassurance I have tried to give you; and that you stop searching the internet, since like many anxious persons you are being drawn selectively to information that inflames your somewhat irrational fears. Go to the mirror, look yourself in the eye, say (out loud) "You don't have HIV" ten times. Then fix yourself a martini, put your feet up, and relax in the security that I know what I'm talking about.
I'll bet not one person in the past 10 years in all of North America had exposures like yours, plus symptoms like yours, and turned out to have caught HIV. And in the 10+ years of this forum, nobody has actually been found to have caught HIV after a heterosexual exposure they were worried about. You aren't going to be the first.
Odds of HIV from oral to penile exposure? If the oral partner has HIV, the standard estimate is one infection for every 20,000 exposures. That's equivalent to receiving oral sex by infected partners once daily for 55 years before transmission might be likely.
H. pylori is the bacteria that causes many cases of peptic ulcer and some cases of acid reflux.
Your oral/throat symptoms are trivial issues, not at all likely to be due to anything serious and certainly not HIV. This simply doesn't happen! You cannot read lists of HIV symptoms and draw conclusions because you have one or two of them. It isn't the individual symptoms that suggest HIV, but the pattern and combination of symptoms. And you don't have any of the suggestive patterns or combinations.
Your negative 7 day 4th generation test is meaningless; it would pick up less than 10% of infections by that time. But that doesn't mean you have any significant chance of having HIV.
My advice remains that you trust the science, and the reasoned reassurance I have tried to give you; and that you stop searching the internet, since like many anxious persons you are being drawn selectively to information that inflames your somewhat irrational fears. Go to the mirror, look yourself in the eye, say (out loud) "You don't have HIV" ten times. Then fix yourself a martini, put your feet up, and relax in the security that I know what I'm talking about.
Thank you Dr. Hunter, I really appreciate the effort and time you have put in this forum.
Your reply really helps me gain some confidence, I was not able to sleep properly because of worrying and reading too many internet articles.
I think I was not able to write coherently to explain the dates and test types:
Sex Encounters:
May 12, 13 and 25, 2014
Throat Issues Started:
June 1, 2014
HIV (4th gen DUO) and Other tests:
June 3, 2014
Throat issue Persists and 2nd doctor consulted:
June 10, 2014
Second test, which was done on June 10th was not a STD panel test at all. It was a CBC and H Phlori Antibody tests(Not sure what this is!).
Is the percentage accuracy of HIV 1/2 4TH GEN W/RF test 70-80%, 7 days after sexual encounter?
Also as you recommended I will schedule an appointment for another test on June 24 (4 weeks over), considering what you said about the risk with heterosexual partners in Brazil, I am still little worried.
I am just worried because the tonsils are also lymph nodes, and I think the swollen lump I feel under the ears are also lymph nodes, they are keeping me worried. Second thing that worries me is oral sex. Can you please comment on odds of oral exposure.
I will keep you posted of the results(I hope you wont mind) and the tongue/throat issue(Will do a follow up with the doctor on this).
Your reply really helps me gain some confidence, I was not able to sleep properly because of worrying and reading too many internet articles.
I think I was not able to write coherently to explain the dates and test types:
Sex Encounters:
May 12, 13 and 25, 2014
Throat Issues Started:
June 1, 2014
HIV (4th gen DUO) and Other tests:
June 3, 2014
Throat issue Persists and 2nd doctor consulted:
June 10, 2014
Second test, which was done on June 10th was not a STD panel test at all. It was a CBC and H Phlori Antibody tests(Not sure what this is!).
Is the percentage accuracy of HIV 1/2 4TH GEN W/RF test 70-80%, 7 days after sexual encounter?
Also as you recommended I will schedule an appointment for another test on June 24 (4 weeks over), considering what you said about the risk with heterosexual partners in Brazil, I am still little worried.
I am just worried because the tonsils are also lymph nodes, and I think the swollen lump I feel under the ears are also lymph nodes, they are keeping me worried. Second thing that worries me is oral sex. Can you please comment on odds of oral exposure.
I will keep you posted of the results(I hope you wont mind) and the tongue/throat issue(Will do a follow up with the doctor on this).
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