concerned about risk and symptoms

[janneman]

Dear Dr.,

During my last stay in Thailand I had sex with a prostitute. Before putting on the condom I rubbed my penis against her vagina and vaginal fluids were on my penis. We had safe. Then I fingered here vagina (quit a while) and her anus (very short, only tip of finger). Then jerked my self a little to get my penis hard again, put on another condom and had sex again for a short period.

The other day I noticed a little (round) wound (aprox. 1 mm) on the finger (first notch) that was inserted. There was a little crust (dry blood of myself) in it.

Symptoms;

Week 1: none
Week 2: no symptoms, I had one or two day high fever, maybe this week, maybe week 3
Week 3: I had one or two days fever, then few days was ok, then yellow/green snot, coughing and maybe slight temp. raise
Week 4 : yellow/green snot, coughing and maybe slight temp. raise
Week 5: feeling fatigue, less coughing, temp normal, got a little bit sore throat (swallow a lot) and a hairy (white) tongue
Week 6: same and maybe also lymph nodes irritated *
Week 7, same as week 6 plus two ulcers in mouth

* My cheek is a little bit thicker (also swollen on the inside of the mouth) and I have sort of stiffness below/behind my ear. It does not feel comfortable, but no knots. Starting week 3 or 4 I do have very light muscle pains (were the arms and legs start).

The first day of the 7th week (after six weeks) I had a rapid/quick -> negative. But I still am concerned.

Could you please answer the following questions for me;

- can you tell me something about the risk
- can the muscle pain (frequently short light pains) be related to acute hiv or could this indicate lymph problems
- what can you tell me about the probability my lymph nodes symptoms are related to acute hiv
- can you explain what underlying processes causus these symptoms and when in the timeline they usually appear

Generally I think I am interested in clues that this is not hiv.

Thank you for your answer,

[Edward W Hook, MD]

You can find any sort of information you want on the net.  No change in my advice.  You fears are groundless.  EWH

[janneman]

Thank you for your quick response.

I did read that symptoms are non-specific and that a test is 95% reliable after six weeks. But I am concerned about the risk associated with the little wound on my finger and want to assess the chance of belonging to the 5%. I read on the internet that a slow immune system could be the reason of late development of anti-bodies. I would like to know if the timing of the symptoms in relation to the negative test after six weeks could exclude or emphasize this possibility.

The reason I worry about this is that I had the flu 3 times earlier the past 12 months (not with lymph node, white tongue and ulcer symptoms by-the-way) and recovery to normal health state was about 3 to 4 weeks on each occasion (which is longer than years before).

Please advice,

Jan

[Edward W Hook, MD]

Your symptoms are not relevant.  At seven weeks, over 95% of tests that are going to be positive will be.  Your sex was safe sex, thus, at this time, you can be quite sure that you do not have HIV.

You may have missed our repeated statements that the symptoms of 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 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.

As for what is causing your symptoms, I cannot say, you need to deal with that with your regular health care provider.  There are simply too many possibilities to list.  EWH

[chilly willy]

You had condom protected sex .No need to worry . .Genital to genital is no risk . I would forget about it and move on . You dont need to test . You proably caught a cold or the flu ..