Am I infected ? Please I need your help .

[sindbad]

Hello and thank you  for your time in answering my question. It is greatly appreciated.

I'm male, 30 year old, medical student. I was with a man of unknown HIV status on December 1st, 2006, it was my first time with a man. Actually, it was my first sex experience at all. He was inside me about 10-20 seconds unprotected, there was no ejaculation. Then he gave me oral and we kissed. After about 2 days i experienced a pain in my left chest wall under my arm '' 6th - 7th intercostal space'',at first I thought it was because he hugged me so tight, i kept checking for any lymph nodes so many times every day, but there was not any palpable lymph nodes.
After about 15 days i had another sex experience with another man, we kissed long time before he penetrated me unprotected for about 20 seconds, there was no ejaculation. Then, he gave me oral and we kissed again.
I kept searching for any lymph nodes every day, until 2 weeks ago i felt 2 left axillary lymph nodes, about 1 cm each, mobile, non tender, and soft .
4 days ago i found another one, a right supra-clavicular lymph node, it was soft, mobile, non-tender.
Since the first day i had sex with the first man, I have not experienced any other symptoms.
I'm experiencing acute anxiety over this experience, I certainly am overwhelmed with guilt, which in turn is manifesting as a vicious circle of fear, obsession, and the flashing images in my head that my test result would be positive.  

My questions are :-
1- Could the cause of these palpable lymph nodes be HIV infection ?
2- What is the possibility of being HIV + because of these 2 experiences ?
3- Is there any other possible cause than HIV ?

Thank you ,and sorry for my bad english !!!
Sindbad
Jan 14, 2007

[H. Hunter Handsfield, M.D.]

You don't say what sort of sex you had, but "inside me" and "penetrated" suggests you had receptive anal sex.  That is the highest risk activity for HIV. But even with receptive anal sex with a known positive person, the chance of transmission is no more than 1 in 200--and probably lower in this case, because there was no ejaculation.

1) A few small lymph nodes does not suggest HIV.  Lymphadenopathy with acute HIV infection is more prominent; involves most node-bearing areas, not just a few; and almost always is associated with prominent fever.

2) Less than 1 in 200, probably much lower.

3) Having a few small palpable lymph nodes is not necessarily abnormal at all.  If you have lymphadenopathy, there are innumerable possible causes; I cannot begin to speculate about whether you have anything abnormal at all, or the cause.

Because you are so anxious, you should be HIV tested.  You can expect a negative result, which probably will be more reassuring than any advice I can give.  My other advice is that you should never again have sex with another man without asking him about his HIV status.  Of course some people will lie, but most will not, but you will markedly improve your sexual safety by avoiding sex with anyone who says he is positive or does not know.

Good luck--  HHH, MD

[sindbad]

Thank you so much for your advice, i feel much better now.

[Brian123]

Curious....(out of educational purposes)

How significant is the difference between ejaculation and non-ejaculation for the probability of HIV infection? (based on this scenario)

Assuming that this person has to wait approx. 6 weeks to get a baseline, then again at 3 months (based on this situation) for ascertaining a definitive result (since it is considered a high-risk scenario), should a 6 week test (if negative), give comfort to this person due to the lack of ejaculation?

Do you see these situations a lot at your clinic?

B.