Can I stop testing and be confident?

Hi Doc HHH,


     8 weeks ago, I made the stupid decision to have sex with a prostitute.  We had brief protected sex and I took a quick look at the condom after, which appeared intact, but the lights were dim.
     Since then I have had a number of different symptoms, the most recent group having begun around 30 days after I had sex. These included crampy / upset stomach and loss of appetite that came and went, loose stool, moderate muscle aches / pains starting in my arms and moving somewhat into my back and shoulders, some joint pain primarily in my right nuckles, wrist, a little in my right wrist, and a little in my knees, several small lymph nodes in my groin and neck that a Doctor found, fatigue, malaise, ocassional feeling like a small bump when I swallow on right side of throat (I had a sore throat a few weeks earlier, but it went away), a temperature usually around normal but occasionally reached up to 99.4 for half-a-day, a few moderate night sweats (never with temperature when going to bed or waking up), and quite a bit of itchyness all over my body.  I usually have breakout on my chest and upper back - it seems like I might have had more than usual.  Of course i have been extremely anxious.
     I have been tested at a clinic with the oral fluid OraQuick Advance, at 42 days and at 51 days after we had sex, both negative.  Usually you say that people in my situation don't need to worry, but given my group of strange symptoms, the high incidence of HIV in New York City, and the fact that I have HSV-2 (but no sores), i wanted to ask:

[H. Hunter Handsfield, M.D.]

This reply follows the additional information below.  Please use the search link to read the innumerable times I have said that symptoms NEVER are a reliable indicator of new HIV infection and that test results always outweigh symptoms.  Your test results prove you were not infected with HIV, and that's all that matters.  That is, ince you aren't infected, it doesn't matter what the risk was or what symptoms you had.

1) Risk of HIV:  Zero for practical purposes.  Condom-protected sex is always low risk, and most CSWs don't have HIV anyway. HSV-2 increases the risk, but when the risk is practically zero anyway, it makes no difference.

2) Testing at 7+ weeks is definitive in cases like yours.  You don't need further testing.

3) Every single symptom (and combination of symptoms) you can find listed as being caused by HIV are causedbb by innumerable other conditions, all of which are more common than HIV.  That's why your symptoms are meaningless as a possible indicator of HIV infection.

You don't have it.  Move on.   Good luck--  HHH, MD

[JohnDoeGo]

sorry, I'm on a mobile device and entry got screwed up.  My questions are:

1)  what is my risk of HIV?  Can I be esentially 100% confident I don't have it, even given all these symptoms, or not yet?
2)  would you recommend that I test again?
3)  does the fact that I still had symtoms (symptoms) for 3 days or so after the last test draw into question its accuracy (antibodies not built up yet)?  The last 51 day test was about 3 weeks after some of these symptoms started.

I really appreciate your help.

[JohnDoeGo]

sorry, this post is a mess, the symptoms I described have lasted about 3.5 weeks, and transitioned between different things - first stomach, then aches but little stomach discomfort, then some more stomach discomfort again.

[JohnDoeGo]

That's a big relief.  Just to clarify, what I meant by question 3 was, I've seen some cases of data collected by hospitals, where they indicate that while the patient is experiencing ARS symptoms, antibody tests are often still negative (but it shows up on PCR, etc).  So I was asking whether the fact that my symptoms continued for a few days after the last test draws into question its accuracy.  On the other hand, though, my symptoms had been around for about 3 weeks before the 51 day test.  

Also, side note, im 22 so joint pain cant come from Arthritis or anything, right?

[H. Hunter Handsfield, M.D.]

Time since exposure determines whether or not an antibody test is positive, not timing in regard to symptoms.

I have no comment or opinion on this forum about possible causes of symptoms other than HIV.  Some kinds of arthritis can occur in young people, but arthritis is unlikely if you don't have swelling, redness or tenderness of your joints.  But of course see a health care provider if you are concerned.

[JohnDoeGo]

I do have some redness on my knuckles, etc., but i assume this doesnt change your opinion about HIV?  I won't post anything else, i cant thank you enough for the help.

[worried_sick94]

One odd thing. The more you look at the boards and see all these stories related to inviduals who had little or no risk, and have had extensive testing beyonfd the window period, they all complain of one thing. Muscle aches/joint pains...coincidence?not sure, but very odd

[H. Hunter Handsfield, M.D.]

I already told you that symptoms make no difference in judging whether someone has an HIV infecton.  What did you not understand about "NEVER" in all caps?  Therefore, knuckle redness makes no difference in my opinion.

The frequency of such symptoms in anxiety-provoked questions on this forum is not odd at all.  Such body aching is one of the most common of all human symptoms due to innumerable conditions, including stress, anxiety, etc.

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