Seroconversion and testing

[worriedtourist]

I made a major drunken screw up recently in Thailand with a CSW. I had unprotected vaginal sex with a woman. A few days later I noticed a tingling sensation in my testicles and a flat,small, painless bruise (brownish) like mark on my wrist (the circumfrence of a pen cap). No pain when urinating or blisters but an occasional stinging sensation in the penis. About 4 1/2 weeks later I started noticing a slight fever (if any) but not to sure as I work in the hot desert and it could have just been the heat. I have also occassionaly experienced muscle and joint pains in combination with slightly swollen lymph nodes in the neck.

I took an ELISA test at 5 weeks (give or take a day) and it read negative. I couldn't wait for the 6-8 weeks! Do you think the 5 week test is probably a good sign? I plan on testing again at 6 weeks and 3 months. Does anyone have any idea what the occassional stinging sensation in my penis or tingling testicle pains might be? I noticed recently that there are small tears or maybe ulcers around the penis head but they come and go. They have been accompanied with some dry skin on the penis head as well. Today I noticed one ulcer bleeding a tiny bit, but there is no pain, just occasional pain in the general area. Do you think the small brown spot on my wrist might be KS, even showing up a few days after the exposure?

I'm really worried about this screw up and hope the 5 week negative is showing me some light at the end of the tunnel. Please help!!!

[H. Hunter Handsfield, M.D.]

Herpes lesions can occur anywhere on the penis.  It could cause muscle/joint pains, but probably not.  You need to see a health provider immediately.  If "as soon as I can" means more than a couple of days, it will make it very hard to properly diagnose your penile lesions.

[worriedtourist]

One more thing I forgot to mention, the muscle/joint pains have seemed to intensify, would this be a symptom of herpes?

[worriedtourist]

Thanks for the advice doc! The "ulcers" (or small tears) appear around the penis head, under the edge where the head meets the shaft. Does herpes usually show up there? I will see a doctor as soon as I can.

[H. Hunter Handsfield, M.D.]

Your 5 week negative test result is virtually 100% proof you didn't catch HIV.  Your symptoms don't suggest HIV, and Kaposi's sarcoma is a sign of late/advanced AIDS, not ARS.  The odds of catching HIV from a single exposure like you describe are extremely low anyway.  Genital tingling of the sort you describe does not suggest HIV or any STD; the most common cause of such symptoms probably is genitally focused anxiety.  As to your penile dry skin, I would think nothing of it--but I'm concerned by your mention of an 'ulcer' (on your penis?).  That raises the possibility of herpes.

Bottom line:  See a health care provider if you remain concerned about your symptoms, and especially see a provider if you have a genital ulcer.  You can have another HIV test if you want, 6 weeks or later; the 5 week test is almost 100% reliable, but a 6 week case will nail it down for sure.  So just relax about HIV; no chance.

Good luck-- HHH, MD