Coincidence? Very scared

[worried93]

I would like to preface my questions by saying that this is a great forum and I have truly learned a great deal just by browsing for a few days.  

2 weeks ago I went to a sex club in Frankfurt Germany.  (It was professionally run, large and popular although this probably doesn't matter)  I had unprotected oral and protected vaginal sex w/2 different girls.  

I did not ejaculate inside of either girl. (mouth or vagina)  The first time was on the girls chest, the second time inside of the condom.  As far as I know, the condoms stayed intact during both sessions.  There may have been slight slippage during the first encounter but afaik the urethra was always covered.

I had a fresh blister from golfing 2 days previous on my left middle finger.  While there was no blood coming from it, now that I think back on the incident maybe this could be a factor?  I did not touch the vagina of either girl with my hands but I might have touched the used condom with that finger.  I am unsure.

I understand that these instances put me at a very low risk and I generally would not have been worried.  However, 7 days after the possible exposure I began experiences A WIDE VARIETY of symptoms that I have read have a connection with possible HIV.  I was experiencing the following: fever, headache, dry cough, shortness of breath, swollen lymph nodes in the neck area, and fatigue.

These symptoms lasted approximately 4-5 days and have now subsided for the most part.  I have read through a ton of threads and I understand that symptoms are never a clear cut indicator.  However, I am very scared as my symptoms are EXACTLY what many doctors describe from the research I have done.  I've also read that generally the symptoms go away after about a week, which is again, EXACTLY what has happened in my situation.  Is this just some freak coincidence?

[Edward W Hook, MD]

Your risk is low.  Your number of exposures was low, you used a condom and you do not know that the women you had sex with were HIV infected (in fact, it is most likely they were not).  It is important to appreciate that the symptoms described for acute HIV infection are also caused by many other viruses which are far more common than HIV.   Thus most peole who have these sorts of complaints DO NOT have HIV.  I'm glad to hear that your symptoms have gone away and that you are feeling better.  I would suggest you get an HIV test (just once) at about eight weeks after your exposures.  If it is negative, you have almost nothing else to worry abobut from that exposure.

Good Luck EWH

[jenkinjimmy]

Dude, you used condoms that according to you did not break. The symptoms you describe can be caused by a number of different conditions other than HIV, which is why, as you said, symptoms are never a good indication of HIV.

Also, the risk from oral is zero. Ejaculation or not, doesn't matter regardless of oral or vaginal.

If you're really nervous, get a test after 6-8 weeks. I'm sure that you'll be negative.

[worried93]

Well, I guess I can honestly say that your comments haven't calmed my fears (I know thats not your job)

I'm very scared because my symptoms are exactly what is described for acute HIV infection and they happened in the exact time frame after my possible exposure.  Its all just very very scary and seems like a really bad dream.  

Now I'm freaking out and thinking that maybe the condom broke and I wasn't aware of it.  I hope and pray that it is some freak coincidence....just seems like I defied the odds and got unlucky.

Would it be any use if I was tested 2 weeks after possible exposure, or would that be a total waste?  This is really driving me insane.

[ExtremeStress]

WASTE!

[worried93]

So should I not be having unprotected sex w/my girlfriend until after the test?

I am very worried.  The doctor tells other people on the forum who have had unprotected sex with a prostitute that they don't even need to be tested.  Yet I have protected sex and he tells me I should be tested and doesn't even say that he believes it will be negative.

You cannot say that these symptoms don't mean anything as obviously they have even influenced the Dr.'s opinion.

[joggen]

I think the doctor suggested a test based on the level of anxiety in your post, NOT based on risk and especially not based on your symptoms. You could get the same symptoms from visiting a day care center. Non-HIV viruses that are much more easily transmittable (e.g. respiratory viruses) are undoubtedly spread between sex workers and clients (strippers and clients, airline passengers, etc.) and cause the same symptoms. Also, when condom's break they tend to rupture noticeably. And as Dr. Bob of The Body has said, HIV cannot permeate intact latex, no way no how.

Another way to look at the situation is to estimate your risk numerically. Chance a sex worker in Germany has HIV, 1:100 (Europe has low HIV prevalence). Chance of infection from a single epidose of vaginal sex (if partner is infected), 1:2000. Risk reduction from condom, 1:10 (and that is a conservative estimate and includes occasional breakage). So, 2 x 1/100 x 1/2000 x 1/10 = 1/1,000,000 (1 in a million). The #'s used are from previous responses from Dr. HHH but you can corroborate from other sources if you are skeptical.

However, the only way to prove to yourself you don't have HIV is to get a negative result from a test. In the meantime, forget about your symptoms as an HIV indicator

[worried93]

Well,

I would appreciate it if the doctor replied to my previous post.

I don't know what to do.  Unless it is some miracle coincidence that I get the exact symptoms in the exact time frame (now have sore joints as well to go along with my other 999999 symptoms although they have gotten slightly better) it really appears as if I  am the unlucky one and have contracted HIV.

I am upset at myself , as I should not even have had sex with a condom I suppose.  I'm just going to assume at this point that the condom broke because every time I read anything about acute HIV infection it describes my SITUATION EXACTLY 100%!  

So terrified.

[worried93]

Dr.,

Could you please reply to my previous 2 posts?  I am having a breakdown and I would appreciate it very much....thanks in advance.

[monkeyflower]

You're comparing answers from two different doctors. They're both saying essentially the same thing, but they have very different communication styles. Dr. Handsfield tends to be much more direct. I think you're getting hung up on Dr. Hook's more conservative-sounding tone. So for what it's worth, while I'm not a doctor I can assure you that you weren't at any risk--getting a blowjob is really no risk, and condom-protected intercourse is no risk.

If you're having a breakdown over this, get help. Talk to your doctor about meds for your anxiety, and seek counseling.

[vrider]

first of all shortness of breath and dry cough are not syptoms (symptoms).

I have experienced even a wider variety of symptoms...

Fever, rash, malaise, fatique, diarrhea, weakness. These were experienced 35 days after exposure. I wasn't even really paying attention or really anxious at the time. For you you are stressed out, and were really thinking about it at the time. My symptoms lasted for 10 days.

It seems that your symptoms have started too early. They say 2-4 weeks.

Also, usually the CSW are tested. My girl was some random chick I met at a bar in Asia.

[worried93]

Well,

I have done extensive research on this, and almost everywhere it has said that dry cough and shortness of breath are symptoms.  I guess they could all be wrong.

I also had fever, fatigue, diarrhea, and weakness.  Again, it happened 7 days after exposure and lasted approximately 8-10 days.  This is EXACTLY what happens for acute HIV symptoms.

I'm actually kind of upset that the doctor hasn't responded to my other posts and it is making me worry more.  I have a feeling he understands that my symptoms are exactly what happens with people who have acute HIV thus the tone of his post.  

He rarely even tells people they should get tested,  even people who have unprotected vaginal sex with prostitutes.  Yet he tells me I should get a test.  Also he says nothing about if he believes the test will be negative or not, and he almost always says he believes it will be negative.

Again, this has to be due to my symptoms as they are MUCH TOO SIMILAR for even the doctor to ignore.

I guess I was the unlucky one out of however many thousand.

[ExtremeStress]

your are crazy! how are you going to tell someone symptoms, when you think yours are. You had no risk whatsoever and can't let it go. Don't give advice until you can take it.

[monkeyflower]

Did you read my response? For one thing, it's *different doctors*. I think Dr. Handsfield would have told you no risk, only in a more direct way ;-). Dr. Hook basically said the same thing, but he has a more cautious and conservative tone to all of his posts. He's new. Give the poor guy some time to adjust. Unless he's spent a lot of time on other similar boards, he probably has little to no idea of just how incredibly intensely anxious 99.9% of the posters are. It's soooo different from real life, with real patients who have real risks. Worried well tend to be unable to tolerate ambiguity, tend to be hyperaware of bodily sensations in general, are highly anxious, and need clear, concrete, black-and-white responses.

Anyway, I'm thinking Dr. Hook probably hasn't responded for a couple of reasons:
1. he probably doesn't read followup comments
2. he thinks you're way too anxious over this and doesn't want to encourage you further
3. he didn't think it was an issue that needed a response
4. some other reason--but NOT that he thinks you have HIV. You are sooooo overthinking this. There isn't anything special or different about any part of your post--not your experience, not your symptoms. Really, how do you think you're going to get HIV from protected intercourse? You're NOT. Symptoms mean nothing--and he even pointed out that your symptoms are more likely symptoms of other illnesses. Like colds.  I realize your anxiety is likely preventing you from thinking clearly and rationally about this experience and your risk, which is partly why I suggested the usual meds-and-therapy route.

[worried93]

Thanks alot for your comments and reassurance.  I really appreciate it.  Even if I am HIV positive I still appreciate what you have done.  

I do have a great deal of anxiety but I do feel like Im thinking clearly about this.  The symptoms are just too similar and in the exact time frame.  

The doctor did say I should get a test; but I've never seen him recommend a test to anyone else who had exposure like myself.  The only reason I can think of this is because of the exactness of my symptoms.  It could be because of the blister on my finger, I'm not sure.

I am going to get tested, but unfortunately have to wait a long time.

[monkeyflower]

Whoa there, buddy, easy on the drama. First of all, the 'don't test' responses you mention come from Dr. Handsfield. Your post was answered by Dr. Hook. From what I can tell, he seems a little more guarded and careful in his responses, more conservative in his advice. Which is cool, except when you're talking about responding to freaked out worried well. I can't speak for the guy, but I think it's clear he was not insinuating that you have HIV or are even likely to have HIV. Your blister is irrelevant. For one thing, no one ever got HIV from protected intercourse. And the risks from receiving a blowjob are really more theoretical, so infinitesimally small it's not worth thinking about.

Not that you asked, but in reading your posts it's clear to me that your anxiety is way over the top. Especially if you find yourself thinking like this (catastrophizing) about other things, definitely do consider therapy. It can help you learn to think and react differently, help you learn to control your anxiety. Meds can help too. Just a thought.

[worried scik]

The chances of you being Hiv+ are vanishingly low.  You had protected vaginal sex which is no risk and oral sex which is also no risk.  Your symptoms are due to some other totally unrelated virus or from anxiety.  Another way to look at this is based on odds which should calm your nerves.  You are at much higher risk of being diagnosed with cancer this year than you contracting HIV from the incident you describe.  Are you nervous right now about cancer.  If no, you shouldnt be nervous about Hiv.  

[allthesigns]

You would have known if the condom broke.  Zero risk for HIV.  The only reason an antibody test was suggested by Dr. Hook was to relieve your anxiety.  Move on.  

[worried93]

Well, I guess its official.  I'm now 99.9% sure I have HIV.  Today when taking a shower I was inspecting my penis and noticed a purple spot on the head.  This goes along with more symptoms of fatigue and loss of appetite, I haven't been able to eat in 2 days.

I'm feeling so many emotions at the moment.  Disgusted at myself for even having sex with a prostitute, anger at how unlucky I have gotten to receive HIV from these exposures.  

I will get an HIV test next week (only 3 weeks after exposure) and also will get one 6 and 8 weeks after.  I knew the symptoms were too serious to be a 'coincidence' and after seeing the purple spot on my penis there is nothing more to see.  

I did not want to die young, but unfortunately I made the mistake of having protected sex with a prostitute and I will die for it.

[bigdummy1]

There is no chance you have HIV- you had condom protected sex and hiv cannot penetrate through latex.  Oral sex carries near zero risk.  Therefore it is virtually impossible for you to get infected.  All your symptoms are emotionally driven and the purple spot has nothing to do with hiv-where did you get that from.  You dont have hiv so calm down.  Your chances are no greater than being struck by a metorite when you walk out your front door tomorrow. Relax you had protected sex-why do you think you have hiv for gods sake. From what exposure-certainly not from the incident you describe!

[bigdummy1]

Also why do you think you have a loss of appetite and are constantly fatigued.  Dont you think stress is the main cause of those two symptoms.  Your stomach is tied up in knots and will continue to feel that way until you realize you dont have hiv.  you also going to give yourself a stomach ulcer from all the acid you are producing which undoubtedly you will attribute to another hiv symptom.

[worried93]

Yes, but where else could ALL these other symptoms be coming from?  I have just assumed that the condom has broken now and am resigned to my fate.  I am fairly sure there was slippage in one of the encounters, but my urethra was always covered I think.  

Either way with this new discovery of the purplish colored spot on my penis, it looks to be certain I am HIV positive.  I didn't even mention the blister that showed up on my upper lip a few days ago that is still there.  

With ALL of these other symptoms I think it is fairly obvious I have contracted HIV.  There really isn't any other explanation.

You never appreciate what you have until its gone,,,,I had a great life/future ahead of me and I destroyed it because of one STUPID night.

[H. Hunter Handsfield, M.D.]

I don't normally jump in on Dr. Hook's threads. But there is no realistic chance you have HIV.  As has been said innumerable times on this forum, symptoms never are a valid indicator of new HIV infection, since the identical symptoms occur with large numbers of garden variety medical conditions that are much more common than HIV; even in people with absolutely classical symptoms of ARS--which you do not describe, despite what you think you learned by online searching--most do not have ARS.

Stop ventillating your fears on this forum and stop trying to figure this out by online searching.  See a health care provider about yoru symptoms.  Fell free to return to report your test result, if it becomes positive (it will not).  Aside from that, any further comments, by you or anyone else, will be deleted.

[worried scik]

Is there a reason why Dr. Hook has not responded to a single follow up question?

[H. Hunter Handsfield, M.D.]

Because it is an anxiety driven question with an obvious answer that doesn't qualify for his time and energy, or mine.  And I just answered it anyway!

This sort of stuff wastes everybody's time.  If you reply with any further comments, I will delete the entire thread.

[worried93]

Took a Home Access Express HIV-1 test.  Called in and got the results tonight.

POSITIVE.  The counselor said I tested positive for HIV-1 infection, but I couldn't bare to hear her speak anymore so I hung up the phone.  WHAT DO I DO NOW?

For anyone saying this isn't the risk that infected me; this is the only time I have had sex in the past 5 years with anyone other than my girlfriend.  (she tested negative today)  I have never touched a drug and have zero other risks.


I am in shock and I my worst nightmares are now a reality.   WHAT DO I DO?

[H. Hunter Handsfield, M.D.]

That's really too bad.  I hope it turns out to be a mistake.  If the result is truly positive, you'll be the first ever on this forum.  It remains unlikely that you caught HIV during the exposures you describe, but if that's the only possibility, then that's where you got it; the odds were low but not zero.  Or you have been infected for more than 5 years.  Or your girlfriend became infected recently (from someone else), and is inn the window period.

What do you do now? First, call back Home Access.  It was stupid to hang up without hearing the full information they were prepared to give you.  For example, maybe the result was preliminary, not yet confirmed; i.e., an indeterminant confirmatory test.  If truly positive, of course the next step is to seek out a health care provider who is experienced in HIV care; that's also obvious and you did not need to ask.

Of course we would like to hear if it turns out there is a mistake and you're not HIV positive afer all.  Otherwise, we will not have further comments and there is no point in continued discussion.  We will not participate in discussions or questions about where you actually got infected.

Good luck---  HHH, MD

[angstconcern]

Is this positive test even a remote likelihood ? I realize that you have to take what is said on face value, but this flies in the face of trying to practice safer sex outside a monagamous relationship. I realize having condom protected intercourse and unprotected oral sex with sex workers may not be appealing to a lot of people, but this is reality. I check this forum every few weeks out of interest, but this is disturbing, particularly if it is someone trying to make a point or get attention. Bottom line question - I have had many similar exposures and tested negative several months ago after getting tested per a question I posted previously, is a positive result after something like something you have actually seen in your practice? I ask in order to have a little peace of mind moving forward.

[worried93]

I want to respect the Dr.'s wishes about not replying in the thread unless I had news about not being HIV positive.  However I feel that I have to post something because it seems that a lot of people are getting the wrong idea.

I AM NOT claiming that I was infected via oral sex.  When I made the initial question to the doctor I was too scared/in denial to mention that there was a high likelihood that there was condom failure.  When I pulled out and finished in the condom, the tip of the condom did not fill up with my ejaculate.  There was no semen in the condom, and the girl was wiping up a spot on the bed after. (presumably my ejaculate)

That is how I was infected, not from a blow job.

I am going to a specialist on Monday, please pray for me and THANK YOU FOR YOUR HELP DR.

[down742]

I would like to know how many days from your exposures to the day you use Home Access to test HIV? I truly hope you will come back negative, I'll pray for you

[cshaman]

As someone who is counting for 4 weeks for my HIV test.. This news freaked me out :( I thought it is nearly impossible to get HIV in first encounter. I pray that your results will be corrected to negative.

[H. Hunter Handsfield, M.D.]

If someone is struck by lighting and posts that experience in an online forum, it doesn't increase the risk of lightning strike for other forum users.  Rare events occur in the world; i.e. "s*** happens".  When they do, somebody has to be the unlucky one.  Nobody else should be "freaked out" by worried93's experience, even if his test result proves accurate.  That one forum user acquires HIV from a CSW through unprotected vaginal sex (apparent condom failure) does not change the odds that someone else will also catch HIV from a low risk exposure.

And knowing worried93's time to the positive test cannot affect the seroconversion window in someone else.

I'm closing off this thread, unless worried93 comes back with the hoped-for news that his test result proves to be falsely positive.  Please take any further discussion over to the HIV support forum.  Thanks.  Best wishes to worried93.