Evaluation of situation

About me: Healthy 22 year old heterosexual male.
Risk: Unprotected vaginal and oral sex with stripper of unknown HIV status.  Condom completely broke.
Symptoms:  Bilateral swelling of lymph nodes under jaw. Both lymph nodes are identical size (3/4-1") and location.  Noticed 5 days post exposure when I read about ARS and started checking for them not because they hurt.  Also noticed white tongue about 10 days post-exposure when I read about it and checked.  Not sure if it was present before.  Both symptoms still persist 60 days post exposure.  Also had a small rash in my lower back about 42 days post exposure and I have had a very slight soar throat for about 7 weeks.  No fever but I have had hot flashes when my anxiety has been through the roof.  At this point (60 days post exposure) only swollen lymph nodes and white tongue persist.
Testing: HIV PCR DNA/HIV antibody via ICMA 17 days post-exposure.
HIV PCR DNA/HIV antibody via ICMA 45 days post-exposure.
All test done by LABCORPS and all test NEGATIVE.
Questions:
1) Can these test be conclusive?   Do you recommend any further test?  I am at 9 weeks post-exposure today.
2) Lymph nodes have me extremely worried.  Can they be my submandibular salivary glands?  Are they palpable?
3) I'm scared to have sex with my wife.  Is it ok to depend on these tests results?
4) Any explanation for symptoms?  Is it ok to rule out that swollen lymph nodes and white tongue are caused by HIV because after there onset I had an negative antibody test about 4-5 weeks after?

[H. Hunter Handsfield, M.D.]

Welcome.  However, I hope you're not expecting to hear something different compared with Dr. Cummings' responses to the same questions on the HIV International forum.  We recommend users not to re-ask the same questions; there has never been a significant disagreement between opinions and advice on this and the international forum, or between teh 4 doctors on the two forums.  Re-asking is generally a waste of the posting fee.

As that suggest, I agree with Dr. Cummings.  You had a low risk exposure, since few strippers have HIV; and your multiple tests prove you did not catch HIV.

1) Your results are conclusive.  It would be a waste of money to have any further testing.

2) I cannot judge whether your lymph nodes are inflamed or enlarged, but it doesn't matter.  There are many causes of lymph node inflammation, and HIV is one of the least common.  And HIV test results always overrule symptoms, no mattter how typical for HIV.

3) From an HIV standpoint, you can safely have unprotected sex with your wife.  You cannot infect her with something you do not have.

4) On this forum, we don't try to explain symptoms not due to HIV.  There are many possibilities, mostly not serious.  Probably they have nothing to do with the sexual exposure that concerns you.  See your doctor if you remain concerned.

Regards--  HHH, MD

[Baseball28]

If the stripper was known to be HIV positive will you still say my test are conclusive or would you recommend further testing?

[H. Hunter Handsfield, M.D.]

Conclusive even if she had HIV.  But that's pointless speculation anyway.

That will be all for the "yes but" or "what if" questions.  There's nothing you can add that would change my opinion or advice.  Accept it or not, I don't care -- but this isn't a debate.

[H. Hunter Handsfield, M.D.]

Stop with the follow-up comments like the ones I deleted!  As I said, "There's nothing you can add that would change my opinion or advice."  That includes any and all medical illnesses and conditions you might have or that might come to mind.

[Baseball28]

Dr.
I know you gave me a warning, but please help me as I desperately need your help at this point.  Now 10 weeks post exposure I went to see a doctor and he diagnosed me with swollen glands in my neck, armpits, groin, and behind the knees (popliteal lymph nodes).  The ones behind my knee are the size of golf balls sticking out.  All the lymph nodes besides the ones in my neck swelled over the weekend (9.5 weeks post exposure)   He sent me for an HIV antibody test at the lab and it came back negative at 10 weeks post exposure.  Despite this test and my previous tests what are the chances this can be HIV?  I want to trust my test results, but I have never had swollen lymph nodes in my life and I cant imagine that it is just a coincidence that I have them after my exposure.  Thank you and I really appreciate if you can respond  I am in a very bad state of mind at this point.

[H. Hunter Handsfield, M.D.]

Sigh.  Do I have to keep repeating myself?  How exactly did you interpret "There's nothing you can add that would change my opinion or advice", which I have now said 3 times, or "That includes any and all medical illnesses and conditions you might have or that might come to mind"?  

It doesn't matter whether or not you have had such symptoms before; that they are new doesn't mean HIV is the cause!  Your test results show it is not HIV; and lymph node enlargement, by itself, is not a typical symptom of an HIV infection.  Continue to work with your doctor to find the cause.

That is definitely all for this thread.  You may post the final diagnosis if and when it becomes available.  Any other comments besides that will result in immediate deletion of the entire thread.  Also, please do not start a new thread with the same questions; it would be deleted as well, without refund of the posting fee.