Experts Please Help Me...

[godsaveme1]

Hello Doctor,
I would be thankful from the bottom of my heart if you could advise me:

The following is my case. I had two possible exposures:
1) Sep 2009 - A stripper gave me blow for a min or so without any condom. At that time, I had no idea about this is also a possible way of getting infected.
2) Nov 2010 - I went to Tijuana, Mexico and with one of the hookers there, the following happened. I was in my underpants, through which she blew me. I had contact with my mouth to her breasts(nipples) a few times. She then ejaculated me with her hand and a day after, I found that there were some tear on my organ under the foreskin (something like wear and tear). No Vaginal/Anal/Oral Intercourse. I am not sure whether any fluid oozed out of her nipples. To my knowledge, I dint see anything distinctly. I had just consumed three beers. But, I quiet clearly remember what happened.

Since that was the one and only time I had risked my life, I just wanted to make sure everything was fine and took an ELISA after two weeks. I was negative. But the doc said, just take once more after 6 months to get rid of this thought.

I had taken the foll tests (In chronological order):
1) Two weeks from exposure :- ELISA
2) 6 months :- CMIA
3) 8 months - CMIA
4) 8 months - Western Blot specific for type I, general for Type II
4) 10 months - CMIA
5) 12 months - CMIA
6) 20 months - CMIA

All the above tests have been negative so far. However, I am clearly describing my concerns below. Please someone help me:

1) I am falling sick more often nowadays.
2) I am getting mild oral ulcers. Frequent dry feeling in mouth and tongue. In turn due to dehydration, my tongue turns white. My ENT says, it doesn look Bad and it might be Geogrophic Tongue. She doesn know about my exposures.
3) Except CMV(Cyto Megalo Virous) I tested negative for all the other STI's. That is, I got positive for a PAST CMV infection in the past and tested negative for all the other STI's like Herpes, Chlymida etc.. But, some people say only people with lesser immunity get CMV. Mainly HIV patients. Is CMV really an HIV indicator?
3) Currently, the most recent freak out thing is, I am not able to swallow things properly (discomfort and pricking feeling) for the past one month or so. It feels like somethings there in my throat and sometimes its an mild unclear pain. Also, see mild white patches which goes off and sometimes come. I am fearing of oral candiasis.

My questions:
1)Whatever I did, are these possible exposures? Both the ones in Sep 2009 and Nov 2010. That is oral sex and sucking nipples (She said, she had a baby). So I am worried about coming in contact with her fluid.
2) Are the tests that I had taken reliable? Should I take PCR or some other test?
3) Some people on the internet are saying, "however people say these tests are not accurate and everyday people are dying due to HIV/AIDS which has not been identified properly by the tests". Is this really true? My confidence is shaken by this statement.
4) I was thinking hat Western Blot is the ultimate confirmatory test. But now, I am reading about PCR now. Is this PCR better than Western Blot?. Should I take PCR?
5)  whatever health issues I get(Hoping I should not), however may be it associated with an HIV symptom, should I at all be bothered? Thats what mainly freaks me out.
6) I am depressed and seriously concerned about my future. How much safe am I now?. What should I do to know whether I am good to go or not? I want to know whats happening, very soon. I don wanna wait and some one after 5 years comes and says I am screwed forever.
7) Finally, Like anybody else, can I boldly go ahead and start a family? Is there any chance of this issue creeping back again at any point?

Please Help Me. I am spending sleepless nights over the past two years.

[Tony19821]

My friend there was never a risk of HIV exposure in the first place so all this talk about tests and reliability is a waste of your time. This will be my last post it really is time for you to move on from this.

[godsaveme1]

Sure, shall wait for her. As for the latest test in center B done, I spoke to a technician over phone. He says its Ag/Ab combo assay(But he needs a confirmation from the pathologist on Monday only).

I called up the center A which did all my antibody tests- all the other tests in Center A were Ab tests only. They said, Ab alone they can deliver it the same day. But Ag/Ab combo it will take a week. However, center B gave the Ag/Ab combo assay results in the same day evening.

I know this again is a very nervous question. Since, you have been helping me all this while. Just wanted to know whether you have any idea whether it would take longer time to perform the Ag/Ab combo than the Ab only.

The main reason for this rekindling is the below thread,
http://www.medhelp.org/posts/HIV---International/PCR-test-AFTER-ONE-YEAR/show/1803814

Here, the doc indicates a possibility of antibodies never being produced. This is why I started digging up what the tests were and see whether I was tested for the P24 antigen ever. Can you kindly throw some light on these. Should I get tested for the P24 antigen just one final time and throw it away.?

Thanks and I genuinely apologize if you feel I am getting a lil overboard. Sorry Tony, I am lone bachelor guy far away from my family. Hence all this panic.

Hoping to hear back.

[Tony19821]

Just leave it a few hours and see if she sees the thread. I'm sure she'll only confirm what I've already said.

[godsaveme1]

Thanks for the info. Tony.

I havent interacted with Grace. How could I bring this thread to her attention. If it would be a good way to seal this thread off, I would be thankful if you could help me in bringing her also into the loop. How can I contact her?

Warmest Regards

[Tony19821]

Also let's call them sex workers as I hate the term hooker.

[Tony19821]

Cracks in your lip might increase your chance of getting a cold sore if you don't already suffer from them but with regards to HIV you don't need to worry about it.

The very very slight difference in results from test centre A and B is of no significance at all. A negative result is a negative result. Please have confidence in these results.

I think seeing a therapist might be of use to you as these issues are all phycological.

I dont know if Grace wants to confirm anything I've said in this thread but I'm sure she'd agree with the advice I've already given.

[godsaveme1]

Thanks Tony for your kind advise. This has been very helpful in getting facts straight. I am trying hard to move on. In fact After Nov 2011 (1 year from last exposure Nov 2010), I was doing good and slowly forgetting this. But this july - a month back, I again got sick and that with this oral issues put me back into the same track. I am now realizing two things:

1) First to be positive and think positive and move on - This has been the toughest part. Some random thing pops up in my mind and I am getting nervous when I see and HIV/AIDS Ad on TV or Paper. I know its taking into much of stress. But, when I get slightly cranky I get into this convoluted thought about my family etc.. I will/have to move on surely some way or the other. Since I did not want some nasty surprise down the lane(5-10 years later when I am with a family), I am taking all the pains to learn and double/triple confirm about my status.

2)Second is to get educated properly. Thats why all those questions most of which might sound weird/stupid. Though, I promised I would not be asking any more two questions, I could not help but ask these two which I had forgotten from my list. Tony, Kindly excuse and clarify please to educate myself:
a) Does lip cracks - a little bloody in the usual sense increase any risk of contracting HIV. If so what are the acts I should avoid and what are the chances. I get these very often, especially in the cold seasons and I found that I had one when I met the hooker. Hence, the question.

b) All the tests except the latest CMIA (@20 months)  were taken in testing center A. The last 20 months CMIA I took in Center B. All the while my center A tests where absolute "0" readings. While the latest center B reading was "0.11". Does this increase is anything of concern? I know anything less than "1" is negative. Still, to get clarified. This might be too much detailing and ridiculous, but I did not want to keep myself. I thought better ask and get replied in an appropriate way than to keep it within and get hung over it.

Thanks a ton Tony. I hope to close it down for good with this one. Any advise from you would in any aspects physical/psychological be greatly welcomed.

Kindest Regards

[Tony19821]

You haven't frustrated me at all I started answering some questions in this forum after I myself had a scare with regards to STDs and it was only after I got my results that I could look back and realise I had very low risk for anything. My exposure was also from oral sex so I know what you're going through.

With regards to the breast milk issue, even if she was HIV positive you'd have to drink pints of her breast milk to stand a chance of acquiring the virus from her. Couple this with the fact that you've tested negative so many times really only leaves one conclusion and that is no matter how much you've managed to convince yourself you don't have HIV.

You will always get sceptical people raving on about hidden diseases that doctors are hiding etc but that's simply false information. Doctors are not hiding anything so don't worry.

Take a deep breath, relax and move on :)

[godsaveme1]

Sorry I forgot to answer your question. In 2010 in Tj, she blew through my underpants only.

Thanks

[godsaveme1]

Thanks for elaborating tony. I will windup with these two. I truly thank you for your patience and concern.:

1)The only reason I asked about breast contact was, one of the local counselors over phone said that breast milk was a possible source. Since, that hooker had delivered a baby, I was worried about me swallowing her milk unknowingly. To educate myself, does this breast milk a risky affair even if minuscule droplets enter the mouth un-knowingly?

2)I had come across a person in this community and a couple of people in other forums saying these tests do not cover some new strains - some HIV-2 and other thing thats wide spreading from Africa. He even started a thread saying the experts are hiding facts from people and was quoting some article. Thats when I panicked and thought let me first confirm whether my encounter could be termed as an exposure - which I had never analysed till today. Understanding this is very important for me as if the even itself is not a risk I can be even more confident. I would be very thankful if you could share the views on these claims by that random person. Sorry I could not post that link for your reference.

I sincerely hope I did not frustrated you with my load of questions and concerns. I am even more confident now learning that the source of transmission which I thought itself was wrong (If I am cleared on the breast milk/fluid also)

Kind Regards

[Tony19821]

Hi there,

With regards to the incident in 2010 you said she blew you through your underpants is this correct? Meaning she didn't ever have any direct mouth to penis contact? If that's the case then the risk for any STD or HIV is zero and as previously said the risk of HIV through oral is none exsistant. The contact with her nipples is of no significance at all. One of the expert doctors puts this into great context by saying that the estimated average transmission risk is once for every 20,000 events, which is equivalent to receiving oral by an infected partner once daily for 55 years before transmission might be likely.  Many experts believe even this is too high an estimate and point out that there has never been a proved case of oral to penile HIV transmission.

You've been misinformed about CMV. It's thought that half the adult population have the CMV virus it has nothing to do with if you have HIV. It's thought that this virus can cause problems if someone has advanced HIV.

You've been tested 6 times for HIV! There's not a chance at all that those accurate tests have managed to miss a HIV infection so you are 100% all clear from it you need to believe those results. Whatever is going on in your body health wise it is not due to a HIV infection. Return to your doctor and speak to him/her about your throat etc as you need to be looking for alternative causes. Please move on from this worry about HIV.

[godsaveme1]

Hello Tony

Thanks a lot for your answers. I am concerned primarily about HIV only as thats the life threatening infection. Syphilis is the only one I tested two weeks after. Hepatitis B and C, Chlymidia, Gonnorehea and Herpes were all tested well after three months. Hence, I will just summarize my questions.

1) I think, I should have first confirmed about whether the incidents were possible exposures instead of myself assuming it. I understand that 2009 incident (unprotected oral contact) is a minuscule risk, as you said. I am not understanding your view about the incident that happened 2010 in Mexico. Kindly elaborate.

2)Is CMV really an HIV indicator. I know this is not the right place. But, I could not find a right forum. But the physician here scared me of saying that only low immunity people acquire CMV. I had been tested positive for past CMV infection. However, the internet searches point that CMV is very common to acquire. If its relevant to you, kindly share your knowledge.

3)Can this past CMV infection have any impact on my results. Like delay of seroconversion. I have been tested negative out to 20 months. Can I trust the results?

4) As I try to get over it and move on. Some thing or the other health concern is freaking me out. Offlate am having many oral/gum related issues like pain, reddening, difficulty to swallo etc.. As I say all these seem to point to oral candiasis the primary symptom of HIV. I am dwindling b/w moving on and getting back. What should I do now? Any more even more reliable tests? I thought my Westen Blot was the ultimate test till I read about PCR. Is this even better than the Western Blot results.

Thanks a lot again for your time. Hoping to hear back.

[Tony19821]

Wow you are very anxious over these very very low risk exposures. The first instance in 2009 was your only concern as the one in 2010 carried no risk at all for anything. Ok so let's look at the exposure in 2009 when you received oral for one min. There is no risk for HIV from this as its not transmitted via oral sex. Of the bacterial STDS only gonorrhea and NGU are possible and even these are very very low risk. Taking all this into account and after all the testing you've been through its 100% safe to say you have nothing at all STD related and need to relax. The symptoms you describe are very none spacific and I'm sure they're mainly related to the stress and anxiety you've been going through.