HIV Exposure?

[MMM1111]

Dear Dr.


Thanks you for taking the time to read and respond to my post.
I am a 38 yr old Bi-Male. I keep myself in very good condition by weight training and cardio exercise and I eat very wll.
I also take vitamins. Multi Vitamin as well as Omega 3/6/9 and flaxseedoil.etc.

On Sept 30 I engaged in unprotected receptive oral without ejaculation receptive protected anal sex with a partner that I have no knowledge of their sexual history. I kept checking the condom to make sure it didn’t slip etc. When we were finished. I saw him take it off and I also saw that it did not have any tears in it. Yet, It seemed that I had some fluid inside of me. Which totally flabbergasted me. When I checked some fluid leaked out. I was unable to determine what the fluid was weather it was lube/or for him.

In any event, everyone around me has been ill and I too felt very ill about 1 week after the episode. Extreme fatigue, swollen glands in the back of my throat, sore throat and some slight difficulty swallowing yet I have had no temperature. I also have had a very bad flare up of Geographic tongue (which I have had all my life, some small cankers sores in my mouth and the back of my throat and tongue feel like they are burning at times. (After week one-I had a lot of white paste in the back of my tongue that is more prevalent in the morning. It lasted for about 10 days and has improved a bit, but the Geographic Tongue and burning tongue and throat is still and issue). I also have had general itching for about three weeks; sometimes it gets worse then others. Also have some slight itching in my groan areas and near my anus, yet dont see any rash or bumps. I sprayed some antifungal spray(Jock itch spray on groan, inner thigh area to hlp  this)

This morning 10/28 on top of the itching I now notice for the first time a blotchy rash on my abdomen and chest that that seems to bother me more when I wear clothes.


I tested negative for Elisa HIV on 10/10
I also when to my doctor and they did blood work on 10/20 as well Mono, EBV for STD's and throat culture for Gonorrhea and and also the Elisa and the HIV Proviral DNA by PCR and everything came back neg.

Question:

I do plan on testing with the Elisa again at week 12 and week 24(based on the indow period) But do you think the HIV Proviral DNA by PCR is a good indicator even at 21days that my present symptoms are not HIV related as viral loads would be indicated with the symptoms I’m describing (If they were HIV related?)

All these strange uncomfortable symptoms Mouth/Tounge Burning, Fatigue and inconclusive tests on top of the itching and rash now have me stumped. Could I have a fungal/bacterial infection,Candida, scabies? Any thoughts/Suggestions steps and direction I should take to figure this out?

Thanks again.

[H. Hunter Handsfield, M.D.]

You had safe sex.  If the condom indeed remained intact, you could not have acquired HIV from the exposure you describe.  Therefore, your symptoms cannot be due to HIV, unless you have had other risk exposures; and in any case, they don't particularly sound like HIV anyway.  You do not need HIV testing at 12 and 24 weeks; a single test at 6-8 weeks would be sufficient.  (And I would have recommended against the PCR test, but since it was negative, that also is highly reassuring.  And I can't imagine why you were tested for mono and EBV.)

I imagine the fluid from your rectum after sex was your own mucus, or lubricant.

How to "figure this out"?  Follow up with your doctor if your concerns persist.  Whateverr is going on, it isn't HIV--and it doesn't sound serious in any case.

And now back to the most basic issue of all:  What in heaven's name were you doing having sex with a partner you don't know without asking his HIV status and sharing your own?  That is the single most important element of safe sex for gay men, especially for anal sex.  Condoms break, and intention for safe sex sometimes go out the window in the heat of the moment.

Good luck--  HHH, MD

[MMM1111]

Dr,

Thanks for the quick reply and detailed reply. I am going to follow up with Primary Care doctor on Nov 8th to explore what can be going on. I just was curious to why you wouldnt reccomend the PCR Test? Do you think it can be used as a tool to find out within the window period if one has been infected?

Thanks for the reassurance.

[H. Hunter Handsfield, M.D.]

Thanks for the opportunity to clarify this.  The point has been made many times on this forum (search for "HIV diagnosis"), but it bears repeating.

The PCR test has a relatively high rate of false positive results, much higher than with the antibody tests.  It's main use is to monitor viral load in people with known infection.  For diagnosis in the window perriod, the test is recommended when the risk of new infection is especially high, e.g. if a person has had unprotected receptive anal sex with a known infected person.  But in low risk situations, many or most positive results are false.  Such persons then go through an agonizing several days thinking they have HIV when they do not.  It isn't a pleasant experience.  And if the test is negative, as in your case, it still doesn't prove anything; it is only partly reassuring without giving a definitive answer.

So many experts agree it is a misuse of the test in situations like yours.  Admittedly, your situation is borderline, because bottomed with a high risk partner, and there might have been some doubt whether the condom remained.  So although I would not have recommended you have a PCR test, some experts might disagree with me.  But there would be no disagreement in the more common stories on this forum, after (say) oral sex, or sex with women at low risk for HIV.

And to repeat my closing comment above:  Think how much less anxious you would be about all this if you knew your partner didn't have HIV!

HHH, MD

[Alex73]

Listen to the good Dr.regarding PCR testing. I have had a "false" positive PCR result myself. After countless follow-up PCRs tests and Antibody/P24 tests up to the 100 day mark, I am now sure sure it was a false positive. But I still suffer from anxiety. You don't want to go through what I have been through the last 3 months or so.

[Alex73]

Forgot to mention, the take home message from my experience – (as per Dr. recommendations) – a simple antibody test at 4 weeks mark is reliable, at 6-8 weeks it is definitive.

[ScaredUKGirl]

Is Mouth/Tounge Burning a symptom of HIV???

[sparkeler]

You don't have hiv.  OMG please go for a jog or talk to a therapist.  It seems as if your on your computer all day long convincing yourself you have H.I.V.  YOU DON'T !!

[WorriedUS]

I second that Sparkeler!  She needs a job, massage, yoga, tai chi, warm bath, anything to CHILLAX,

Yes Scared..Relax.  The more you stress, the more your mind will activate your body to "seem" like those symptoms are extraordinary.  And of course, the more sensitive you will be to those changes in your body. You're goin "pyschosomatica" right now!!

Consider this, would you be acting any different if you didn't have ANY ARS symptoms and new that up to 30% of HIV+ people DO NOT exhibit symptoms?? check the link out below.

http://hivinsite.ucsf.edu/insite?page=ask-01-03-17

So, I'd bet you'd STILL be stressing out if you did not have ARS symptoms. If you would, then you're a SUPER DUPER WORRIER like 'moi'.  Conclusion: there is NO way of knowing until you get tested, if need be. And you have been, right?  Stop worrying!  You're doin more harm to your body than good.  And..I will REPASTE wat the Good Doc told YOU specifically then, when you FIRST mentioned your 'Spain' incident...and the good thing?? His comments STILL applies NOW, only a few weeks later!
----------------------------------------
"That post is totally irrelevant to your situation. The worst possible source for you to get information about your risks for HIV is looking for bad news on the web. The more you look, the more you will find.

You do not have HIV from the exposure you describe, period, full stop. Additional "yes but" and "what if" questions really aren't welcome. Have the final HIV test that I initially recommended--but except for coming back to post the negative result, there is no point in continuing this thread.

HHH, MD
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ScaredUK----> Just Chill Yo!!  

Regards,

-WorriedUS

[ScaredUKGirl]

"You don't have hiv. OMG please go for a jog or talk to a therapist. It seems as if your on your computer all day long convincing yourself you have H.I.V. YOU DON'T !!"

What on earth was that all about? I was just asking because he said he had it!!!!!!!!!!!!!!!!!!

[WorriedUS]

She might be sayin relax cuz she really believes you do not have it, or that she sincerely hopes you do not.  Nothing condescending I believe.  Everyone on this site is a Stresser Outter, I think , to varying degrees.  If I can speak for Sparkeler, I think she means nothing bad and everything good by saying that.

-WorriedUS

[sparkeler]

Thank you.  I used to be a Worried Well for a long time.  It took me a long time to learn the facts of hiv and accept the fact that I was being unrealistic about this disease.  It still can nag at the back of my brain sometimes.  For example, if I go to give blood,  i'll think, 'What if I just somehow developed antibodies?'  I don't think my boyfriend has it.  I've been tested, he's been tested, we're monogomous.  I'm being as safe as anyone can be in a monogomous relationship (with the exception of not wearing condoms all the time.)  But I can't worry about, 'what if he cheats, and what if he cheats w/someone with hiv?'  I'm not living my life or giving myself a chance to relax and enjoy the benefits of a relationship if I thought like that.  I realize that it's a fear, just like a fear of heights or fear of flying. Something can possibly go wrong, but will it?  Unlikely. I'm doing my best to keep my FEAR under control and try to offer support to others who are just like I have been.

[ScaredUKGirl]

It was just uncalled for...
I was asking because he said that he had burning mouth/tongue so I was just asking is that 'even' related to HIV!!!!!!!

[WorriedUS]

I don't think so.  Only thing I know that is related to HIV in the mouth is thrush.  type it in google and click on the "images" link of google's search engine. It's an extra white coating on tongue, but it has other symptoms also, so not sure if 'burning' is related, but I HIGHLY doubt it, unless it exacerbates some other condition of the mouth like oral herpes.  

[ScaredUKGirl]

Thankyou. That much better answers what I asked instead of telling me 'YOU DON'T HAVE HIV' which wasn't my question. x

[sparkeler]

I'm sorry if I offended you.  I'm glad you got the answer you were looking for.

[ScaredUKGirl]

No worries Sparkler.x

I did have burning tongue soon after my incident but I didn't ever associate it with HIV after reading that it is often a mental thing, which in most cases here mental issues is the problem so I still won't associate it with HIV! But thought I would ask anyway!

I also know what thrush is and I don't believe I have it...I've always-since like FOREVER had a white coated tongue but I don't think it's thrush...Surely my dentist would have noted it if it was!