HIV exposure?

Dear Doc,


Its 52nd day. I (a male) met a CSW in Singapore twice, on the same day. The girl appeared to be very careful.Used condoms both times, pushed both of us to get a shower before and after the sex. She refused any kind of kissing except very mild lip kissing (no open mouth kissing). I had protected oral sex once for half a minute. She applied gel on my penis and vagina. No idea whether that was water or oil based. She applied that to her vagina first and then on my penis. I came both times inside and remained there about a minute or less. Being a stupid person as I am, completely forgot to check the condoms. But I think they were intact. I assume that the girl would have pointed that out had the condoms were broken.

High fever on day 5/6 after I started reading about HIV stuff. After some medicine it went away the next day and never came back as of today. In Week 3 I was on a long international flight and in the middle of it I had a sore throat which was mild. Good amount of neck pain and a bit muscle pain here and there in the body. But I have cervical spondylosis. The pain has been continuing and radiating to upper arm, left chest, and hands. Eczema on hand and on the body. I have eczema for a long time. It was very itchy and then disappeared completely after 5th week. From that flight I have become very sensitive to cold and whenever exposed to a/c, I develop a mild sore throat, a feeling of throat congestion and a bit white looking phelgm. Little muscle pain sometimes in the back of the right thigh and groin area. Some tingling sensation in the feet and palms in week 7. I have read that cervical spondylosis may cause this. I never had loss of appetite, swollen glands and fever after that, and diarrhea.


Do I need HIV and other STD testing at all?

Are these symptoms indicative of any STDs other than HIV?

Have you ever come across a case where an insertive penile-vagina male had contracted HIV after safe sex?

Am I a rare case of advanced HIV?

[Edward W Hook, MD]

Welcome to our Forum.  The exposures that you describe were safe sex and you should not be concerned about HIV or other STDs resulting from the activities you describe. Condoms are highly effective for STD/HIV prevention.  The risk for HIV when condoms are used is virtually zero and the risk for other STDs, while not quite zero is very, very low and likewise should not be a concern unless you develop symptoms.  

There is no concern that your condom failed.  When condoms failed, they break wide open leaving no doubt that they have failed.  If your condom appeared intact, it was. Condoms do not "leak a little".   The lubricant used by your partner is of concern only because oil-based lubricants increase the risk for condom failure. Since your condoms did not fail, you need not be concerned.

I would also point out that when commercial sex workers use condoms and avoid open mouth kissing, this is typically to avoid being infected by clients. thus it is unlikely that your partner had an STD or HIV given her care to protect herself (and you).

The symptoms you describe all have good alternate explanations and should not concern you with regard to having acquired HIV or an STD.  Further, symptoms are a terrible predictor of risk for HIV. While I do not hear any medical reason for you to seek testing, your post suggests that you are very anxious about this exposure.  Thus why not get a single  HIV test (and STD screening if you wish) to put any lingering concerns that you were infected aside.  Should you opt to take this course, I am confident that you will find that you were not infected and, as I’ve said, I really see no medical reason for testing and recommend it only in an effort to make sure you can get peace of mind from your concerns. EWH

[scared_person]

Dear Doc,

Thnk you for your comments. I appreciate them
This is my first venture down such a path and would never go this path if I am clear this time.
For my symptoms, I have some logical explanations except two.
What is happening to my throat and it's been for 5 weeks or so. Why so sensitive to cold?
Second thing is tingling sensations in feet and palms a bit more frequently. Is it related to my cervical spondylosis.

Also I see you chose not to comment on my questions:

Are these symptoms indicative of any STDs other than HIV?

Have you ever come across a case where an insertive penile-vagina male had contracted HIV after safe sex?

Am I a rare case of advanced HIV?

I would be grateful if you could respond.

Thanks.

[Edward W Hook, MD]

I did answer your questions but apparently you chose not to see the answers.  Here they are again:

Are these symptoms indicative of any STDs other than HIV?
NO!

Have you ever come across a case where an insertive penile-vagina male had contracted HIV after safe sex?
No!

Am I a rare case of advanced HIV?
No!

EWH

[scared_person]

Sorry Doc for missing the answers.
I just missed two small but may be important details. I promise this is my LAST post.
I had a bit of burning sensation (thrice in last 51 days) after urination and redness of the sclera.
The problem is that I have had those two things for a long time. So they are confounded.
Does this information change your evaluation of my situation?

Thanks a lot for putting up with me and my anxiety.

[Edward W Hook, MD]

No this does not change my assessment.

Clearly you are anxious about this encounter.  I am comortable that you are not at risk for STDs or HIV.  You are not.  I realized this when I suggested you get tested for peace of mind. That remains my recommendation.  If you don't I worry that you will continue to be plagued by your concerns.  

3 episodes of burning on urination in 51 days is not suggestive of STD but does suggest that you are focused on possible symptoms.  The burning associated with STDs is not intermittent and would not take over a month and a half to appear.

Redness of sclera is likewise a non-specific finding. EWH

[scared_person]

Dear Sir,

I know I promised that the previous one should be my last question, but can I ask one more, please? You can be very brief in your answer. Please do not ignore the questions.

1. After the first time sex, both of us had shower in the morning. Then at night before the sex we had shower and I used (mistakenly) her used towel from the morning to dry me in the night. Does it in anyway increase my chance of contracting any type of STDs including HIV?

2. During the second time, after the sex I noticed a bloddy little scratch on one of my toes. It may have been cause by her nails or something I am not sure. Can scratching increase chnace of contraction?

Please answer these 2 questions and I will be really grateful.
Please

[Edward W Hook, MD]

1.  No, STDs are not transmitted on towels and similar inamimate objects.

2.  No

With further questions the entire thread will be deleted.EWH