I am very worried, Doctors, Please Help.

[NYC_Never]

For the past 4 weeks, I have been living in a highly anxious, roller-coaster emotionally life.
I visited NYC on Sept 21 and had sex with a korean CSW (my first time besides my gf who I have been with for 6 years). The condom broke and I was inside her unprotected for maybe 10-30 seconds. I also gave unprotected oral on her.
Oct 7 (day 14) I did the first quick test and it's neg. I am in Canada and my test used blood from finger tip.
Oct 9 (day 16) I started to experience pain in my groin area (between leg and genital area).
In a few days, the pain then spread out to around groin, leg muscles (inner side of both upper legs), arm muscles, joints(mostly fingers) and genital. It comes and goes, around every 20 seconds. pain is bearable, but noticable. There is no rash, no fever, no discharge.
Oct 11 (day 18) started to feel headache, not so painful but I can feel it.
Oct 14 (day 23) 2nd quick test was neg
Oct 16 (day 25) I started to feel some light pain/tightness behind my ear but above my neck which I believe is my neck gland
Oct 19 (day 28) a pimp on the neck, ichy, but disappearred next day.
Oct 20 (day 29) I did 3rd quick antibody test and it was neg. This time because the nurse heard my flu-like symptom(muscle/joint/groin pain and headache) she drew blood for a P24 Antigen test, resutl back on Oct27
In past 2-3 weeks my body feel tired, especially legs feel tired, heavy
some loss of appetite and lost 5 lb (154 to 149) in 2 weeks
Night sweat only on my head, and feel hot in general in 2 weeks sometimes feel chill
Always have loose bawl, in the morning, white coated tongue
Temp constantly 36.6c (in mouth), can't tell if gland swollen

Questions:
1.what's chance of I having HIV with all symptoms.
2. I am nervous cuz all my STD test are negative, so I can't explain my symptom if it's not HIV. What do you think my problem is? I can't eat and sleep well now.
3. what's accuracy of quick+p24 at week4?

[Edward W Hook, MD]

Welcome to the Forum.  Let's summarize your situation, then discuss your risk (here's a preview, it's very low).  You had a single. [partially protected exposure to a commercial sex worker.  Most CSWs are not HIV infected (Less than 10%). Furthermore, the risk of HIV infection from a single, totally unprotected exposure is 1 in 1000 (your risk is lower since you were protected for part of the time).  In addition, you have negative HIV test at 4 weeks, when even without a p24 antigen, over 90% of infections acquired 4 weeks ago would be detectable.  Taking all of these facts together, your risk of HIV is no greater than 1 in 100,000 and probably lower.  You really do not need to worry.  As for your symptoms:

1.  The symptoms you describe a non-specific.  they do not match the ARS well and it is far more likely that you simply have the "flu" or some other community acquired viral infection.
2.  See above.  A combination of anxiety, guilt and perhaps a community acquired viral infection.
3.  Along with your negative antibody test, certainly greater than 95% and probably higher.

Bottom line.  You have little to worry about.  Try not to worry.  EWH

[NYC_Never]

Hi, Doctor, please help me. I started to have pain in neck gland, armpit and groin areas. I am so scared to death now. I don't know how I can get throught this 1 week to see my p24 result. Thanks and appreciate your answers.

[NYC_Never]

Thanks for your response, Dr Hook.
I have done urine/blood work for STDs and they are negative.
I know I should've got some relief after 4 weeks HIV negative, but the fact I have unexplained muscle/joint/groin pain and the way the nurse was cautious to take my blood for P24 test make me very very nervous.
Altho my symptom is non-specific, it does start with groin pain (which I never ever had before), and later on spread over whole body as joint/muscle pain. I am so freaked out, but can't tell anyone except you.
Nurse also said in Canada, quick test (finger tip) is conclusive only after 3 months, which I am still far from it. This is far from 90% in 4 weeks.
I appreciate your understanding of my stress.

[Edward W Hook, MD]

Just for calrification, the ARS would not be expected to start in the groin and then generalize.

Furthermore, the nurse you spoke with was being overly cautious.  Niethor of us on this Forum, nor any of our peers have seen anyone who seroconverted to HIV in more than 8 weeks for more than two years, with the exception of people who took PEP and failed it.  Take care.  EWH

[NYC_Never]

Thanks for your explanation, Dr Hook.

Now I have a more peaceful mind.

I would like to just ask you one more question before I get my P24 result back next Tuesday.

I have pains from muscles (hand,arm,leg), from joints (hand, arm, leg), from gland (not sure it's the right word, but bacially the pea-size things around my groin areas, under my arms) and from my neck (behind and below ears). Groin pain started first and the rest started 2-3 days afterward. These pains have been going for about 2 weeks now, and they still hurt (bearable). Some of pain feel like from bone although I can't tell. They come and go, sometimes more frequent (every 5-10 sec) and sometimes less frequent. I can't see any obvious swollon gland. Also have light headache come and go. It disappear after some sweat, but come again after some chill wind blow on my face. Sometimes I really feel I have a flu except there is never a fever.

I asked my doctor but all the STD test he did was negative, and he can only wait for the HIV test to come back. I am very worried because I don't know what it is, and I can't stop associating it with ARS.

From your experience, could you shed a light for me? could it be bacteria or virus, and any tests I missed etc?

Thank you so much, Doctor. Even if you don't have an answer, I still truly appreciate your help.

[Edward W Hook, MD]

I repeat, nothing you mention is at all worrisome regarding any STD, including HIV and your symptoms are really not at all likely to be related to your NYC exposure in Septemeber.  you may have caught a community acquired viral infection, as we all do from time to time, including the flu. Alterantively this could be some other sort of illness.  In that it sounds as though these symptoms are quite troublesome to you, my recommendation would be to discuss this with your regular doctor.  I would not worry that it is a sexually acquired process however.

Since I am confident that your p24 will be negative, proving that this is not HIV related, this will conclude this thread. Take care.  EWH

[NYC_Never]

Thanks Doctor Hook. I do want to be confident but there is something new to my symptoms yesterday and today. I can feel my swollen node in the left side of my neck (below and behind my left ear), it aches a bit when I touch it. There might be also slight swollen on the right side of my neck. I am so tired of these unexplained symptoms and everytime it put me in the edge of mental meltdown.
Would the swollen nodes in my neck be anything alerting? I am going try for another quick test today.

[NYC_Never]

Doctor, before I say goodbye, I would like to thank you for your reassurance. My p24 test result at 4week IS Negative.

Something off topic, If I want to ask further question on my genital/groin pain generalized to body pain, which Doctor's forum should I ask?

Thanks, and goodbye.

[Edward W Hook, MD]

Further questions about groin pain should go to the STD Forum.  eWH