Possible HIV Exposure and Symptoms

Hi Dr.,

11 days ago I had protected sex with a sex worker.  She performed oral and then we had vaginal intercourse.  The condom stayed on the whole time.  In the middle of intercourse we switched positions and when my penis was outside of her vagina, I adjusted the condom with my hand.  On my hand I had an open sore similar to that of a small blister that was popped and the dead skin removed so the raw skin was exposed.  The cause of the sore was a blister than I ripped out from my skin instead of just pulling it out.It was 1 mm x 1 mm.  Her vaginal fluid was around the sore and possibly penetrated it.

7 days after exposure:
1.  I had allergy symptoms of sneezing and a runny nose which are currently going away, but now have a stuffy nose.  I was sleeping in a cabin that felt musty and had really dry air.

2.  I have not had a fever or flu like symptoms

3.  Mybody does ache a little but this could possibly be due to the fact that I went hiking up a sand dune, played football on the beach for 2 days prior which made my body ache last year as well, went swimming in the lake and pulled a muscle in my back.  The majority of the soreness resides in my quads which when I stretch feels good.

4.  Have not had swollen lymph nodes.

I am now under the impression that I was exposed to the virus through the case worker via the open sore or with the condom on somehow.

I had a false positive test two years ago and ever since I have convinced myself that I have had HIV this whole time and every little thing triggers my HIV belief.  I am under severe stress and anxiety due to my sex with case worker experience.

Am I possibly infected with HIV?

Thanks.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  You had accurate replies on the HIV community forum.  There is no risk of HIV here.  The same questions have been asked and answered innumerable times, so my responses will be brief.

An "open sore" is no more than a theoretical risk for HIV in this situation.  Nobody has ever been known to catch HIV by hand-genital contact, even with sores on the hand.  If a cut is fresh, deep, and actively bleeding, there might be some risk.  Anything that has started to heal -- even by a matter of hours -- carries little or no risk.  And condom protected sex means no risk.  As for symptoms, we have repeatedly pointed out that even when classical ARS symptoms are present, other things are much more commonly the cause.  And your symptoms don't sound like ARS anyway.  HIV doesn't cause stuffy/runny nose, sneezing, etc; and fever is almost always present in ARS.

So on the basis of this exposure, there isn't the slightest reason to be concerned you could have caught HIV and I recommend against being tested.  But if you remain concerned, visit a health care provider for professional advice.  Your previous false positive test result should not be a consideration; it's easy to sort out false positive versus true positive results.

Let's not get into a string of "yes but" or "what if" follow-up comments.  It is unlikely you could add any information that would change my opinion or advice.

HHH, MD

[taurusman]

Hi Dr.,

Thanks for your response and you've helped me feel at ease.  One follow-up question- after we had intercourse, I used a shirt to take off the condom and flush it.  I then proceeded to use a watered down washcloth to clean my penis.  Is there a chance that an infection occurred at this point if any of the water touched my urethra opening after I wiped my penis and surrounding areas?  How long does the virus live outside the body?

7/7 was the 2 year anniversary of my false positive, could the cognitive effects of stress and worry be the cause here?

Thanks so much for your reply

[H. Hunter Handsfield, M.D.]

None of these things increases the chance of HIV; this doesn't change my opinion or advice.

Whenever a person suspects a psychological/emotional explanation for his or her own symptoms, usually s/he is correct.  That certainly applies to the symptoms described in question 3.  But these won't cause nasal congestion etc; that sounds like a cold or allergy, as you mentioned yourself.

That will be all for this thread.  Take care and move on.