Question about HIV Testing and Exposure

Back in June on my bachelor party, I had an encounter with a CSW in Las Vegas. I have never done this before and I feel great regret for doing this but we had protected oral and protected vaginal. I got so freaked out after this that I tested for everything 4 days after the encounter. All results came back negative but I know it was too soon for some thing such as Herpes and HIV. I then tested again for everything 3.5 weeks after and everything game back negative. I also did a DNA PCR HIV test with the antibody test and both came back negative. I just recently took a 6 week anti body test for HIV and it came back negative (whoo hoo). I have had some symptoms since the exposure but I know that HIV cannot be diagnosed by symptoms. I do have anxiety but all of this can be attributed to that since I felt great displeasure and guilt. And I know that if my symptoms were due to HIV then I would have tested positive at 6 weeks. is that true?

Here are my questions

1) If my symptoms were related to HIV, would I have then tested positive at 6 weeks? ( i never had fever, rash, or swollen lymph nodes)

2) My doctor says that I was low risk and therefore done need a 3 month test but should I test at 3 months anyway?

3) How conclusive is a 6 week test in my situation?

4) I have had a mild sore throat that I only feel discomfort when I sing or yawn. Do you think that is at all attributed to acute hiv infection?

5) I have had some back pain but it seems to come and go depending if I do activities or not. This wouldn't be because of HIV infection right?

6) I have been having protected sex with my wife (she knows about the situation and we are doing counseling) and she wants to have un-protected sex but I want to until my 3 months test before we continue to have un-protected sex. Should I be holding out?

[Edward W Hook, MD]

Welcome back to our Forums.  As I mentioned to you last month, the exposures you described are no risk. thus all of your negative tests serve to confirm what I've already told you, this was a no risk exposure which has no risk for HIV or other STD associated with it.  If your symptoms had been due to HIV, your HIV antibody test would have been positive within a week of the time the symptoms began and your HIV DNA test would have been positive at that time.  In answer to your specific questions:

1.  Yes, they would have been positive.

2.  I agree with your doctor. A 3 month test is a waste of time and money.

3.  A 6 week antibody test would have detected at least 95% of recently acquired HIV infection and probably more.

4.  No, there is virtually no chance your sore throat is due to HIV acquired through your encounter with the stripper you described.

5.  No, your migratory back pains would not be due to HIV.

6.  I really see no reason elated to the encounter you described to worry about unprotected sex with your wife at this time. You had virtually no risk to start with and now have negative tests to validate this statement. EWH

[Keepworrying07]

I have also noticed little red bumps on my penis but my doctor says its normal skin variation. I was afraid of Herpes or Warts but the little red bumps have been there for 6 weeks that I have noticed. They might have been there before so I am not sure...They are on the penis glans (glands) and dont hurt or scab. They are tiny. Does this sound like herpes or hpv? I am un-circumsized by the way.

[Keepworrying07]

Dr. Hook

Thank you so much for your reply. It is very comforting to hear you say this now. I am a little more at ease but it scares me a little when i think about it.

I will ask you four more questions, if I may, then I will be done with this thread.

1) My backache started 1 week after the encounter and lasted almost a month and a half. It was constant but the pain wasnt as sever as the first day. The severity lasted about 1 hour or so. The only thing I did differently was I was taking Cipro and had other side effects so I thought this one was one of them. Does that change your assessment about whether my backache is related to HIV?

2) My wife has been getting these pimple like bumps on her butt-cheeks. They are maybe like 10 and they are all spread out. They look like pimples to me and she says they don't hurt her or bother her. We just got  back from vacation about 3 weeks ago. Do you see any concern here or do you think they just might be pimples and not an STD symptoms?

3) Would any STD have an impact on the appearance of sperm? I am just curious...

4)have also noticed little red bumps on my penis but my doctor says its normal skin variation. I was afraid of Herpes or Warts but the little red bumps have been there for 6 weeks that I have noticed. They might have been there before so I am not sure...They are on the penis glans (glands) and dont hurt or scab. They are tiny. Does this sound like herpes or hpv? I am un-circumsized by the way.

Thanks in advance for your reply!

[Edward W Hook, MD]

Directly to these questions, all of which have reallyalready been answered:

1.  No, this in no way changes my assessment.  If anythng, the additional information makes it less likely your back pain is due to HIV.

2.  No, your wife's rash does not in anyway concern me in realtionship to your risk for HIV.

3.  No, HIV does not impact the appearance of male genital secretions, including sperm.

4.  No this does not sound like herpes or HPV (which are questions unrelated to your original post)

EWH

[Keepworrying07]

Dr. I hate to bother you with this follow up question but I must ask since its causing me great distress. After your answer, I will not reply with a few questions and I will work hard to put this all behind me.

1) I recently developed a weird sore throat. I have had sore throats in the past but this time around it just feels different from other times. The pain seems to be located in or around my adams apple and I mostly feel it when I yawn, sneeze or sing. I also feel like something is stuck in my throat and I cant swallow my saliva. Does this sound like HIV and would this change your assessment?

2) I have been having some nausea the past 3 days which comes and goes. Would this change your assessment and is it an early sign of HIV? Keep in mind my exposure was 8 weeks ago and my 6 week test was negative.


3) I had a doctors appointment last week for my sore throat and he said that based on my symptoms, it sounded more like irritation from GERD. I have had GERD in the past so it is very likely. However, When I spoke with the doctor (not my GP, hes another DR there) and I explained to him my concerns for HIV based on my exposure he also said it was low risk but that I should test at 6 months cause the virus can stay dormant for many years and a person will not even know it. He then told me to test every year for 10 months just to be sure but that it would only be to put my mine at ease. Does this mean that my 3 month test ( which is in 4 weeks) is not going to be conclusive?

I seem to be getting mixed information and not sure which to go by and which to believe. Thank you so much in advance for your reply and for all of the work you do here. It is greatly appreciated!

[Edward W Hook, MD]

I'll take you at your word- this will be my last answer.  

Before I adddress your questions, like me say that if you are searching the internet on these issues you will likely receive as much mis-information as correct information.  I would advise you to stay off the internet.

1.  No, this does not suggest HIV and in no way changes my advice or assessment.

2.  No, this is too late to be ARS.  It could well be heartburn (GERD) or anxiety however.

3.  This doctor is mistaken. Testing at 8 weeks or any time beyond is conclusive.

Hope this helps. EWH

[Keepworrying07]

Dr. Hook,

I know I said it was my last question and I feel bad for not keeping my word and coming back and asking another question but the way I am feeling right now, I think its a must to ask despite me looking like a fool. After this question, I promise that I will not post any more questions or any more replies about this encounter.

My two part question is; What are the chances of my 6 week anti body test changing to positive at 12 weeks? and have you seen this happen before?

[Edward W Hook, MD]

At 6 weeks over 95% of tests will be positive. Thus the math says that about 5% or fewer persons will develop positve tests between 6 and 8 weeks.  This of course is irrelavant to your no risk situation.  You did not need testing to start with but you seem to need to waste the resources.  

This thread is now over. EWH

[Keepworrying07]

Dr. Hook,

You deleted my last question and I do not blame you, as you said your last answer was your last. However, I sincerely ask that you answer this last question and not delete *** as I am very curious. You do not even need to give me long explanation.

My question is; I took an antibody test at 10 weeks and it was negative and I would like to know the reliability. Has anyone ever tested positive after 10 weeks.

Your last answer is all I need to move on. I promise I will not start any threads or keep asking questions after this. Thanks in advance Dr. for your good work!

[Edward W Hook, MD]

Please move on. This question has been answered numerous times.  With further questions the entire thread will be deleted. EWH

[Keepworrying07]

A related discussion, Question about HIV Testing and Exposure - Follow up was started.