Seeking advice

[sg92]

I had what I believe to have been a protected sexual exposure with a CSW. To my knowledge there was no breakage as I've been informed that condom failure is not a guessing game. A day later I began to feel ill and from then up until now I've felt not back to 100 percent. The main symptoms That are bother some are a persistent soar throat for almost a month now and redness on my urethra with a semen discoloration. I attempted to ask the escort of her status and she claimed that I am not the one who has to worry about that kind of stuff which was moderately assuring but I don't know still. For the past 9 weeks I have been living in anxiety and fear. I've also had nausea during my days which at one point was bad but I've progressed over time until now. I've tested at various points during these past few weeks, all with standard AB tests/rapid tests and they've all been negative. The latest test being at 8.5 weeks. What advice would you give?

[H. Hunter Handsfield, M.D.]

You misunderstood something.  My guess is that the 85% figure referred to the oral fluids rapid test, and even that applied only to testing at around 6 weeks.  As I wrote above:  "...the most important information in your question is your negative HIV test results.  With the standard tests in regular use today, negative results at 8+ weeks after exposuire are 100% reliable".  

That's definitely all for this thread.  I suggest you stop searching the internet or this forum for bad news.  Do your best to stop worrying about this.

[sg92]

Hello, Doctor H

I read an old thread from you the other day with regards to rapid testing.
You mentioned in there about them having 85% accuracy. I tested negative all the way from 2 weeks through 10 weeks. The first test I had done was a lab based AB test and the last 3 test i had were indeed rapid test. Unigold Recombigen I believe. I was almost ready to move on but kind of got stuck again on the accuracy of my test. The 10 week one to be specific. I still have symptoms, one being a throat with bumps. Doctor said there was nothing to culture but did see the bumps and irritation. He said it was allergies and mucus. Its been almost two months.

Was that because it was 2010 then, and now its 2014?

[H. Hunter Handsfield, M.D.]

No comment.  Asking the same questions with different words won't change the answer.  This thread is over.

[sg92]

Thanks for the small laugh I got there at the end. I am slowly starting to realize that whatever it is that is bothering me is not due to HIV. I guess I have a last question for you. From other readings I have scanned I have come to understand that ARS is the body's response to the antibodies, causing the symptoms that are reported. Now since these issues I've been having have been here for multiple weeks, that would mean if it were true ARS the standard AB test would result in a positive? I'll do my best to put this behind me.

[H. Hunter Handsfield, M.D.]

As I said, the blood test results overrule everything.  If enough time has passed, there are no exceptions.  Your test results PROVE you don't have HIV, i.e. that something else is the cause of whatever you are seeing in your throat.  As you suggest, such abnormalities indeed are almost always due to minor medical conditions like allergy or minor virus.  And if you are medically untrained, I don't trust that what you are seeing is abnormal anyway.  But for sure they have nothing to do with HIV or with the sexual exposure described above.  If you remain concerned, see a doctor.  But get off your obsession with HIV.  No chance, no way, nada, rien, nichevo.  Got it?

[sg92]

Thank you, Doctor.
With all due respect, I would like to point out that I've looked into my mouth with a flashlight and have seen reddish bumps on the wall of my throat. Though I have also read that sometimes bumps there are normal, but I can't help but wonder since I've had a sore throat for a few weeks now. This as well as my genital issue concerns me. I have avoided sex with my long term girlfriend for weeks now. Every test I have done has been done in the midst of on going symptoms. Could you elaborate on whether or not you believe a test would show if symptoms were due to HIV? I suppose some other common illness could be the cause. I've tested 3 times now for the standard STDs and HIV.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

As you were correctly advised on the community forum, this was a risk-free exposure:  condoms work.  Congratulations on the wisdom to have safe sex!  And it is true that condom failure "is not a guessing game"; you would have known.  Also, I agree exactly with your escort partner's comment about who is really at risk here.  Sex workers in general are at much higher risk of HIV and other STDs than their clients are.  Like most escorts (expensive female sex workers, by appointment), it would appear your partner understands the risks and how to protect herself.

But by far the most important information in your question is your negative HIV test results.  With the standard tests in regular use today, negative results at 8+ weeks after exposuire are 100% reliable; see the threads linked below.

http://www.medhelp.org/posts/show/1891685
http://www.medhelp.org/posts/show/1704700

Therefore, test results always rule:  no matter how high risk an exposure seemed (yours was low) and no matter how typical the symptoms for HIV (yours are not at all typical), negative testing proves you aren't infected.

Your symptoms sound like they are primarily just the result of your heightened awareness due to anxiety, with minor variations in body sensations that are not abnormal.  If they persist or you remain concerned, see a doctor or clinic.  But you needn't worry at all about HIV or other STDs.

Best wishes--  HHH, MD