How likely do I have HIV?

[scaredyafraid]

  I am a gay male, 26. On July 2nd, I had an affair with a 24 y.o. male outside of my 5 year relationship. It was unprotected and I was bottom. The next day, I was tested for multiple things including HIV (life insurance purposes). It came back negative.
  The days passed and my guilt and anxiety about the encounter kept mounting, my mouth became really dry, working out in the yard gave me a case of poison Oak on my wrist. I got so scared that it was HIV that I started doing a lot of reading and really became a hypochondriact about the situation.I worked myself up so much that I got tested again 10 days after the encounter. It came back negative. During that time, I have not been able to think of nothing but and have been having a huge problem with anxiety, I was put on Lexapro to calm all of my text book symptoms of GAD. I went to the doctor again on July 23, and my dry mouth has turned into a very mild case of Thrush. I have been taking the antibiotics and my lexapro and everything seems to be calming down. I think the thrush could possibly have come from my anxiety/stress and/or from the guy I had the affair with. He was uncircumcised and when I was doing oral on him it tasted and smelled kind of odd. I have never had sex with an uncircumcised guy before.

[scaredyafraid]

I have contacted him and he explained that he was negative and that he gets tested quarterly...he is drug tested so he gets HIV testing done with that...So, can my reaction to everything be from anxieties...

[H. Hunter Handsfield, M.D.]

The main lesson--which you undoubtedly have learned--was that no gay man should ever have sex with another guy without first asking about his HIV status and sharing his own; not to mention the condom part of it.  Not to lecture you--just to make a point for other readers.  Knowing and sharing HIV status is one of the most important and most effective HIV prevention strategies.  Even now, it probably isn't too late.  Call the guy and ask him!  If he says he is HIV negative, almost certainly you are in the clear.

Even if he has HIV, the chance of transmission to you probably was 1 in 100.  High enough to be concerned, but still the odds are strongly in your favor.  Every single symptom you describe is consistent with anxiety; not one bit of it suggests acute HIV infection.  I'm even skeptical you really have thrush (oral yeast infection); just coated tongue etc is not the same thing.  (However, it is true that dry mouth--an anxiety issue--can predispose to yeast overgrowth.  Anyway, true thrush occurs in healthy people with normal immune systems.  I had it myself once.)  You probably didn't get yeast from your partner, regardless of his circumcision status.  Most people carry yeasts normally from time to time in our mouths, intestines, and on our skin; thrush happens when our own yeasts overgrow, not from a new infection.

You need another HIV test around 4-6 weeks after exposure--and given the high risk nature, a final one at 3 months.  The odds are strong the results will be negative.  And if you can get hold of your partner and he has tested negative recently, that will be greatly reassuring.

Good luck--  HHH, MD