Worried a lot

6 days ago, I posted an ad on craigslist and a lady (not a sex worker) responded. We had sex that night. We started with french kissing, me licking her nipples. Then she performed unprotected oral sex on me. We then had vaginal sex using condom. In the middle, I took out the condom and she gave me oral sex (I am worried that she might have transferred some vaginal fluids-if any- from the bottom of my penis close to where my hair grows that was not covered by condom completely to the tip of my penis). After the unprotected oral, I've put on another condom and we did vaginal sex again until I came. In both cases, condom was intact. I don't know if she has any STDs (tho she claimed at the time she didn't).

Since Day 1 including today (Day 6), I have this musle pain in my neck, and this weird feeling on the tip of my penis (as if it is mildly hot, and mildly burning inside, but no real pain, and no pain during urination).
Day 2 I was very worried, and ordered standard array of STD tests including HIV online and gave blood & urine sample in the morning. 3-4 days after I've got the results and they were all negative. In the afternoon, I've got really worried and went to an urgent care. They collected urine and put a stick through the opening on my penis head (very painful). Urine result came immediately showing no UTIs. They gave me a shot and 1 dose of antibiotics for just in case that day. Stick test result came today (Day 6) negative. Started reading up on HIV online, read forum posts, symptoms etc. I started having mild night sweats.
Day 3 & 4 - I started getting chills every once in a while at work. Mild-medium night sweat again at night

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  Let me start with the bottom line.  While you may be ashamed and feel badly about your behavior and the encounter it lead to, it did not put you at risk for HIV and you clearly did not an ST from the encounter.  I will elaborate on these comments below.

HIV first.  HIV is not spread through oral sex.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  You will not be the first.

Your symptoms are not due to HIV. They have occurred too soon. The symptoms of HIV typically occur 2-4 weeks following exposure, not within days.  Your symptoms are more consistent with the sort of non-HIV, non-STD virus that people tend to get all the time.  

STDs.  You have now been tested twice at a time when the tests will provide reliable results an despite negative tests have been treated.  I suspect the medications you were given include ceftriaxone (the shot) an azithromycin which would cure/prevent the most common STs, gonorrhea, chlamydia and NGU.

My advice.  You need to stop worrying.  You are not at rsik. Further testing for STD or HIV is a waste of time and money.  I hope my comments will allow you to do this.  EWH

[miccim]

Day 5 - Didn't sleep well -because I was very worried. Night sweat again. Started feeling mildly itchy whole day around different parts of my body. Which increased my worries 1000 times. I've observed couple of small rash on my face and 1 on my hand. Any other day, I'd call it just minor irritation to something (like dust etc).
Day 6 (today) - Night sweat again but no longer feeling itchy. Felt very very mild sore throat and very mild stuffed nose in the morning when I woke up. Few hours later it was gone. I've got super worried, had a little anxiety attach there for few minutes and ordered HIV DNA PCR test and gave blood for it in the morning. Later today (after following my post yesterday), I started reading these forums, and started reassuring myself that this is all in my head. For couple of hours I wiped the fears off my mind and felt fine just like any other day. Then I was looking at my neck and noticed a swallen lymph node on the left front side of my neck. It is not visible normally, only if I stretch my neck muscles (as if I'm swallowing my spit and holding it like that), I can feel the small lump by hand (tho it is still not visible). I've ordered another standard STD test with standard HIV test + HIV DNA PCR again and I am thinking of giving blood for it on day 10 or 11.

I am very ashamed of what I have done, never had a one night stand in my life before - let alone finding someone through craig's list. I usually get worried easily when it comes to health problems and I don't know if all these symptoms are due to my anxiety/paranoia or whether I've really got infected with HIV. I'd described my situation as honest and best I could, and would very much appreciate your professional view.

[miccim]

Thank you so much Dr. Hook. I can't describe how good your post made me feel. You are right, the single dose of antibiotics was called azithromycin. I'm not sure what the shot was called, but it was done on the top of my buttocks and they said they had to observe me for 20mins after the shot before releasing me.

Do you think the std blood+urine test I've got on Day 2, and stick test are good? On the web sites I've ordered them from they state I'll need to wait longer or get retested (I've ordered them using my savings, and not through insurance). I should get the results of the blood I gave today for HIV DNA PCR sometime next week, and was planning on redoing standard STD test again towards the end of next week (Day 10 or 11). I am so relieved that you believe there is no need. Thank you again!

[Edward W Hook, MD]

Glad to help. As I siad, there is no need for aditonal testing for STDs.  EWH

[miccim]

Hi Dr. Hook, I wanted to share my results. After talking to you, just for a piece of mind, I did complete STD tests with HIV DNA by PCR upgrade on day 15 and they came back negative. For additional piece of mind (tho realizing it was probably waste of time and money like you mentioned), I ordered the expensive HIV RNA by PCR test and got tested on day 22. Today morning (day 25) results came back negative. I believe a negative HIV RNA by PCR at 3 weeks is conclusive (I've read window period for RNA test is usually 9-12 days).

Thanks again so much for your help and great contributions to this forum.

[Edward W Hook, MD]

I hope these results will help you to move forward from your concerns. It is time.  EWH