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HIV concern
Hi Doctors, Early Nov of this year I had one instance of protected sex with someone I did not know well, and upon finishing we saw that the condom broke. He told me off the bat I have nothing to worry about, that he is clean. Since I did not know him well I decided it best to get myself to an HIV clinic and get PEP. I did that in the 48 hr window period and started taking the pills, only to find out that they were giving me massive side effects and I needed to stop them. I begged my partner to go and get tested at this same clinic, which uses OraQuick Instant oral mucosa tests, he came out -. After discussion with the doctor there he told me that based partner’s - Status and my intolerance of the meds its fine to stop the PEP and be back in 3 months for a final test. I relaxed after this but a week after stopping PEP (Nov 25) I came down with classic sympt of a viral infection - body aches, fever, rashes in mouth, liver pain, fatigue, loss of appetite, sweating. My partner has also gotten similarly sick at this time. It took a couple of weeks to get better but not completely. 3rd week of Dec, about a month after it all started I am still feeling tired and have massive sweat issues throughout the day, not at night. An incident finding on a neck ultrasound showed 3 enlarged lymph nodes, all on left side. Also feel constant tongue inflammation with orange coating and oral pain. Pain in the urethra, with a diag UTI treated with a 3 day course of Cipro, lingering irritation persists. Bloodwork was done, WBC counts are within norm but borderline high. Everything else is norm. Did STD testing at 6 weeks post exp, HIV is -, but still awaiting rest of the results. My questions: 1) Is a - HIV test at 6 wks a good sign, even considering i was on 1 wk of PEP 4 wks before before getting tested? Would 4 wks post PEP be enough for most to develop antibodies? 2) How accurate are instant HIV tests that use oral mucosa sample?Are they more or less comparable to the ELISA tests? Thx
MEDICAL PROFESSIONAL
That you remain "overly concerned" and "keep thinking about" outlandishly remote scenarios is not something I can resolve. I remain convinced you did not catch HIV and that any future test results will remain negative.
Doctor, thanks for the reply. Although this seems logical Im still overly concerned about my condition. I'm worried that when he tested he was just recently infected and hasn't had time to develop the antibodies, while for me they are not showing because I was on PEP for a week. I know that the chance of both events happening at the same time is very remote but nonetheless I keep thinking about that possibility. I will retest in a couple of weeks just to calm myself down, but will do a final test at 3 months.
MEDICAL PROFESSIONAL
Welcome back to the forum. Unfortunately, it's the wrong one. Questions about HIV risks and HIV prevention belong on the HIV Prevention and Safe Sex Forum. Therefore, my reply is brief.
The bottom line is that I agree with your doctor: since you now know your partner did not have HIV, you shouldn't be at all worried about it. (The risk was sufficiently low that most experts would not have recommended PEP. Certainly you would not have been given it at my STD clinic.) Further, although some of your symptoms could occur with an acute HIV infection, the overall description and timing of your symptoms is not at all typical for ARS. But most important, the fact that your partner didn't have HIV, plus your own negative HIV test results at 6 weeks, prove you did not acquire HIV during the sexual exposure you are concerned about. Although HIV antibody may be delayed by PEP, I stress "may": this isn't actually known, and most experts believe PEP doesn't make any signficant difference. The oral HIV antibody tests are just as accurate as the lab-based ELISA blood tests, so no worries there.
Since your doctor has recommended a final HIV test at 3 months, you should follow that advice. You can be confident that test will remain negative.
Happy holidays-- HHH, MD
The bottom line is that I agree with your doctor: since you now know your partner did not have HIV, you shouldn't be at all worried about it. (The risk was sufficiently low that most experts would not have recommended PEP. Certainly you would not have been given it at my STD clinic.) Further, although some of your symptoms could occur with an acute HIV infection, the overall description and timing of your symptoms is not at all typical for ARS. But most important, the fact that your partner didn't have HIV, plus your own negative HIV test results at 6 weeks, prove you did not acquire HIV during the sexual exposure you are concerned about. Although HIV antibody may be delayed by PEP, I stress "may": this isn't actually known, and most experts believe PEP doesn't make any signficant difference. The oral HIV antibody tests are just as accurate as the lab-based ELISA blood tests, so no worries there.
Since your doctor has recommended a final HIV test at 3 months, you should follow that advice. You can be confident that test will remain negative.
Happy holidays-- HHH, MD
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