HIV Concerns

[WorriedWell5]

Hello -

About 7 weeks ago I had a questionable sexual encounter, after which I was very concerned with STDs, especially HIV. I tested negative for HIV 1, 3rd generation ELISA, at 1 week, 4 weeks, and 6 weeks. I also took an OraQuick Advance at the free clinic at 5 weeks which was also negative. At the same time I have also been experiencing anal discomfort (comes and goes) however after few Gastroenterologist appointments I was told there was nothing to worry about. Also, I've had what appears to be tendonitis in my arms for the last 2 weeks and a sudden outbreak of bumps on the my upper arms that another doctor said was Keratosis Pilaris (which I don't believe I've ever had before). I've been under an extreme amount of stress the last 7 weeks and I really don't feel like anyone has been able to help me. I guess my questions are:

1) What are the chances of having HIV after those tests? Should I be worried about HIV 2?

2) Could acute tendonitis, accompanied by what appears to be Keratosis Pilaris on my arms be a sign of early HIV infection? If not, could it be a sign of something else?

3) Could EXTREME anxiety cause these symptoms to appear? I have also lost weight (173 down to 165).

4) I was tested for gonorrhea, syphallis, chlymidia, from a urethra swab at my first exam which came back negative. Is it still possible I have these STDs and they are the cause for the 7 weeks of on and off slight anal discomfort?

I'm still really worried about all of this and I guess I'm hoping for some peace of mind.

Thanks for this service.

[H. Hunter Handsfield, M.D.]

It would have been helpful to know your sex and whether the encounter 7 weeks ago involved your rectum.  I would be most concerned if you are a gay man who had receptive anal sex.  With that caveat:

1) There is essentially no chance that you have HIV with those test results.

2) Tendinitis isn't a sign of HIV or other STD.

3) Tendinitis likely isn't related to anxiety, and I can't comment about the skin bumps (and I am unfamiliar with the skin condition you mention).  But your vague rectal symptoms could be normal sensations magnified by anxiety.  As I have said many times on this forum, when a person susepcts his or her own symptoms are due to anxiety, they usually are right.  On the other hand, if you were on the receiving end of anal sex, you should have had rectal STD testing to be safe.

4) Not knowing exactly what tests you had, it's hard to be cerrtain.  But most likely you aren't infected with anything.  But, to repeat what I said above, you don't say whether you had receptive anal sex or whether your tests included rectal testing for common STDs.

Good luck--  HHH, MD

[smithers]

how reliable is the 4 week test compared to the 3 month?

[tfe]

Hiya.

I'm not a doctor, but based on a gazillion posts about this very topic, I can offer that unless you've had a significant exposure (unprotected sex with a confirmed HIV+ person), 3 months is more than sufficent.

I was in your shoes not too long ago; I had every symptom in the book until my negative test. A day or two later, magically, everything from bumps to pains to this and that went away.

I hope this reassurance is helpful until you get an official reply from Dr. HHH; you may wish to consider checking out some HIV/AIDS counseling programs in your area if you are having difficulties accepting your negative status. Good luck and try to relax. I hear the Virgin Islands are nice this time of year ;)

[barneyc]

Doctor,
I have a related question. How effective is the oral rapid HIV test. I received one at 4 months after exposure and was wondering if it is as accurate a standard blood test. The test required me to wipe the swab along the top of my gums twice and once along the bottom gums. It then was read 20 minutes later. Is that the proper procedure and is it an effective test?

[H. Hunter Handsfield, M.D.]

smithers:  See many other threads about reliability of HIV test results at various intervals.

barneyc:  The oral test has the same reliability as the standard blood test.

HHH, MD

[WorriedWell5]

Thank you for your quick response.

The encounter 7 weeks ago was protected anal receptive intercourse as well as un-protected receptive oral-anal intercourse (my first experience). The intercourse seemed to hurt and I discontinued after a minute or less.

1) Would you still support that: "There is essentially no chance that you have HIV with those test results"?

2) My testing did not include rectal STDs. Is a slight burning sensation around the rectum that persists for 7 weeks or more indicative of a particular STD? (I did have a sigmoidoscopy and several inspections of the area by a gastroenterologist that revealed nothing).

Thank you again for your help.

[H. Hunter Handsfield, M.D.]

If you are confident the condom was in place before anal penetration and did not break, the chance of an anal STD is almost zero.  Your rectal symptoms probably are anxiety-related, perhaps combined with continuing discomfort due to stretching the anal sphincter, which is common after rectal sex; most gay men acclimate and trauma/discomfort lessen with repeat episodes.  Evolutionarily and anatomically, the rectum simply wasn't designed for sex and it takes getting used to.  (The fact that anal sex is inherently traumatic is an important reason why HIV transmission is so more common among gay men than heterosexuals.)

None of this changes the reliability of the HIV test result.  But the official recommendation remains for testing at 3 months.

To keep your HIV risk low, for future anal sex just be sure you always use condoms; and avoid exposure to HIV positive men (even with condoms) (i.e., ALWAYS ask partners HIV status, and always share yours).

HHH, MD

[WorriedWell5]

Thanks again for the quick response.

Do you think it's necessary for me to get re-tested at 3 months?

I will most probably follow through with a complete physical at 3 months including an STD test, however I really want to put my HIV fears to rest for now at least!

Once again, thank you for this service and please excuse the extra messages.

[Yippy]

I had an unprotected sex encounter 4 weeks ago. I have not gotten tested yet, but I have a slight sore throat and a few pains in my left arm and side. No other symptoms. I was wondering if this is a concern. I will no doubt be tested, but this situation is destroying my mind. This encouncter was only once and was a mistake. I did not know this female and insertion was vaginal and oral only. My question is:

Could I have these symptoms becasue of stress or because of HIV, and when is a good time to do a test, which is more accurate, lastly what are the chances of me catching HIV or any other STD's through a situation like this.