I'm very worried and need an expert opinion

[sykomike]

Hello Doctor, I am a heterosexual male who has had an encounter with a sex worker on 07/31/08. I had performed oral sex on the woman for less than a minute and then proceeded to vaginal sex wearing a latex condom. During the incounter which lasted about 20 minutes, I did not ejaculate. A week later, I had a bladder infection in which medications cleared up. During the time of the infection I was tested for Chlamydia and Gonorrhea, the results were negative. I took an HIV test 1 month and 2 months after the sexual encounter and the results came back negative both times. I am worried because before I took the second test a couple weeks ago, I started noticing that the glands in my neck were a little bit swollen, but without pain. They aren't visibly swollen, but I can feel them. I used a flashlight to look at the back of my throat and it look strange. It was veiny and there were strange looking spots at the back of my throat that are not red, but a little orangy. I went a doctor and he told me that its probably a sore throat, but my throat is not sore. I have been been coughing and was congested with a runny nose. The doctor gave me a syphilis test and a mono test and I tested negative for those too. I've asked my sister who is a nurse practitioner what could be wrong and she thinks that I just have allergies and thats what caused my glads to swell. I have also been very stressed since the time of my sexual encounter, which she says could be another cause. Other than the above mentioned, I have not had any loss in appetite, fatigue, or swollen lymphs in the armpit or groin area. However, I am still very worried because of my throat appearance which scares me that it could be a cause from the oral sex that I performed on the woman. Do you think that it is just seasonal allergies or some other kind of STD or even HIV? I still plan to keep getting tested. If the results are still negative after the sixth month, should I still worry?

[Edward W Hook, MD]

You have posted on the wrong site.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your questions with this reply but, if you have additional questions or follow-up they must be on the HIV Prevention site.  Sorry

To start with, let's re-cap your exposure: protected vaginal sex which is safe and very brief oral sex which is low risk.  Add to these facts that you have taken antibiotics and been tested for STDs with negative results and that you had two HIV tests both of which were negative. Your last HIV test at 2 months (8 weeks) was taken at a time when 98-99% of persons who had gotten infected 8 weeks before would have positive tests.  Then combine that with the low risk nature of your exposures and the fact that statistically your partner was not infected and the odds of you having gotten HIV from the exposure you describe are less than 1 in a million.


So why worry?  The answer is that your sore throat and perhaps swollen glands make you wonder if you got HIV. The answer to this issue is that symptoms do not in any meaningful way change your risk or the likelihood that you got HIV.  It is far, far more likely that you indeed do have seasonal allergies or a viral (non-HIV) sore throat that you caught in the course of normal life that are causing your symptoms. You have nothing whatsoever to worry about as far as HIV infection is concerned from the exposure you describe.  You can focus your energies on other things.  Hope this all makes sense.  If it does, you will not worry.  I hope that is the case. EWH

[sykomike]

Thank you very much doctor, you've helped out alot :)