Should i get tested?

3 weeks ago I had unprotected insertive vaginal sex and performed cunnilingus (i chew snuff) on a woman I had just met.  Since that time, I have corresponded via e mail with this person and she has since began to ignore me as I think i may have put her off with my incessant questioning regarding std/hiv status, actually told me i needed "help" when in the last e mail i expressed that i was going crazy with anxiety and guilt (i am married).  She consistently told me that she was safe and clean, but never stated that she was hiv negative.
This is where I am at now.  I have had "night" sweats my whole life, or for as long as i can remember, so having those now only adds fuel to the fire.  I think i have had "shotty" lymph nodes for a long time, haven't felt for them since my last hiv episode prior to getting married 7 years ago, had myself convinced i had it then due to my college days, was tested and it was negative, sought mental health and was diagnosed ocd and took meds for about a year and no flare ups "mentally" since then.

I am going to get tested, i have not told my wife as of yet, however i have only had "safe" sex with her since for fear of infecting her, so i my frame of mind is a bit compromised as well.  My question......it has only been 3 weeks since encounter if i am experiencing ars will testing now be more accurate or how long should i wait if i only want to take one test.  I have not had a sore throat, no fever other than night sweats (seem to happen when i have myself convinced i am +), my lymph nodes (underarms, groin and front of neck) are about the size of the tip of my finger or smaller and not sore, although i have been constantly (50 + times a day) pushing and prodding them.  I know you can't diagnose me but i am also just venting a bit, and i thank you and your site for allowing me to do so.

[H. Hunter Handsfield, M.D.]

If your casual partner knew she had HIV, she probably would have told you.  My guess is that her refusal to be clear means she hasn't been tested or, as you suggest, she has taken personal affront because of your insistence  My bet is that your OCD--or your manner and approach because of it--probably turned her off, perhaps with good reason.  But even if she were infected, the chance of HIV transmission during any single episode of vaginal intercourse is less than 1 chance in 1000, and cunnilingus isn't a risk at all.  Your symptoms don't sound at all like HIV.  Pushing and prodding for lymph nodes is irrational and it sounds to me like your OCD needs attention right away from a mental health professional.

From a mental health standpoint, getting tested for HIV makes sense; the result will be negative.  However, perhaps you will be interested in the following, in which I quote myself from a thread earlier today:

"As I have said many times, in general I don't recommend testing for HIV after particular sexual exposures, except in obvious high-risk settings (e.g., unprotected vagainal or anal sex with a known-positive partner). The better approach is periodic routine testing, e.g. every 3-12 months (depending on risk level). Most people at risk do this--unlike most who post questions on this forum, who on average have inflated perceptions of their risks.  Here is a good rule of thumb (I just thought of it; don't assume it is a standard recommendation by CDC or any body): If the risk is high enough to consider PEP, testing should be done. Otherwise periodic routine testing makes more sense."

Bottom lines:  Almost certainly you did not acquire HIV during the exposure you describe.  Consider seeing a health care provider for follow-up advice about your OCD.

Good luck--  HHH, MD

[nutcase?!?]

I truly appreciate your comments, i actually slept well last night sans sweating, very nice.  Woke up with a stuffy nose, which made me happy!

Anyway, how long should i wait to have my test, that was my original question.....i am married, this was a one time encounter (very drunk in vegas) and i truly do not see it happening again, if for no other reason than the guilt that i am experiencing is debilitating.

[H. Hunter Handsfield, M.D.]

There is no single answer about when to get tested.  My advice is that 6 weeks after exposure is plenty, but some people believe in 3 months.  It depends on how much certainty you require.  Search the threads and archives for "time to positive HIV test" for many discussions of this.

HHH, MD

[nutcase?!?]

Seeing that I have not had a sore throat, except a little one one morning when i awoke with a stuffy nose that was gone the next day and that I am really not sure if my lymph nodes are swollen or just shotty, i haven't had a fever that i am aware of, the woman that i slept with won't respond to me cause she said "you need help" I guess i am going to assume that i don't have hiv.

[H. Hunter Handsfield, M.D.]

You're going to "assume [you] don't have HIV"???  Did you read my initial response?  Your chances of dying in some sort of accident in the next 24 hours is higher than the odds you caught HIV from the exposure you describe.  Get a grip.

HHH, MD

[nutcase?!?]

No need to be so rude.......i found your response to be unnecessary and a bit pediatric or juvenile if you will.....

[nutcase?!?]

Would you change re think your assertation if i told you that i have what feels like tiny bb's on both inner thighs and stomach?

[H. Hunter Handsfield, M.D.]

No.

Re "rudeness":  You are not the first to get a message like that.  Call it tough love.

HHH, MD

[nutcase?!?]

I am sorry, you seem to be a very nice and professional person.  Tough love is probably what i need.  For lack of a better term i "felt" my brother up and he has the same little bb's on his inner thighs and stomach, i guess it is probably just "fat", now he thinks i am a nut as well, but it made me feel better, but i still cannot bring myself to have intercourse with my wife.  I am at 4 weeks now, gonna wait another 2 weeks then get tested, just for my mental state.
FYI, i have an appointment with my mental health doc tomorrow, same one i saw 7 years ago.  Yay for meds.