Stomach Ulcer and Expert Opinion PLEASE

[InNeedOfExpert]

The service you provide on MedHelp is invaluable. My recent fear of HIV infection has led me down a road of shame, fear, and unparalleled anxiety.  

I am 25, usually healthy, past mono. Athletic and now monogamous in a 5 month relationship.

October 27th, 2007 became intoxicated and engaged in sexual activity with a CSW in Las Vegas. Protected oral and then protected vaginal sex.Older lady.She provided the trojan condom and put it on.Oral then She was on top and then I was behind. Do not recall the condom breaking at any point, but clearly so drunk I was in no shape to recall the condom’s final state. It definitely was not ripped to pieces. Small hole possible.The activity was no more than 10 minutes.she asked to clean herself up (foul smell after “cleaning herself up” in my bathroom). I asked her if there was anything I should be worried about. She responded “I always use condoms”.  After this I scrubbed.  
Tested as follows:
3 days post exposure all std’s negative (hiv antibody)
1 month all negative
4 ½ months hiv negative – antibody chemoimmunoassay by BAYER and rapid oral test
5 month 2 week rapid test – negative.
Hives on girlfriend and flu like symptoms begin .NO FEVER.small rash on me and my sharp stomach pains begin.
174 day post exposure - negative all std's - antibody immunoassay and separate rapid test.
NAAT test pending any day.Diagnosed with stomach ulcer by GP and given nexium. From HIV or worry/ alcohol/ skipped meals? GP told me too much stress.

-Are tests conclusive? waiting on NAAT (unfortunately).
-Does the ulcer or girlfriends rash/ my rash warrant ANY further testing?  Can I attribute it to weekend binge drinking, stress, and skipping meals (due to stress)?
-Can I start sleeping unprotected with girlfriend again?
I HAVE started to see a therapist as of three days ago to address my extreme worry.  I know I need help.

My stomach, heart, and relationship are indebted to you.

My birthday is Sunday, PLEASE help me!

[Edward W Hook, MD]

Get over it.  Your exposure was a single, protected exposure.  Most commercial sex workers in the US are not HIV infected.  You have had multiple negative HIV tests out as far as six months. I can state categorically that you do not have HIV or STD form the exposure you describe.  On to your specific questions:

1. The results are conclusive
2.  No, your GF's rash (and yours) is not related to STD or HIV.  As to what is causing it- I cannot say. This is best addressed by your health care provider.  What I am sure of however is that this is not HIV or STD.
3.  Yes, you can resume unprotected sex.

Hope this helps.  EWH

[InNeedOfExpert]

Dr. Hook,

Thank you endlessly for your response.  Apologies for my FINAL questions -  If the condom were to have broken slightly, my tests out to beyond 5 months would remain conclusive despite the rash and ulcer…?

I truly believe that the onset of my stomach ulcer and the sickness of my girlfriend really put me over the edge of worry.  I just could not find anywhere whether this ulcer could be tied to late seroconverting.  Is it safe to say that those that seroconvert beyond 5 months are those with severly damaged immune systems?  I trust your opinion that neither of these symptoms of mine would warrant further testing beyond the tests at 174 days already received (probably excessive to begin with), and I imagine it’s safe to think my NAAT test will come back negative.  

For those that read these posts and forums consistently (as had I), I would like to suggest that you not only listen to the Doctors…but also stop with the underlying factors in your decision making that have led you to do something that causes you so much concern…i.e. (in my case) excessive alcohol consumption.  I have worried myself to an ulcer, an actual health concern, over what turns out to have been psychological concerns – fear, guilt, shame, etc.  As for me, binge drinking is a certain thing of the past.  

This is an amazing service that you all offer…to everyone from regulars on the forum board, to the Doctors, to the administrators.  This, as are many, disease is a horrifying monster that encapsulates one from the inside out and I would like to make a donation to a foundation for future research (already have to AHF) if at all possible.  

Many Thanks. One happy soon to be birthday boy.

[Edward W Hook, MD]

1.  Condoms do not break slightly.  If the condom had broken, it would have been obvious.
2.  At five months your results are conclusive.  Believe them.
3.  Persons who have converted late are medical oddities and should not be of concern to you.  Your ulcer is not related to HIV although your worry over the matter may have made things a bit worse.

Time to move on.  Take care.  EWH

[InNeedOfExpert]

Thank you. Thank you. Thank you.  You do a great thing.

[InNeedOfExpert]

It turns out that many people in my office do not respect my GP.  They suggest I seek a second opinion as to my ulcer (just burning pain in my stomach).  If this does not turn out to be an ulcer, but rather some other sort of stomach/ gastro injury, I am still in the clear correct?  I know my questions must sound redundant and annoying, but I just want to cover my basis to prevent a sneak attack when I receive the results of the NAAT next week.  My negative antibody at 175 days was just at the very onset of my stomach problems and rash.
Thank you one last time.

[Edward W Hook, MD]

This is the last answer.  Additional questions will be deleted. Your tests are negative.  You do not have HIV.  This is not a concern for you.  EWH

[InNeedOfExpert]

Sorry Doctor Hook - Fear does play a role in the anxiety driven questions and because it has been so difficult to receive an experts opinion, I had to take advantage of your services.  Thank you for calming my nerves...and giving me the facts.  I feel much better and know that my NAAT will confirm your statements and this nightmare will be behind me entirely.  I am going to move forward in my life and I'll always owe a piece of that to your caring career move.  Good luck to you and thank you truly for all.