Do you think I need to retest

[rodrick123]

Doctors:

I recently had a negative HIV test for 1 & 2 (along with testing negative for all other std's.  I had three risks within the three month time period and they were as follows:

1.  Protected vaginal with massage girl 8 weeks prior to test.

2.  Protected vaginal with massage girl.  Pulled out and pulled off condom and masturbated to completion 9 weeks prior to test.

3.  Unprotected oral receiving, protected vaginal with massage girl.  Pulled out, pulled of condom and masturbated to completion 11 weeks prior to test.

All of the risks were with different women.  The condom never broke but honestly I didn't really check it other than to notice that it wasn't completely ruptured.  Also, I'm not sure if I used the same hand to masturbate that I used to take off the condom.

I never had any actual ars symptoms but a girlfriend of mine who I had unprotected sex with had a fever, muscle pain and headache for about a week's time roughly two weeks after we slept together which is what led me to my current concerns.

For the last three months I have had fullness in my ears that has since been diagnosed as Eustachian tube dysfunction.  Currently they are starting to feel like they are infected because they really hurt.  I was given Flonase to take care of it which has done nothing in over 6 weeks of taking it.

So my questions are these:

1.  Are the risks I've described high risks in your opinion?
2.  Would my test, with the most recent risk being 8 weeks be seen as conclusive as to my HIV neg. status?
3.  Is ETD a symptom of HIV?  Not ars but actual HIV infection?

4.  And this is the big one . . . if you were me would you retest?

Sorry for the encyclopedia but if you could answer these questions for me I'd be forever in your gratitude.  Thanks for all the great work you do.  It can't be easy to continuously answer the same questions over and over again.

[Edward W Hook, MD]

Welcome to the Forum.  The exposures you describe- condom protected sex, receipt of oral sex and masturbation following condom protected sex do not carry any risk for HIV.  This is true not matter what hand you used to take the condom off before masturbation.  Thus, based on these exposures you are not at risk for HIV and do not need testing. I note however that you also, almost as a side note, mention unprotected sex with at least one other female partner.  

If you have had unprotected sex with anyone, massage girl or otherwise, and whether or not you have symptoms of any sort, we would recommend screening for STDs, including HIV.  Screening is testing in the absence of symptoms and is recommended because you have had a new or multiple partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had a new or two or more sex partners in the past year, even in the absence of symptoms (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).  STDs such as gonorrhea and chlamydia can be present without symptoms. Thus I would suggest testing for gonorrhea, chlamydia and HIV. Your risk is very low but it is a good idea.  

Finally, in answer to your specific questions:
1.  The exposures you describe are essentially no risk.
2.  A test 8 weeks following exposure is conclusive.
3.  No, ETD is not a symptom of HIV.
4.  See above. I did not recommend screening because of the exposures you describe but as a general health measure.  I predict if you do get screened yoru tests will be negative

EWH

[Edward W Hook, MD]

Not angry, just trying to be clear.  Glad to hear of the course you are planning to take (this thread is still over).  EWH

[rodrick124]

Thanks for the tough love Doc.  Sorry I had to make you go there.  You sound a little angry and you certainly don't deserve that from a neurotic like me.  I'm sure everybody on these boards thinks their situation is unique (and I'm sure they are to an extent) and I certainly am no different.

The problem was that I wasn't completely honest with my doctor about my potential risks.  I mean I told him I believe I've had a few risky events but I didn't want to elaborate.  He never pushed at all and in fact didn't seem to take me all that seriously only agreeing to give me the ok for a test after I persisted.  Then he called and told me my tests (He ordered a full std panel) came back normal.  He didn't elaborate on them at all.  I realize that by not just being completely open I brought this kind of vaguery on myself.  

Now armed with your resoluteness I can honestly tell myself that either my sinus and ear issues are unrelated or their was some mix up with my results from the lab.  I live in a big city, my doctor is amazing and the lab that performed my test is one of the best in the country so I'm pretty sure I should be good there.

Knowing that you certainly would want to error on the side of caution and still feel so strongly about my test results helps me tremendously however.  I'll take up any further issues with my doctor.

Thank you so much for everything.  I'm not sure how you've managed to keep an even keel all these years.  But I thank you from the bottom of my heart for putting up with me.  Somehow you managed to make me feel like you truly cared about my issues even thought I'm sure you've heard everything a million times before.

[Edward W Hook, MD]

Sorry, I am not going to feed your anxieties by debating you over your anxieties, your arguments or things you've found over the internet.  You can find just about any sort of nonsensical reports you want on the internet and if I were to engage in these sorts of debates I would never get to answering the questions of others.  

Your 9 week results are conclusive and to be believed. If you cannot accept this I urge you to seek help in working through your unfounded anxieties.  EWH

[rodrick123]

So my doctor said he thinks I may have an adenoid issue and is sending me to an ENT.  Then I read this on line:

A woman aged 25 yr consulted the Department of Otorhinolaryngology with complaints of persistent nasal obstruction caused by adenoid hypertrophy recurring shortly after recent adenoidectomy. Previous elaborate investigations did not reveal the cause of this unexplained phenomenon. Testing for human immunodeficiency virus (HIV) was positive. In case of an unexplained recurrent adenoid hypertrophy, an infection with the human immunodeficiency virus should be considered in the differential diagnosis.

So of course now I'm freaked out beyond all measurable reason.  Do you still think that a 9 week negative with the risks I've described mean I'm conclusively negative and I don't need to retest?  

[rodrick123]

OK.  So I'm officially looney tunes.  I get it.  But my sinus issue and eustachian tube issue persists to this day (going on 3 1/2 months).  In your last post you mention that masturbation with someone else's genital secretions on your hands is virtually impossible because the contact is with non mucous membrane skin and because the secretions come in contact with air.

However, I know the urethra is a mucous membrane.  Why is it impossible to think that secretions from the sexual act could get in there during masturbation?  And I've read that HIV can survive outside the body for at least a few minutes even in conservative estimates.  So if the virus could survive for that long it could definitely have been alive when I rapidly removed the condom and proceeded to masturbate.  And I was pretty rigorous about the masturbation by the way and it took a long time to get to completion.  So in this situation couldn't it be possible that, if the woman was positive, that the virus would have survived long enough to make it into my urethra during masturbation and infect me?

I know, or rather I hope, you're going to say its impossible.  You've said that its never happened but isnt it possible that people could have been infected this way but had other exposure risks that seemed more likely so they blamed it on those and not the masturbation?

What I'm getting at is, is there a single scientifically proven reason for why there is no possible way to catch HIV this way?  Like maybe the act of sex causes the head of the penis to slam into the mucous membranes of the vagina slightly opening the urethra each time it does so.  The act of masturbation does not allow this semi opening of the urethra in the same way so its physically impossible.

I don't know.  I'm so sorry to continue to question you but you're really the only person I can go to this with and I really need a little more on the explanation front to calm my fears.

Sorry.  My illness is just starting to make me feel somewhat irresponsible for not retesting even though its the last thing I want to do again.

[rodrick123]

Thank you so much for your help.  Now I can relax just in time for the holidays.

[Edward W Hook, MD]

Masturbation, when it involves participants getting each others' genital secretions on one another leads to contact of external, non-mucous membrane skin with genitla secretions, not mucous membranes. HIV is transmitted more easily through mucous membranes.  Furthermore, secretions and thus the virus is exposed to air. These two effects greatly reduce transmission effectiveness.  This in turn has, as you note been proven by observation of millions of such events without transmission.

Yes, when the upper respiratory tract is effected by HIV it is when the infection has been present for some time, not early infection.

You need to stop worrying and accept that the exposures you describe REALLY did not put you at risk.  EWH

[rodrick123]

Thanks so much for your quick response.  Please allow me two final questions that have been eating away at me.

1.  I'm having a problem understanding why masturbating after protected sex isn't a risk.  All of the risk factors would be there.  I know you've said about 1 million times that no one has ever contracted the disease this way.  Does your faith in that not being a possible cause of infection lie solely on that fact that no one has ever been diagnosed with only that as a risk factor?  Or do you have a medical reason as to why it's not medically possible to contract hiv this way?

2.  I know that ETD isn't a symptom of HIV.  But I've read that ETD presents often in HIV patients and in fact in patients that are asymptomatic except for the ETD is usually the first thing a doctor will want to rule out.  Often it occurs because of adenoidal swelling.  My ears began clogging up about 7 weeks after my last exposure so about 10 weeks after my first.  Would this be way too early to be HIV related?

Thanks for your time and thanks again for your patience.