HIV risk: Indicative symptoms?

[oceanscape]

I am a 22 year old male. In June 2009 I had oral sex and mutual rimming with another male. He did not insert his penis into me, however he did put/rub his penis near my anus and around the hole. He ejaculated on the cheeks, near my anus. Around 3-4 weeks after this exposure I got tested and found out I had anal gonorrhea. The doctor was surprised given the fact we did not have anal sex, in fact, I think she thought I was lying. The HIV test was negative.

Since this exposure back in 2009 I have had a few other encounters, but oral sex/rimming only. I have not had (given or received) anal sex at all, not even protected.

In the past few months I have become increasingly paranoid and upset about the possibility of having HIV. I frequently feel drowsy and depressed. I have lost weight. I regularly get colds and sore throats. My lymph glads on my neck are regularly inflamed and I often experience a dull under-arm pain at the same time. I have read that all of these are HIV symptoms.

I know I should brave up and get tested, but before doing so I would be grateful for guidance on the following issues:

1) Is a negative HIV test 3-4 weeks after the exposure accurate?
2) Given the fact he had gonorrhea, is it considerably more likely he also had HIV?
3) Do you need full insertion of the penis into the anus to contract HIV (consider also the fact that I somehow got anal gonorrhea without proper penetration)?
4) Are my symptoms common HIV symptoms? - should I be concerned?

I'm losing sleep and can't concentrate. I keep reading about HIV symptoms and get convinced that everything mentioned applies to me.

Four months ago I fell in love. We have had protected sex only and I am always extremely careful. However, he too had cold/flu like symptoms within a few weeks of our first exposure, and has had colds/flu symptoms more regularly since meeting me, as he "never usually gets ill". I'm feeling so guilty that if I do have it, he could now have it too and it's all my fault.

[oceanscape]

Doctor, I had the test today and the result was negative. Thanks so much for the invaluable advice and support you offer. All the very best wishes.

[Edward W Hook, MD]

1.  Yes, results of the rapid, finger stick tests are just as accurate as tests performed in the lab.

2.  Corrrect.  The symptoms of early HIV do not wax and wane.  Further they typically appear 2-4 weeks after exposure, not after a matter of months.  EWH

[oceanscape]

Thank you, I really appreciate you taking the time to offer advice. I will get tested on Monday and come back here and post the result.

1) Is a "fast" finger pin prick test accurate? Or should I just choose to get a standard HIV blood test? I know that the anxiety of waiting for results would cause me immense stress and sleeplessness, so I figured the test where I get the results right away would be better.

2) Regarding my symptoms - is it true that symptoms of HIV do not normally continually "appear and re-appear"? Is it rare that they would start to show so long after the initial exposure? I did not experience any of the symptoms described until at least a fair few months after the exposure.

Thanks again, Doctor. This will be my last post until I come back to share my result.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to  help but the bottom line is that you need to be tested.  In my judgment, as I'll elaborate on below, it is most unlikely that you have HIV but only a test will resolve the concerns and doubts that currently plague you.  Testing does not give a person HIV but it does give them the power to know what is going on and whether or not they have the infection.  Most tests are negative and if you were so unfortunate as to have HIV, the test would allow you to seek treatment sooner.  There is no reason to delay or avoid HIV testing.  With that as background, let's work through your questions:

1.  At 4 weeks a standard HIV test will detect over 90% of recently acquired infections. Thus your negative test is strong but not definitive evidence that you did not get HIV.

2.  Gonorrhea and HIV are both STDs but most people with gonorrhea do not have HIV.  There is a somewhat increased likelihood that a person with gonorrhea had HIV but it is not great.  gonorrhea is much, much more easily transmitted than HIV.

3.  I have never heard of or seen a case of HIV transmitted without penetration.  I find it most unlikely that you will be the first.

4.  Swollen lymph glands can be symptoms of HIV. they can also be due to viral infections including mono, which are far, far more common than HIV.  

Bottom line, there are many reasons to presume that you do not have HIV- no penetration, a negative test, etc.  Please get tested.  I predict the test will be negative.  let us know when you get your result.  EWH

[oceanscape]

I should also mention I have an eczema-type rash on my arms and dry skin on my feet. I have also had a mouth ulcer, which I've not had before, but believe can also be associated with HIV.

Thanks for taking the time to respond; I really appreciate it.