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Avatar universal

HIV risk

12 weeks ago I had sex with a sex worker.  Received 10min or unprotected oral and 2 min of vaginal protected. Started burning.  Went to see Dr. at week 5.  Tested for Chlamydia and Gonnorhea.  Chlamydia came back positive after one week, meantime symptoms persisted,  Dr. gave me 1gr of azithromycin.  I took it and the symptoms subsided but not entirely.  I started to have left testicle pain, lower back pain and pelvic pain, especially after mastrubating.  Dr. thought it was epididymitis, gave me Ofloxacin for 7 days.  My symptoms went away.  By last day of Ofloxacin I ran a half marathon heat.  I thought nothing of the Chlamydia as i believed I acquired it through oral.  The condom didn't break, maybe a small tear?  I began researching the subject and many told me it is not possible through oral and many said it is.  Apparently many prostitutes have oro-pharyngeal Chlamydia from giving blow jobs and mostly are asymptomatic.  Started to stress about HIV.  I haven't any symptoms that I can recall except for one.  Is this a symptom?  Around the time of exposure I was watchig TV, eyesight got a bit blurry and then followed with a bad migrane, I had to turn off the lights and couldn't stand any noise.  I quickly got sweats and chills followed by nausea, within half hour I threw up and took a ***t.  Showered to cool off, went to sleep and woke up as good as new.  The whole incident from blurry vision to throwing up was two-three hours, I felt immediately better after throwing up.  I also ate like a pig beforehand.  In week 9 I started to freak out about HIV.  Looked for symptoms that waren't there.  To see if I had a hard time swallowing I swallowed every ten seconds until it slightly irritated the roof of my mouth for like two three days.  I am terribly scared to get tested.What are your thoughts on:
1.  Am I at risk of HIV?
2.  Does my migrane resemble ARS
3.  Can ARS last a couple of hours?
4.  Do ARS symptoms happen all at once? and when?
Thank you
9 Responses
239123 tn?1267651214
Welcome to the forum.

I scanned your several discussions about your apparent chlamydial infection and will comment first on that aspect.  Although I didn't have time to read all the details, apparently it is uncertain whether you actually had a lab test for chlamydia, or if your doctor just assumed chlamydia because you had NGU.  Your symptoms don't help sort it out.  You could contact the doctor's office and ask directly.  If you had an actual positive lab test, then the only possibilities are that there was a condom failure that you didn't recognize; that there might have been brief penile-vaginal contact before you put the condom on; or that you were infected at some other time and place.  Chlamydia can persist for many months, so it is possible you were carrying it for some time before the sexual exposure 12 weeks ago.  It is very unlikely you caught chlamydia by oral sex, but nonchlamydial NGU is often acquired that way.  In any case, the treatments you received would have definitely eradicated chlamydia if you had it.

OK, now turning to the main question here, whether you might have caught HIV.  The answer is almost certainly not.  To the specific questions:

1) It is statistically unlikely your partner had HIV; in the US, under 1% of commercial sex workers is infected.  Oral sex is little if any risk, even without a condom.  Vaginal sex with a condom carries no risk, if the condom does not fail and is properly used.  However, if you in fact had a positive test for chlamydia, it could indicate condom failure, as noted above.  But even so, the chance of catching HIV from a single such exposure is very, very low.

2-4) No, HIV does not show up as migraine, or as headache (unless there also is fever, sore throat, etc).  ARS symptoms start in 10-14 days, certainly never later than 3 weeks.  The 3 most common symptoms are fever, usually 101 or higher; sore throat; and a body-wide skin rash; 70% of people with ARS have all three of these, and generally they all start within a few days of each other.  The symptoms generally last 1-3 weeks.  ARS symptoms definitely cannot last only a few hours.  

You say nothing about HIV testing.  You should do it now.  Not because I believe you caught HIV; I definitely do not.  But you should be tested for reassurance, since the negative result will probably calm your fears about it better than anything I can say.  And anyway, everyone with any new STD (NGU or chlamydia, whichever it was) always should also be tested for HIV.

Feel free to return to let me know your HIV test result.  If the events 12 weeks ago are your only potential risk factor, you can be sure it will be negative.

Regards--  HHH, MD
Avatar universal
I feel much better.  I will get tested in a few days and will post back.
I have one question please.  You said the chance is very, very low.  Could you provide some odds please?  I would find it more reassuring.  Also, do these numbers reflect the assumption the worker is positive or not?  Anyway, could you please provide me with the odds for both scenarios?
I promise not to bother with any more questions.  Your first reply has calmed my nerves greatly.  Much obliged for the help :-)
239123 tn?1267651214
Assume 1% chance your partner had HIV; if she did, 1 in 2,000 risk of transmission from unprotected vaginal sex; lower that by 99% because a condom was used.  The risk calculation then becomes 0.01 x 0.0005 x 0.01 = 0.0000005.  That's 1 chance in 20 million.

It is very rare for any single heterosexual exposure to result in HIV transmission in the US.  I'll bet not 10 people a year in the entire country acquire HIV from exposure events similar to yours.
Avatar universal
Hello Doctor,
I went to the public health clinic here in Toronto.  They were so busy that I would have had to wait three hours just to be seen.  I ended up booking an appointment for this coming Wednesday.  While I was there they told me to in the meantime call their Health Hot Line to speak to a nurse.  The nurse proved to be very nice and made sure to read to me word for word facts out of their manual.  I found very little help from her.  However, she said that most people do not even experience symptoms and that the duration is not important.  Even if the exposure is 2 seconds then there is a great chance of transmission.
Can you please comment on,
1.  Duration of exposure.
2.  How many infections result in ARS symptoms.
3.  Also, why is single exposure less likely to result in transmission vs. multiple?  Isn't each act independent?
I don't mean to inundate you with these questions, I just found that speaking to this nurse was somewhat disheartening.
It took a lot for me to go to the clinic today, I thought I was going to be sick :-)  I really appreciate what you do here as without this dialogue I don't believe I would have the courage to go to the clinic in the first place.  I am still very scared.
Avatar universal
Hi Doctor,
I am having some discomfort on my left top side of abdomen.  It has been uncomfortable for a few days now.  Started when I read this can be a symptom (coincidence?)  I am worried it could be swollen spleen and am starting to freak out again.  I am also burping a lot.  Could it be my spleen is enlarged at 12 weeks past exposure?  Does it come with other symptoms?  Please help me as soon as possible as I am going to get tested in15 hours.
Greatly appreciated.
239123 tn?1267651214
Your username says it all.  You are overanalyzing a low risk situation.

Just have the HIV test.  When you get the result, which will be negative, believe it.  In the meantime, suck it up.  Do not post any more comments or questions until have the test result.  If you do, they will be deleted without comment.
Avatar universal
Just came back and the results are negative!
I feel so much better.  Like just got a new lease on life.
You do amazing work here!  Thank God there are people like you that provide this great support!!!
239123 tn?1267651214
Congratulations -- but of course you are the only one who is surprised by the result!  But thanks for the thanks.  Take care and stay safe.
Avatar universal
My pleasure.
Since tested at twelve and a half weeks, I can now move on, yes?
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