HIV?

[dj8]

Hi Dr. On August 16th I had vaginal sex with a woman of unknown status. Looking back it did appear that she could have been high risk. She asked that I use a condom and when I tried to do oral she pulled my head away. She was 20 years old and told me she already had 35 partners and her ex had a criminal history as a felon, this was all told to me after the experience and made me nervous. When we had sex she asked if I had condoms and I used lambskin condoms. During the night we had sex twice. Immediately after I removed the condoms.  I met this person who worked at a bank.I had just talked with her and she accessed my phone number to contact me. The day after the exposure I woke up feeling a chill like feeling and right away I thought for sure I had hiv or some other disease. Over the next two days I started to have what I would descibe as  hot flash feelings. I also developed white spots on my tongue that were later tested and were thrush. I also felt nauseous. I of course was very upset and went to a medical center to be tested. At the eight day mark I was tested for HIV, Hep A,B, and C which were all negative. I was also given a PCR viral load test. The infectious disease doctors at this hospital said that the eight day mark if my symtoms were caused by hiv there would have been a detectable viral load. In fact there would have been a high viral load. This test was sensistive to 400 copies and this test was also negative. I continued to have symptoms of fogginess and slow processing, hot flashes, soar throat, pain in armpits, and groin but there was never any swelling noted in my lymph nodes by DR.'s.I have felt lethargic and have not felt energized after sleep. I have also been coughing up flem alot over the last few months. I was given nyastin for the thrush and it went away after a couple of weeks. I also have HPV.I had several more warts appear and new growth several weeks after the exposure and currently they have gone back down and started to disappear. I have also gone to sleep much earlier than normal. I did take some medicine combivir but it was prescibed at the eight day mark after tests. I took it for around a month and it made me very sick. At the 23 day mark I was given an antibody test which was negative. I have been given several normal blood work tests which were within the normal range. A couple of weeks I was given an ANA test which was negative and a hepatitis C test which was also negative.  I have continued to be light headed at certain times of the day and the pains have continued under the armpits in the groin and under left rib cage no swelling detected. I know I have to have another antibody test to be sure. I was wondering what my exposure risk was? I was also wondering based what I have experienced if it appears to be hiv related. And if they are not hiv related are there any std tests or other tests you would recommend? Please help me! What protection does lambskin provide against hiv or other diseases? Thanks!

[H. Hunter Handsfield, M.D.]

All I can do is repeat my opinion that you do not have HIV.  I have no opinion about other possible causes for your complaints, but anxiety seems more likely than a physical explanation.  Continue to follow up with your personal health care provider.  I will have no further comments.

[dj8]

Dr. Just a few quick questions. I was not actually examined by an infectious disease Doc. They consulted with a Nurse Practitioner and also me on the phone. So inyour perception if I did become infected with hiv it definitely would have shown up in the PCR test at the eight day mark which measures the amount of hiv in the blood. Also the anitbody test I was given at the 23 day mark was by a life insurance company what hiv test do they generally use. Also in general I am still having symptoms now. Such as feeling tired and pain under left rib cage and under arm pits and sometimes groin but no swelling. I also have some nausea. Is it at all possible for people who are newly infected to contunue to have symptoms from first exposure right through five months after? I am having a CAT scan this week to see if there is any enlargement in spleen or lymph nodes, or anything else. Thanks for your help!

[dj8]

I was given a test by a life insurance company at 23 days. do you know what type of test they typically use? I thought that DR. H has said that lambskin condoms do provide some measure of protection against HIV? Do  you know what could cause pain under the armpits, in the groin and under the left side of the rib cage? I have been examined and Dr's say there is no swelling yet there is pain? It does come and go. How accurate is an antibody test at 23 days? And is it affected by taking Combivir?

[sparkeler]

Well, your *symptoms* developed to soon to be hiv.  You had a negative test at 23 days, which is reassuring.  Take one more test at the 6 week mark & then forget about it.  Chances are you didn't contract hiv.  For future reference, natural or lambskin condoms do not protect against STDs because they have larger holes or "pores" that allow the small particles that can cause some STDs to pass through.

[H. Hunter Handsfield, M.D.]

The advice from an infectious diseases specialist who has directly examined you is more reliable than anything I can say from an online question.  Since your ID doc says you don't have HIV, that's also my opinion.

Further, the odds are your partner was not infected, and if she were, if you used no protection at all, the chance you caught HIV would have been around 1 in 2000.  With a condom (even natural membrane) that risk was reduced still further, probably by 90% of more.  Finally,  the combination of a negative PCR test at 8 days plus negative antibody test at 23 days comes close to 100% assurance.  On top of all that, your symptoms came on much too soon to be due to HIV.  Putting it all together, the chance you have HIV is literally less than the chance you'll hit the jackpot on the next lottery.

Natural skin condoms are considered less reliable than latex condoms, but the actual protection factor has not been studied.  But any barrier is better than none and almost certainly you were highly protected, even if your partner had HIV.

Bottom line:  Mellow out. You cannot have HIV.  But continue to follow your own providers' advice.

HHH, MD