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Avatar universal

Hiv symtoms after oral sex

Hi Doc,
               I received an unprotected oral sex from a sex worker on 03 march 2006 (no vaginal or anal sex) which I believe was hiv+. After a week I felt very tired all the time and I had a sore throat so I went to a doctor which gave me amoxyllin 500mg 3 times a day but that did not help me and till now I have recurrent pain in my neck and throat which sometimes is painful but sometimes it feels like it is stiff and sometimes pain in my muscles near armpits and in the neck. I also now have what is called geographic tongue ,also my tongue is always white and if I brush hard the white coating gets removed.
                  One month after my possible exposure I went to the STD clinic and got all my possible STD tests done which included (syphilis, chamlidya,gorraehia, HIV1,HIV2,Hepatitis C) but all came back negative. But my problems persisted so I got another antibody test done at 2 months which also came back negative. After that I got a swollen armpit in the third month which hurted me a lot for couple of days and finally I got tested for hiv at 3 months, which also came back as non-reactive.  Then I went to India and I had severe pain in my neck and throat and I again got tested in India at 5 months mark and the reading of elisa test were .02 and .03 .
                    
                                   My problem is that I have few days when I feel that something is wrong with my body and I feel very tired and also there is pain in my neck and throat which comes and goes and I also found some hairs grown on the back of my tongue and it really worries me a lot .One more thing doc I also have small pimples on the chest and they are there for last 6 months now and I think they are
33 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
NOTICE TO ALL FORUM USERS:  *PLEASE* READ THROUGH THE FORUM FOR RELATED THREADS BEFORE YOU POST YOUR QUESTIONS!  IT IS VERY FRUSTRATING TO REPEAT THE SAME INFORMATION SO MANY TIMES!

Symptoms never reliably indicate new HIV infection, and when testing is negative at least a few weeks after exposure, it is ALWAYS the test result that tells the truth, never symptoms. Five months is more than enough time, no matter what HIV test was used, in India or any other country.  Whatever is causing your symptoms, it isn't HIV.  Anxiety or depression sounds like a good bet.

Also, nobody has ever been proved to catch HIV by receiving oral sex.  NEVER ANYWHERE IN THE WORLD IN 20+ YEARS OF AIDS!  There have been such reports, but I stress "proved".  If it occurs, it is too rare to measure.  If that was your only potential exposure, you did not need testing for HIV, and probably not for the other infections either.

Pimples of the chest probably are just pimples.  If you have molluscum of that location, it wasn't sexually acquired.

No follow-up "yes but" or "what if" questions, please.  There is no additional information you can provide that would change my opinion and advice.

HHH, MD
Avatar universal
I donot understand abouth this result
*5 months mark and the reading of elisa test were .02 and .03 .
is it negative or positive. can anyone explain about this
Thanks
Avatar universal
Excellent post.  Very clear. Thanks
Avatar universal
Actually, a person could factor in .20 (20% or, i.e 80-90% of infected people get ARS)) that you did not get Acute HIV symptoms as well that would jump the odds quite a bit in itself.  Is that logical?
Avatar universal
Why would a gay man who had anal sex with a known HIV positive person be any more at risk than a woman who had anal sex with a known HIV positive person? I find the comment by the doctor to be troubling....
Avatar universal
Thanks Doc, I am extremely happy today after reading ur comment and now i have no more worries at all.Once again thanks doc.
Avatar universal
"Why would a gay man who had anal sex with a known HIV positive person be any more at risk than a woman who had anal sex with a known HIV positive person? I find the comment by the doctor to be troubling...."

I don't think he is.  He is saying that in the United States and most industrial communities HIV is much more prevelant in the gay community and IDU users.  So statisticly your chances of receptical anal intercourse within the gay community carries a much higher risk than a male hetero act.  

Symtpoms mean nothing so factoring symptoms into any equasion is pointless.  Especially if people started calculating -20% because they have a sore throat.
239123 tn?1267651214
MEDICAL PROFESSIONAL
I don't understand what troubles Ronnie99.  I didn't say that receptive anal sex is any less risky for a woman than for a gay man.  Receptive anal sex with a known-infected male is the highest of all sexual risk activities for HIV transmission.  The gender of the receptive partner doesn't matter.  (Presumably Ronnie isn't offended because I just happened to pick a gay male scenario rather than a heterosexual one.)

HHH, MD
Avatar universal
That is not what was said. The quote is: "Situation B: High risk, really at risk person, a gay man who has receptive anal sex with a known HIV infected person."

I'll repeat: How is a gay man who receives anal sex from a known HIV positive person any more at risk than a female who receives anal sex from a known HIV positive person, be that person a IV drug user, bisexual, or heterosexual man?

Avatar universal
So essentially you are saying that the behavior is the key, not the sexual orientation. I brought it up because the web is worldwide and HIV is a vastly heterosexual disease worldwide.
Avatar universal
dumbo, the reason I said symptoms shouldnt be inclued is because the doc has given you, me  and everyone a clear way to assess your/our risk.  The predictive value will mean little to those with symptoms if they feel that their symptoms lower or debunk their odds.  HHH, aidsmeds, Dr. Bob have all stated that symptoms or the lack there of mean nothing in reguards to HIV.  Only testing tells the true story.  

I've said it before, I'm not an HIV expert but I did stay at a Holliday in last night.....

Avatar universal
If u have reading >.25 then its positive otherwise its negative and to be precise if u have a range in between .07 and .25 then its weakly positive.
Avatar universal
Thanks Doc u really releaved my fears as the ENT doc to which i went said that there have been cases that people have become positive after 8 months and u need to keep ur fingers crossed and pray to god so i was really scared, Can u suggest me any tests i should go for to know what is wrong with me from the above said symtoms as i always feel that my neck aching and my throat is little bit sore and tongue white. I really apologize for not writing it in my previous question.
Avatar universal
i am in same situation unprotected oral. i got tested at 14, 18 & 19 WEEKS all are negative by Elisa, Orasure & Oraquick. but still i have problem with white coated tongue, neck and head ache but no sore throat never and fever also. i have some dental problems am expecting that might be problem. The white coated tongue because of Amoxillin(antibiotics). whatever symptoms you have are not ARS. symptoms never descibe HIV+ only HIV test. i have two concerns about your situation i.e
1)5 month test 0.03 means later its going to be >0.7/>0.25 i have no idea and for my case i never get the result like that
2)Positive result after 8 months ( I dont think it happens)
overally i would say STRESS is mother & father for all pains.
Thanks
Avatar universal
Yes the fact a person at low risk, who has possible exposure, but has no symptoms does factor into the equation especially if 80 to 90 % of infected people show symptoms....how could it not?  Stacked with all of the odds the Dr. has stated AND showing no symptoms does apply especially combined with a 4-6 week negative test.

Anyway, I will not argue with you, you are now an expert since you are in the clear obviously, hence the reason for the more, say, cocky posts. Interesting thing is that when you were worried, you did not listen to the re-assurance on this board (the same stats you now state to others) or the many others you frequented at the time of the worry.

Glad to see you are out of the woods so to speak.

As the Doc says, this is my last post on this thread.

take care.
Avatar universal
Actually if u have a reading less than .07 then u don't need any further testing if it is not in the window period i.e 3 months so if u have greater than .07 then u might need another one after few weeks. That is what i know . Anyways my throat is also not sore and i can eat properly without any problems but its like some  mild constant pain in the neck and throat. I am really repenting what i did 7 months ago and i swear to god i won't do such a mistake again in my life. Anyways thanks for the comment
Avatar universal
Dr. Rockoff from the dermatology forum, (2004, subject rash as an HIV symptom)said to dcnelsonmn that he needed to test out to 6 months for HIV to rule it out. My question is why would he say that? It's the same forum as this one, only for dermatology.
Avatar universal
the similar problem i have thats is just because of stress. now am at 21 weeks mark am still woriied. my 19th week test is Neg. all the three HIV tests i took in USA i am scared to take the test in India becoz of 0.00 system, your comment please.
Thanks
Avatar universal
Actually i had only one test in india that was on 5 months mark, rest all were done in canada and they also tell if its reactive or non-reactive so all my earlier one's were non-reative and last one that i had in india was .02 for hiv-1 and .03 for hiv-2.
239123 tn?1267651214
MEDICAL PROFESSIONAL
OK everybody, listen up.

1) An ELISA result that is below the cut-off is absolutely negative.  A result of, say 0.05, is every bit as negative as a result of 0.00 or 0.01.  It has to do with the physical chemistry of ELISA technology, not that some people have "a little bit" of HIV antibody.

2) The longer cut-offs for reliable results (3 months, 6 months) are old news, but when knowledge moves as fast as in this field, "old" is only a few years.  Providers who are not AIDS experts should be forgiven if they are unaware of the latest information.  Many providers tend to worry about lawsuits, so they lean toward conservative advice--and the longer you go, the more reliable a negative HIV test.  On top of that, a lot of docs simply don't understand the concept of "predictive value"--about which more below.

3) As I have said many times, there is no time cut-off for the last HIV result that applies with equal usefulness for all patients.  For most of the very low risk exposures that generate the giant number of irrational, unrealistic fears on this forum, a 4 week test is fine.  But some people at especially high risk need testing at 8 weeks or even 3 months.

Why?  I have gone through the following calculations several times, but it bears repeating.  This is the concept of the "predictive value" of a test.

Situation A:  Low-risk, worried well, panicked person after a heterosexual exposure, say with a commercial sex worker.  Odds the worker had HIV, say 1%.  Odds of transmission by unprotected vaginal sex, average 1 in 1000 (tops).  Likelihood of a positive test at 4 weeks, 90%.  Even before the test is done, the odds that the exposed person acquired HIV are 0.01 x 0.001 = 0.00001.  That's 1 chance in 100,000.  Add a test that is 90% reliable (the 4 week test) and the chance someone has HIV, after getting the negative test result, is 1 in a million.  Think how low a risk that is:  Equivalent to sex with an infected person once a day for 2,800 years before catching HIV.  In other words, essentially 100% assurance.

Situation B:  High risk, really at risk person, a gay man who has receptive anal sex with a known HIV infected person.  The risk of infection in such a person is 1%, i.e. 1 in 100.  Now test at 4 weeks, same test, i.e. 90% reliable.  After the negative test, the risk of HIV is 0.01 x 0.1 = 0.001.  That means there still is a 1 in 1000 chance the exposed person has HIV.  Although most rational people can live happily with a 1 in a million chance, most of us would lose a lot of sleep at 1 in 1000.  So this person needs additional testing, out to 8 weeks or even 3 months after exposure.  Exact same test, same test peformance--but difference levels of assurance.  That is, different predictive values.

worried1947, your risk of having HIV, even before you had your first test, was less than 1 in a million.  That's why you didn't need testing at all.

HHH, MD
Avatar universal
Doc, you really need a FAQ section.  This one would be at the top of the chart.
79258 tn?1190634010
Jeez. The "gay male" analogy was just to illustrate ONE example of a high-risk event. That's all. I think you read way, way too much into his comment.

Re: HIV as a gay/straight disease--this article was posted the other day on a sexuality listserv I participate in...

http://www.latimes.com/news/printedition/la-me-hiv30sep30,1,7654094.story
Avatar universal
This indeed is an insightful post for someone who hasn't been following this forum previously. At the same time, we can't thank the doc enough for re-iterating what he has been advocating all this while.
At the same time, I would like to question predictive value with respect to test conclusiveness in massachusettes at 6 weeks. It is in common knowledge of HIV forum surfers that mass advocated 6 weeks testing as conclusive. I am not sure if they attach any predictive value in giving out a set time frame for all kinds of exposures(be it high or low). Nothing in medicine is 100% but if the odds for high risk is 1/1000 after 4 weeks negative result, testing at what point of time will be feel good indicator that hiv is not present especially in presence of symptoms(ie. 8, 10 or 12 weeks) which are obviously meaningless but CDC does list them in their website.
Avatar universal
Ronnie,

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