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I am a person who believes in science and facts so I will leave out all the guilt and anxiety driven information.  I am a heterosexual male who had unprotected vaginal and oral sex with a CSW in Miami, Fl, USA.(I am aware that rates of HIV are higher in this area compared to other areas in the US).  I tested at 3 and 6 weeks with HIV PCR DNA done by LABCORPS.  I also tested with HIV 1/O/2 Antibody via ICMA thru LABCORPS at 6,9,12, and 13 weeks.  All test were negative.  I did not know what else to do so I tracked down the CSW and paid her to take an HIV antibody test.  She did the HIV-1 Home Access Test at 10 weeks after we had sex, it also came back negative.  I did test positive for HSV-1, 13 weeks after exposure with a HSV-1 IgG Type Specific test.  The result came back strongly positive at 4.65 (anything > than 1.09 is positive).  I never had an outbreak before and I have never tested for Herpes before either.
1)What are the chances that she was still in the window period?  What are the chances I have HIV? ( I've had many symptoms but seeing how symptoms are trumped by test in this site I didnt state them)
2) I know herpes roughly doubles the chance of acquiring HIV so are my results accurate?  Is there anyway of knowing from the lab values if this was a recent or old infection for Herpes?
3)Do you any expert advice for me?  I have not been able to move on?
4) Do I need any further test?
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300980 tn?1194929400
MEDICAL PROFESSIONAL
I do not know that you need treatment for your HSV-1. Over 50% of Americans have HSV-1. while HSV-1 can cause genital herpes of whom only 10-20% of persons are aware that they have the infection.  Most HSV-1 infections are oral in location.  You do not know that you have recently acquired HSV-1, you do not know the location of your infection and you do not know if your GF already has HSV-1 or not although the odds are at least 50/50 that she does. thus there is little reason to initiate therapy for HSV-1 at this time.  

If there are further questions about HSV, please start a new thread on the STD forum.  Take care. EWH
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Avatar universal
Dr. This will be my last question I promise.  I know this is the HiV thread but it's regarding herpes.  Since I have never has an outbreak do you recommend I see my doctor to initiate treatment. I have a girlfriend so will it make me less infectious if I was on medication?
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Avatar universal
I can't move on so I have decided to seek professional mental counseling.  I have lost my job an everything through this time.  I really hope I did not acquire HIV from this exposure.  But I did want to thank you for the service you provide on this site.  God bless you.
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Einstein said :one defintion of insanity is to do the same thing again and again and expect a different outcome".  Repeat testing is a waste of time and resources.  If you feel you must, get one more test but ONLY if you can promise yourself that you will believe the result.  PCR tests are not recommended for HIV testing -among other reasons, the false positive rate for PCR tests (i.e. a positive result in persons who do not have HIV) is higher than for blood tests.  Each of us on this Forum have seen a number of people who were worried needlessly because of false positive tests.

A solitary swollen lymph node is not a sign of HIV.

EWH
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Avatar universal
Hello Dr.
Thanks for the advice.  Im starting to convince myself that I don't have HIV but I still wake up with "what if" questions everyday.  One of the main reasons of my continued anxiety is a swollen lymph node in the right side of my neck about the size of a marble.  It swelled up 9 weeks after exposure.  I decided to take anoter test at 4 months post-exposure which was also negative.  I see myself testing out to 6 months and it's not to question your opinion, but for my own peace of mind.  I'm also a pharmacist and have 50 HIV patients and they all look so normal so it scares me so much.  I will admit that out of the 50, about 48 belong to high risk groups (homosexual), and only 1 is a female.  My doubts are that I have taken the same antibody test throughout.  Should I take a different type?  I'm also extremely worried because my girlfriend had a sore throat and stuffy nose 16 days after unprotected sex but no fever and now 6 weeks after she has dandruff and large white spots on her right arm.  Would a PCR RNA test be smart to take at this point for additional reassurance? No lab in my area has p24 antigen test...if I take a western blot which looks for p24 be accurate? Do they use the same mechanism to test for p24? Thank you
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  You need not worry about HIV from the encounter with the CSW you describe.  Directly to your questions:

1.  She was tested long after the window period and her results, and yours, all prove conclusively, incontrovertibly evidence that you did not let HIV from the encounter you describe.

2.  The data are that HSV-2 increases risk for HIV.  There are no similar data for HSV-1.  Your HSV-1 result mean only that you, like over 60% of Americans, have HSV-1 which was likely acquired in the past, not recently.

3. My advice- believe your test results.  You do not have HIV.  You need to figure out how to move forward. If you cannot do so on your own, get the help of a counselor.

4. Further testing is a waste of time and money.

I hope my comments will help you to move forward EWH
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