Symptoms

[Stupid_me]

Dear Drs, For the last 7 months or so I've been back in the panic zone of HIV. Nearly 3 years ago I was drunk and had sex with a CSW in Germany. I was drunk so can't remember much about it. I remember it started out as protected oral, then protected vaginal and then I remember her asking me if I want to take the condom off (I was struggling to keep it up). I also remember her giving me a hand job without the condom on. Now, I can't remember if we did have unprotected sex or if she took the condom off and just gave me a handjob. Anyway, at some point I also ended up with a small tear on my frenulum. Plus, the red light district was very multicultural with African and Thai girls. My CSW was coloured but, I don't know if she was German or not. Well, I got tested at 7 weeks, 12 weeks, 27 months and 33 months at a GUM clinic in the UK (the last 2 tests were 4th generation but, the other 2 I'm not sure about). Plus, I had a fingerprick, 60 second test done at 31 months. All these tests were negative. I was happy after my 12 week test and put thoughts of HIV behind me, even though I had enlarged groin lymph nodes and had a change in stool consistancy. I was seeking general medical help for these. But, over the last 2 years I've have had quite a rapid recession of my gums. This triggered my HIV worries and I've been testing and worried since. Even more so that I've had a diagnosis of Acute Necrotising Ulcerative Gingivitis. I've been getting ulcers on my gumline and between my teeth that would clear up with Chlorahexine mouth wash or a visit to the dental hygenist. I got a dignosis of this when I had another ulcer appear just a month after my last visit to the dentist. So I'm now extremely worried that my test results are all false negtives given the rareity of ANUG. In addition, my groin lymph glands are still enlarged 2 years on. I'd really appreciate your advise as to what I should do next. Should I take other tests? If so, what tests should I take?

[Stupid_me]

Thank you for your comments. When I think sensibly about the chances that I have undetectable hiv, the odds against HIV must be incredibly high given the repeated tests and the statistically low risk exposure. I'm way out of the window period, don't have any genetic immune deficiency, had too many tests to consider any test errors and the odds of having a rare undetectable strain are unimaginable low. However, it's these symptoms that are driving my worries and I does make me think about the rare possibility of a rare strain being undetected. Since, my risk was in a culturaly diverse area of Germany the chance of a rare strain is much higher than the US but, I understand still very low. I think my best option is to visit my GP. If there is a non-hiv related underlying cause for my symptoms finding this out will put hiv out of my mind.
thank you

[Edward W Hook, MD]

You need to move on from your concerns about HIV.  they are unwarranted.  Please realize the only positive diagnosis of HIV comes from antibody or antigen tests which you have had repeatedly and which are negative.  In contrast, other findings which are mentioned, particularly at internet sites as "associated" with HIV also occur most often in persons who do not have HIV.  There are few exceptions to this statement.  ANUG is by no means only seen in persons with HIV and for you to try to link your ANUG with a distant past sexual exposure when you have had repeated negative test results is really not a good use of your time or energy.  You really do not need further testing.  Believe the ones you have.  Their results are reliable.  I sincerely hope my comments will help you to move forward on this.  EWH