Was 39 days conclusive for my exposure?

[ease_my_mind_]

I have posted to this forum before in the past and was told my exposure was low risk(1 in 10,000) and that I didn't really need to get tested, but I can't ignore something serious like this. At 39 days I tested negative. Its been 12 weeks since the possible exposure and I want to go get tested again for a final time,i am scared that i may be part of that 5-10 percent of infections that aren't detected by 39 days. I'm a 24 year old heterosexual male who had un-protected oral sex with a homosexual male for a short period of time, as well as let my partner put his tongue in my rectum. This was the first/last time i will do anything like this with another male. He did not ejaculate in my mouth nor did I in his, but I am certain there was precum present. About 5days  maybe sooner, I had a sore throat ,extreme fatigue, tingling sensation in my hands, headaches, dry mouth, diarrhea, lymph nodes and other symptoms that were like ARS. I still expierence extreme fatigue, headaches and a burning/tingling sensations in my hands, as well as cold sores on my mouth that won't go away. I have had cold like symptoms(ear ache, cough, congestion) that are off an on. he  tells me that he is  certain that he is HIV negative, he told me he was tested a month before being with me and hadn't been with anyone since. Since the exposure he told me that he got tested at 8 weeks and tested negative, and because I was scaring him got tested again at 10 weeks and tested negative. Now he refuses to talk to me. I dont know him so i don't know If I can trust him. I dont think he has reason to lie to me, especially about something as serious as this.my questions are as follows
1. Is 39 days conclusive for a low risk (1 in 10,000) oral exposure?
2. When I get tested on monday(12 weeks and 2 days past exposure) can I consider this conclusive?
3. are my symptoms a result of my extreme anxiety? Cold sores included.
4. If I had ARS symptoms would I have tested positive at 39 days?
Thanks for you time

[ease_my_mind_]

Thank You!

[H. Hunter Handsfield, M.D.]

Yes, you know the answer.

[ease_my_mind_]

I got my results from Cedars-Sinai Medical Center, 3 month HIV test, and tested NEGATIVE for HIV 1&2 PLUS O, EIA as well as tested negative and normal for all other STD's. I am truly thankful for all your help, the advice you and the other doctor provided me with and for your work on and off of this site.  Final question, one I think I know the answer too but feel compelled to ask,Should I seek additional testing at a later time or is this it?
Thanks,

-Jake-

[ease_my_mind_]

Thanks for the explanations and the reassuring words, as well as the work you do on and off of this website...I'm going to get that 3 month test on Monday just to be entirely certain. I hope that everything works in my favor.
Thanks again,
-Jake-

[H. Hunter Handsfield, M.D.]

I agree with your self-analysis of the likely real cause of your anxiety.  I doubt that anxiety triggers cold sores in people with oral herpes, but neither does HIV.  And no, I have never had a patient who became seropositive in circumstances like yours.  In fact, in the 5 years I have been doing this forum, not one person has ever described an exposure that led to a new HIV infection.

You're fine. Time to move on.

[ease_my_mind_]

Thank you for you quick response to my questions. I have disscussed this previously with my Health care provider who has done 3 urinalysis' for STD's and other infections and said I don't have anything wrong, He did a CBC to check for infections including Hepatitis and even thyroid problems as well as a renal ultrasound because I had pain during urination.....He has assured me that there is nothing wrong with me and that If I wanted to get retested for HIV I could but to wait until 12 weeks as this would be completly conclusive. as for the cold sores I have gotten them ever since I was little but never this frequent, which kind of scares me (weakened immune system possibly)...but then again I have never expierenced stress to this degree so I am guessing that they are a result of my anxiety.
Can anxiety cause my Cold sores?
Have you ever seen anyone with a low risk exposure like mine test positive after a 6 week negative?
I haven't had any other exposure since 12 weeks ago. I guess the anxiety that I am feeling stems from the fact that I am heterosexual and had a homosexual expierence and have no intentions of engaging in a homosexual relationship ever again. I just want to be sure that I am negative and not going to infect someone in the future, I wouldnt be able to live with myself if I did.
Thanks again for all of your help.

[H. Hunter Handsfield, M.D.]

By the way, I tried to find your previous post, but your username is too nonspecific and comes up with hundreds of hits.  But please adhere to MedHelp policy, which allows no more than 2 questions every 6 months on the moderated forums.  No matter what happens, no more new threads before June 2009.

[H. Hunter Handsfield, M.D.]

Just calculate the odds.  Let's go with the original estimate of 1 in 10,000 risk of transmission if your partner had HIV.  Then let's estimate his risk of having it at 1 in 100.  (It's probably a lot lower than that, given his history -- but we'll make this a conservative calculation.)  Now let's go with an estimate that a test at 39 days would pick up 95% of new infections.  (That's also a conservative estimate for this purpose.)

With those figures, the chance you have HIV calculates as 0.0001 x 0.01 x 0.05 = 0.00000005.  That's 1 in 20 million, i.e. zero for all practical purposes.  To put that in context, it is 11,000 times lower than the chance you'll be dead within a year of some accident (1 in 1,756 for residents of the United States).

To the questions:

1) Yes.

2) I guess so, but you can't get more conclusive than you already are.

3) The test results mean your symptoms cannot possibly be due to HIV, and they don't sound like it anyway.  Whenever a person suggests his or her own symptoms have an emotional basis, usually s/he is correct.  They certainly typical for anxiety, but you'll need to discuss them with a health care provider to learn the specific cause.

4) Yes.

All is well.  You don't have it.  But feel free to test at 12 weeks and and to continue to test and retest to your heart's content.  If you ever turn up with a positive result, it will be from some exposure other than the one 39 days ago.

Best wishes.  Stay safe.  And don't forget your seatbelt....    HHH, MD