Exposure, Symptoms and HIV Testing Recommendation?

[bigfool385]

11 weeks ago I went on a horrifying alcohol and cocaine bender in Bogota, Colombia, and ended up blacking out for a period of time (10-30 minutes) with a street prostitute in a hotel room. My initial recollection and feeling afterwards was that we did not have sex. At the least, there was hand/genital contact. 1-3 days later I developed a lingering soreness on the right side of my throat. I was very distressed, but, believing no sex happened with the prostitute, I had unprotected sex with my girlfriend. After 2 weeks I developed jock itch and/or folliculitis (staph infection) around my groin and inner thighs. I also was experiencing warm/cool skin sensations (shoulders/arms/body) and slight light-headedness. At this point I freaked out, and began to wonder if maybe I did have unprotected sex with the prostitute. I went to a throat doctor, who believed my sore throat was the result of gastritis. I went to a dermatologist who told me I had folliculitis. The meds seemed to work. Meanwhile, I had stopped having sex with my girlfriend. My fear of having and infecting my girlfriend with HIV grew to epic proportions. I have dreams of being infected, and I think about this every second of every day. Worse, my girlfriend became sick about 1-2 weeks after exposure to me. She had general malaise and lost her voice initially, but after 1-2 days she felt better, but had a persistent cough that lasted at least 2 more weeks. At 5.5 weeks I took the HIV Duo Test in Colombia. I tested negative and thought it was definitive. I had unprotected sex again with my girlfriend, and she wound up with my staph infection. I did internet research and became confused of my symptoms and test results, if they were definitive or not. I took another HIV Duo test at 7 and 10 weeks, both negative. We began unprotected sex again, but I scared myself on the internet again and stopped sex again. In my circumstances, do you recommend more tests, or can I consider these conclusive?  

[Edward W Hook, MD]

1.  No this is not possible.

2.  Globally, tests for HIV are amongst the most reliable tests available.  If you were tested at a reputable institution by a reputable health care provider, you should believe the results. Particularly with the repeat testing you describe.  

3.  Yes it would.

Your anxiety and guilt are leading you to dream up scenarios that make no biological sense.  You need to stop worrying about HIV - you did not get it from the events you described. EWH

[Edward W Hook, MD]

No bad dreams suggest guilt and anxiety but in no way suggest that you have been infected with HIV or any other STD.  EWH

[Edward W Hook, MD]

I'll go directly to your questions after pointing out that if you had sex you would likely remember it and, furthermore, why would a commercial sex worker have sex with an unconscious person  .  Sex is her job, not her idea of a good time.

The DUO tests are conclusive at 4 weeks.  Thus your 5.5, 7, an 10 week tests are all conclusive.  You did not get HIV from the exposure you described.  whether you acquired some other non-STD illness in the course of your travels or whether this is just anxiety an guilt I cannot say but I can tell you that you did not get HIV from the events you describe.  HIV is not a worry. EWH

[bigfool385]

Thank you and best wishes.

[bigfool385]

Thank you, hopefully this information takes hold. This will be my last round of worrying about unlikely but perhaps even remotely possible scenarios. 1) Could it, theoretically, be possible for someone to briefly be infected with or carry the virus, pass it on to someone else, but be undetectable by the time they have a test? I am thinking in particular about those with homo or heterzygous Delta-32 cell mutations, in relation to the symptoms my girlfriend came down with. 2) Would you have any doubts about tests performed in Latin America versus fully modernized countries? 3) Would the Duo test detect all strains of hiv found in Latin America?

Thank you and apologies in advance for the persistent questioning, this will be it for me.  

[bigfool385]

Dear Doctor, unfortunately bad dreams continue. The latest dream is that the regular test is negative, but I take another specialized test that shows results for mutative hiv. I understand you are not the psychologist I may be in need of, but have you seen similar dreams signify a physical correspondence, or would you consider it purely psychological/symbolical? In other words, would this change your opinion on my case?

[bigfool385]

Thank you Doctor. To clarify, I was awake the whole time, and doing God knows what is the question. This said, the conclusive tests are what matters here. I will move on.