risk analysis, test results

[imagoodsoul]

Hello Dr,

I have been responsible when it comes to sex.  always using condoms (I am a heterosexual male) for vaginal sex, but I have not used them for oral sex.  I usually get tested twice a year and have been negative.

about 7 weeks ago I received an unprotected blowjob from a prostitute and she swallowed my sperm.  approx 2 weeks later felt warmish and took my temp and it read 99.3.  This past friday (over six weeks past the encounter) I experienced the same warmth, and recorded a temp of 99.5 which lasted for approx 15-20 minutes.    So This past saturday I went in for an HIV elisa test and will be getting the results either today or tomorrow.  Yesterday out of nowhere I had a small rash like thing on my left hand which dissapeared within a few hours.

1.  Should my test come back negative (6 weeks lab/blood), would you recommend testing again?
2.  Has anybody in your knowledge ever "converted" to positive after a 6 weeks negative result.
3.  Does my little recurrent fever sound alarming?  I feel like I go from hot to cold forehead a few times per day.  No night sweats, no body aces.  Just a random "hot" feeling which comes and goes with a slight pressure behind the eyes.  Hightest fever was 99.5  
4.  what about my arm/chest acne?  They look like little red bumps with a very small whitehead in the middle.  How does the rash look and how long does it last?  
5.  I'm extremely worried about my situation and know I've been responsible in the past.  I have a wife now and want to resume unprotected sex with her.  I have not for the past 5 months during which I had a negative test so I know she's clear as well.

I've posted something similar in the community forum and got a simple "no risk" answer which didn't help me feel any better.

[Edward W Hook, MD]

Welcome to our Forum and congratulations on your commitment to safe sex.  You are correct that oral sex does not seem to be a source of HIV transmission. While there are a small number of case reports suggesting that this may have happened, those that I have read have important limitations which cause me to question their accuracy.  Thus while I suppose it is POSSIBLE that at some point someone will get HIV through oral sex, it is less likely that being struck by lightening.  Furthermore, I would add that most commercial sex workers are not HIV infected.  Let's go through your questions:

1.  No, a  six week test would detect at least 95% of infections and probably more.  When this is considered along with the fact that the risk of getting HIV this way is close to zero, there is no meaningful added value to testing again.
2.  No.
3.  Symptoms are a terrible indicator or HIV infection and should not concern you.  Your symptoms have come on long after the ARS would have occurred.  You may have caught some sort of far more common, community acquired non-STD virus. This is not HIV.
4.   See no. 3 above.  If this (or your viral illness) troubles you, you should see your doctor but do not be concerned that either symptoms might be a sign of HIV.
5.  You can see my assessment of your risk- essential none.   The decision of when to have unprotected sex with your wife is up to you but I would not worry about HIV from the encounter you describe.  EWH

[Edward W Hook, MD]

You are not being very patient and do not seem to be listening to what I have already said.  I told you that your exposure did not put you at risk.  If you had been at risk, testing would have been recommended.  You decided to get tested and guess what, it showed that your no risk exposure did not give you HIV.  Not a big suprise.  The doctors recommeded repeat testing out to 3 months because they did not consider the nature of your exposure and  that is what they recommend for everyone.  In your case, there was not risk ,therefore no need for testing.  You do not need further testing.  EWH

[imagoodsoul]

Can you please comment/advise my last question?

[imagoodsoul]

And sorry for bothering you again

[imagoodsoul]

My test came back Negative.  In your advise you would not recommend further testing right?

It was a 6 week test.  Why do the doctors recommended not testing beyond the 6 weeks mark when the CDC and most people on the community forums say 3 months?

Does it have to do with the risk factor?  or maybe time it takes to convert?

I'm asking because this ordeal has put fear into me, and i fed my fear with knowledge and I started to feel better.  I have volunteered my time one day a week at an STD clinic to help people with HIV and other STD's.

I was just curious about the timing and my own anxieties, I want to make sure i dont need another 6 weeks.

[imagoodsoul]

Thank you Doctor, best wishes and thank you for your time and your efforts.

[Edward W Hook, MD]

You are asking me to repeat myself.  That is of no use to you or to me.  The exposure you describe did not put you at risk for HIV.  Nothing more to say.  EWH

[imagoodsoul]

Your response dr?

[imagoodsoul]

That makes me feel better  Doctor.  So in your opinion I do not have this virus?  Also, you mentioned that my symptoms happened to far after the fact, but are they inline?  I was led to believe a 99.5 fever is no fever at all especially since it not sustainied.  When reading about the ARS symptoms, it's usually a severe fever thats sustained and a rash.  You would agree this is not my case?

Also, due to the seriousness of this disease that is crippling the world, in your expert opinion do you see any light at the end of the tunnel with a cure or some kind?