Need further testing?

[lifelessonlearned]

Dr,

Late November, 2007 (54 days ago) I received condom protected oral sex and engaged in condom protected vaginal sex from a CSW worker in Las Vegas.  Upon withdrawal I noticed the condom slipped down the shaft of my penis +/- 50%.  I washed within 15 minutes of the incident.  I'm concerned about the possibility of vaginal secretions infecting me through damaged soft tissue on my penis (due to masturbation earlier in the day).  I don't know there was any damage... just speculating.  My second concern is the possibility of infection because of the condom slippage and the opportunity vaginal secretion would have in getting underneath the condom.

Moving on…40 days later I had a rapid blood test (finger *****) and the test was negative.  I was unsure if I waited long enough and so I had the test repeated at 51 days.  It also was negative.

I thought after the second test I'm good to put this behind me and consider it a scary life lessoned learned.  Then over the weekend I develop a mild sore throat, with what I think is a swollen lymph node and a bad taste in my mouth.  

Is there a chance I'm still in the process of seroconversion and therefore my tests are not satisfactory evidence I’ve not been infected?  

I realize my questions are fueled by both anxiety AND lack of knowledge. I kindly ask that you help me understand my risks and whether or not I need further testing.

Regards,

JSN

[H. Hunter Handsfield, M.D.]

I saw these comments before I replied above.  They make no difference.  No STD causes wrist soreness.  It is neither "legitimate concern" nor a "strange coincidence"; those are not the only choices.  Simple random association with your sexual adventure is the only plausible possibility.  When any symptom appears, the mind tends to focus on atypical or unusual events that preceded it, making the assumption they must be related.  But your symptoms started after every single event that occurred in your life during a 3-6 week period.

[H. Hunter Handsfield, M.D.]

Before I even read your questions, this initial reply responds to the title you selected for your question.  When somebody asks "Need further testing?", usually s/he has been tested beyond the recommended window period and is HIV negative, but remains concerned because of symptoms, the nature of the exposure, or other extenuating circumstances.  The answer is always, always, always the same!  The test result ALWAYS are more reliable than all that other information.  Always.  So my bet is that I'm going to confirm that your negative test results are reliable and you don't have HIV. (I won't change a word in this paragraph after reading your questions, even if I'm wrong.)

Now I have read the rest.  Guess what?  You don't have it.  Few Las Vegas CSWs have HIV.  Even if yours did, the risk from the exposure you describe is close to zero.  And almost everybody with a new HIV infection has postive test results at 7+ weeks (51 days).  Could you be the extremely rare exception on any one of those risk calculations?  Sure.  But not for all three.  The odds are simply too low to count for anything.  The chance you have HIV is zero.

And as I predicted, neither your symptoms nor your wife's have any bearing on the situation.  And neither sounds like HIV or any STD anyway.

So relax.  All is well.  But if you're like most people on this forum, my reassurance won't be quite enough.  So seel free to get tested again at 3+ months if it will make you feel better. If you do, it will be negative (assuming no other risky exposure you don't mention).

Regards--  HHH, MD

[lifelessonlearned]

Dr,

Please excuse me adding to the story a bit... I’ve been experiencing muscle twitches-multiple times a day.  Related to a STD?  Also I have a very sore wrist.  The weird thing about that is my wife has been experiencing a sore wrist!  My wife and I do NOT have unprotected sex to prevent pregnancy.  Could I have infected her? Although it sounds ridiculous as I type it, are sore wrists related to STDs?  We have only engaged in unprotected oral.  Strange coincidence or legitimate concerns?

Thanks for your patience.

JSN