Possible HIV Infection? Really Scared

[Constantine13]

I am a 23 year old, cicumsised white male. While backpacking in SE Asia..met a CSW in Vientiane, Laos. We had vaginal intercourse 3 times over a 3 day period (I was not paying)... the condom broke the third time. I honestly have no clue when it could have broke, but it's possible I could have been unprotected for upwards of 10 minutes. I realized it had broken when pulled out...I asked her if she "had anything" to which she replied that she was "very clean". She left my room to take medicine to "make sure she didnt have a baby".This event occurred on may 25.

1) Five days later I had a sore throat and slight fever (after a 12 night bus ride)..Only hurt for a day or 2.

**2) 2 weeks after event, I woke up (after another night bus ride) and had a sore/ slightly swollen throat.  My tongue may have been burning a bit.I was feeling really anxious. I smoked quite a bit of marijuana and over the next two days I experienced a burning tongue (my taste buds looked to be raised off my tongue) with white/ yellow discoloration in the back of the tongue. My mouth was very dry and I developed a few sores on my inner cheeks (I have braces and they could have caused the sores). Can't remember if I had a fever, but pretty sure I didnt have a rash. Also had general feeling of not being well. Returned home on Day 16 and tongue returned to normal.

3).One week ago I had pain under left armpit and a small lump that was tender (swollen lymph node?).  Pain and swelling completely gone after couple days.  

I'm terrified I was infected...I'm starting my first year of medical school in a few months and I'm terrified to get tested- I dont know what I would do if I found out I was positive.  I can't believe that I jeopardized my family, career, and life.  I'd appreciate any thoughts on the possiblity I was infected (particularly the blistered/ burning/ discolored tongue at the two week mark- this is really freaking me out).  I really appreciate the time and help.

[Edward W Hook, MD]

No change in my recommendation.  You need to stop worrying about non-specifc symptoms and believe tests.  As an aspiring physician youneed to know that the reason we do the tests is becasue they provide us with helpful guidance.  EWH

[Constantine13]

Thank you for your reply Dr. Hook.

As you said, I realize symptoms are a really bad way to evaluate potential HIV infection...

I guess I am just really concerned that exactly 14 days following the potential exposure I developed the burning tongue/ tongue discoloration.  The fact that it occured exactly at the beginning timeframe for ARS as well as the fact that it cleared up on its own within 3 days leaves me very concerned.  I mentioned the pot smoking (not as something Im proud of but as a potential cause of the problem)...but I suppose what I'm asking is whether this type of symptom is found in the recently infected.  Burning tongue, white/ yellow discoloration, tongue blisters on tongue and on tip as well (looked like raised taste buds)...have you seen anything like this before?  Was this potentially thrush?  

I also forgot to mention that I have been very fatigued over the past month (since returning from my trip)....in a way that I have never experienced before.  

I really appreciate any further comment you might have.  I realize that to completely reassure myself I need to test, but I am honestly scared to death.  Everytime I imagine getting back a positive test result I almost puke.  Thanks again,

Sam

[Edward W Hook, MD]

Your risk of infection form a single unprotected encounter, even in the unlikely circumstance that your partner had HIV is very, very low.  Transmission of HIV occurs only once per every 1000 acts of intercourse with an infected partner.

You have many other explanations for your sore throat and other symptoms- pot smoking, the rigors of travel, public transportation, etc.  Symptoms are a terrible way to evaluate risk for HIV. This should be done with blood tests.  It is now more than a month since your exposure of concern.  At this time an HIV test using the combined p24 antigen/antibody tests (DUO tests) will detect well over 90% and probably nearly all HIV infections acquired a month earlier. This plus the low risk of the exposure you describe should provide you with the reassurance you want.   A final HIV antibody test at 8 weeks post exposure will eliminate the final small chances of infection and should be considered conclusive.

Hope these comments are helpful to you. Take care. EWH