Multiple Exposures and risk

[JohnsMe]

Hi MD HHH,
First let me thank you for providing this forum for supporting people like me with HIV facts and advise.
I am a male heterosexual non drug addict live in US.
Over the last 2 years I have sex with several escorts (probably 15+).
Most of them are condom protected BJ and Condom Protected Vagina.
One of the occurrence around August last year I received unprotected BJ from an escort and protected Vaginal intercourse (with condom too big but not loose)
I had an elisa test on August 14th and Oral swab rapid test  on August 16th they both came back negative.
I found out that my wife is pregnant and the last intercourse we did was on end of May or early June (between may 30th to June 3rd). And she had her test (part of pregnancy routine on August 28th and the nurse said all blood test were fine)
My questions are:
1. The unprotected BJ and Condom too big event should be ruled out by my test, correct?
2. Is the test my wife took (12 weeks + 2days) conclusive? we never have any more intercourse after that
3. I also have an event on August 8th which I received Protected BJ, Protected Vaginal, Open Mouth kissing (DFK), and perform cunnilingus to an escort. I confronted the escort 3 times and all 3 times she told me she is clean, and she got tested every 3 months. The last one she took was last month. She also told me that she allow cunnilingus but always use condom for the intercourse and BJ. How is my risk on this event?
I am waiting on the result for 6 weeks test (due a week and a half from now) and very anxious...
4. I know symptom is not a good indicator, but can you analyze this?
around 9 days post the last act I got dry tounge, gastro and my lips swollen (gone now unless dry tongue times to times). After that I got some red mark on my arms (last about 3 days then gone) and red mark on my right knee (2 of them but 1 was gone after a few days 1 becomes fuzzy gray until now).
Some times right side of stomach (near the back) mildly hurts, some times the left side under the ribs. I also notice a pea size lymph node under my right jaw.
Could all these symptoms caused by anxiety or hiv?

[H. Hunter Handsfield, M.D.]

Just read any of several hundred threads on time to positive HIV test.  I have neither the time nor energy to repeat it yet again.

This thread is over.

[JohnsMe]

Doc, Last question.. do not mean to be annoying...
So the test I just did a couple days ago and still waiting for the result, will that be reliable if I haven't have any more exposure?
And in planned parenthood clinic the nurse said the test on ly cover 3 months prior to this month... when I asked her about 6 weeks period she keep saying 3 months ...
while the other staff when I did the previous test kept saying 6 months... any thought of this?

[JohnsMe]

Thanks Doc,
I tested because I don;t want to not knowing if I got one and infecting my wife or family...
Just for precaution I guess and anxiety.

[H. Hunter Handsfield, M.D.]

From a risk assesment perspective, you do not need testing.  Almost nobody ever needs testing after single exposure events, unless especially high risk, such as a known infected partner or anal sex among men who don't know each other's HIV status.  Heterosexually active people should just have a test once a year and not worry about individual exposures.

But whether or not you need a test for reassurance and anxiety relief is up to you.  Probably that applies to most people anxious enough to ask the question--certainly most of those who ask on this forum.

[JohnsMe]

Doc,
My test was 9 weeks from 2nd to the last exposure (condom BJ and condom vaginal... did not *** I stopped after a while like probably 5 mins or so) and around a week from the last one. From your risk assessment, do I really need a test?

[H. Hunter Handsfield, M.D.]

Your risk of catching HIV is low, given the nature of your extramarital exposures, especially condom use.  But the level of risk doesn't matter:  if your August test was 6 or more weeks after your last exposure, you can be certain you haven't caught HIV, at least not yet.  And of course your wife's neative test 12 weeks after her last potential exposure (to you) is proof she doesn't have HIV.

1) I cannot imagine that a slightly loose condom increases the transmission risk, but of course there are no data.

2) See above.

3) Kissing and cunnilingus carry no known risk for HIV, or at least too small to measure and to my knowledge there are no documented transmissions.

4) You're right, symptoms don't help.  IN any case, the ones you describe don't sound like HIV.

As to the follow-up comment below, if you have read the forum even a little bit, you know that THERE IS NO MEDICINE THAT IS KNOWN TO ALTER THE TIMING OR RELIABILITY OF HIV TESTING, with the possible (unproved) exception of advanced chemotherapy.  Why do so many people see such statements and then feel the need to ask "But what about this drug or that one?"???

Best wishes--  HHH, MD

[JohnsMe]

Forget to tell that I was tested STD and they came back negatives
URINALYSIS W REFLEX TO MICROSCOPY
CULTURE, URINE
NEISSERIA GONORRHOEAE & CHLAMYDIA TRACHOMATIS AMPLIFIED
Also will TB medicine treatment (misdiagnosed for TB) 10 years ago for 8 months affect the test result?

Thanks for supporting us Doc...