My Specific Situation

[idiotic]

Bless you. Most of my individual concerns have been addressed previously but not as a whole. Am 50, married, have OCD and depression.Other woman is 51, seperated.She had unprotected vaginal intercourse with two men over the last two years. Broke up with last one in August. Three days before tryst, I split lower lip. Showered three hours before tryst. Scab usually dissolves. The act consisted of cunnilingus, protected vaginal intercourse, more cunnilingus.No orgasms. I have become increasingly concerned that I have contracted HIV from the injury to my lip contacting her vaginal fluid. I don't recall if it was scabbed over or not. I have no reason to expect she is HIV positive other than her previously mentioned sexual experiences. Within the last several days, 4 weeks out, I have had a minor sore/scratchy throat which seems to have turned into a minor cold. Biggest concern is moderate night sweats past three nights. Have had occasional night sweats before but never three consecutive nights. I know your admonitions about diagnosing by symptoms but with regard to night sweats I am scared. Unlike  other ARS symptoms, when you google night sweats it never seems to come back with anything innocuous. HIV is always on the list.  Tested Sunday, Nov. 29. (29 days) Negative results. Still obsessed.. The "other woman" tested Monday, close to four months since her last sex with  previous lover. It was negative. Still obsessed. Saw doctor today for RNA test.Said no. Now I am fixated on the 6 month window. Of the 3 percent that don't develop antibodies in three months, is it usually due to an immune system problem . I believe that and the 3 consecutive night sweats,(first time in my life) are the only two things I have left to obsess over. Hopefully there is an innoculous reason for the night sweats (anxiety, body temperature flucuations at night made worse by stress?) but I can't find one. Should I test at 6 weeks. Could I have HIV? Guilt is destroying me. Please help.

[Edward W Hook, MD]

No, your information is oncorrect.  A variety of published studies indicate that HIV tests detect well over 99% of infections at 3 moths following exposure.  Your source is wrong or, at the veray least, overly conservative.  EWH

[idiotic]

Thank you Dr. Hook. Not a  "but what if" just an answer to your "3 percent" question. I was extrapolating from the 97 percent accuracy at 3 months, which seems to be a benchmark thus the recommendation of testing again at 6 months but it appears you addressed that in your response. Correct?
Thank you.

[Edward W Hook, MD]

I agree with your doctor.  For you and RNA test is a waste of time and money. furthermore, since the exposure you describe was an essentially no risk exposure to a very low risk partner, I would not argue if you had decided not to test at all because the risk that you have HIV is so very, very low.  

I don't know where you heard that 3% of tests in infected persons are negative at 3 months but that is categorically wrong.  At 8 weeks over 99% of tests are positive and at 3 months virtually all infections are detectable unless the person who was exposed is taking antiretroviral therapy.  

Finally, your symptoms are non-specific.  Night sweats can be due to viral infections, reflux esophagitis (heartburn) while sleeping or anxiety.  

You need to stop worrying an move on.  If you wish to repeat your test at 8 weeks, do so but not unless you are willing to accept the results as conclusive.  For you to be continuing to worry about this makes no sense and is not good for you mental health.

I hope my comments will help.  I will not engage in furthe "but what if" discussions or exchanges.  your exposure was virtually no risk and your lip wound does not change this in any way.

Take care.  EWH

[idiotic]

Wanted to clarify. With regards to the RNA test and "said no" I meant my doctor would not do one.
Thank you