Worrying from possible HIV exposures

[sss145]

Dear Dr. Hansfield,

I am losing my mind on the back of two possible exposures that may have put me at risk of HIV:

1. On 3rd September I had an exposure with an escort: protected vaginal intercourse followed by receiving unprotected oral and then fingering.
2. On 15th October I had an exposure with another escort: protected vaginal intercourse followed by fingering (had a minor cut on my finger).

On 16th October I got a cough, which turned into a high fever, sneezing, nasal congestion.  This got better with paracetamol, and augmentin.
On 31st October I went for HIV testing (8 weeks after first exposure, 2+ weeks after second exposure) using ELISA test + Western Blot. Both came back negative.
On 6th November I developed a mild sore throat (no fever), coupled with ear pain, mild headache, jaw pain, swelling of my left parotid gland, and flashes of pain in my armpits.  I have seen three doctors who have checked all my lymph nodes and said there is no lymphadenopathy at all. I dont have any mouth sores, gential sores, rash, or vomiting but I am extremely stressed out.
Grateful if you can answer the following questions:
1. Do you think that my symptoms (especially parotid swelling) could be seroconversion or is this psychosomatic from anxiety and fear?  
2. Are my test results conclusive or do I need to retest for HIV based on my exposures?  
3. Do you think it's fine for me to have unprotected sex with my wife at this stage?

Many thanks for your help, much appreciated.  

[Edward W Hook, MD]

Answered above- no need to repeat the answer.  EWH

[sss145]

Dear Dr Hook,

Juts a quick follow up question.  Can I assume that the unprotected oral exposure I had also didnt present any risk? Thanks!

[Edward W Hook, MD]

Glad I could help.  EWH

[sss145]

Dear Dr Hook

Thank you so much for your response, this is greatly reassuring!

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.  

In addition, you have posted on the wrong site.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your questions with this reply but, if you have additional questions or follow-up they must be on the HIV Prevention site.  Sorry.

The encounters you describe are safe sex.  Condom protected sex is safe sex and HIV and other STDs are not transmitted through masturbation, even when there is a cut on your finger.  Thus there is no reason for concern related to the exposures you describe.  From a medical perspective, there is no need for testing related to these exposures.  Your 8 week test proves this- HIV antibody test results 8 weeks following an exposure provide definitive information about the presence or absence of HIV.  As for the fact, that your most recent test was only two weeks following your 2nd exposure, as I said, this was safe sex and there was no need for testing to start with

As for your specific questions:
1. Do you think that my symptoms (especially parotid swelling) could be seroconversion or is this psychosomatic from anxiety and fear?  
It sounds to me like you caught a cold or some other, non- HIV/STD related viral illness.  Your tests prove that this is not ARS.

2. Are my test results conclusive or do I need to retest for HIV based on my exposures?  
see above.  No testing was needed to start with.

3. Do you think it's fine for me to have unprotected sex with my wife at this stage?
Yes.

I hope these comments are helpful to you.  EWH