Flu-like symptoms after encounter with Gay Stranger

[friedegg67]

I was recently on a business trip to Canada and met someone on-line. He was a 23 year old guy. I am a closeted gay man with a beautiful wife and two wonderful kids.  I have never had anal sex before and thought I would try it.  I told the guy I was married and begged him to be honest with me.  He said he was a nurse and was completely clean.  I put on a condom, he lubed his anus and I inserted my penis into his anus. However, I almost immediately ejaculated.  I was too embarrassed to tell him and kept thrusting for a minute or so until my penis slipped out of the condom and his anus.  I was still fully erect and 90% of the condom came out with only the tip remaining inside him.  He pulled the condom out and the semen-filled tip appeared intact.  I immediately washed my penis with soap and water.  

Because I had used a condom I assumed everything was fine.  I had no idea about PEP treatment or I would have sought that immediately just to be on the safe side.

13 days later I began to experience a flu-like runny nose.  I had cold sweats and the next day was totally knocked out.  I suffered extreme fatigue and could hardly get out of bed, some cramping, headache and total loss of appetite.  I have not had diarrhea, very little dry coughing, no sore throat, rash or enlarged/painful lymph nodes.   I then went online and researched the early symptoms of HIV/Acute Asymptomatic infection I am obviously deeply concerned.  I have always been extremely carefully about my gay adventures.   It's day three and I'm feeling better but still have a mild headache and very little appetite.  I'm also getting no sleep because I am worried to death.  

Given my symptoms should I be concerned about HIV?  How long do I have to wait before I can get 100% accurate test?  What is the name of the test?   Do I need to go to a doctors office or is it a home test?  How long does it take to get the results back?  Thanks for your help doc.

[Edward W Hook, MD]

Let's try to work through this. The fact of the matter is that you were protected.  At no time, as I read your note, were you inside of your partner without a condom in between the two of you. Thus your exposure should be considered safe and probably was.  Why the symptoms you describe indeed are consistent with the ARS, the fact of those symptoms are non-specific and are far more likely to be due to a community acquired non-STD viral infection than to the ARS.  Read any 10 posts on this site  and you will find that on at least 7 of them we discount symptoms as indicative of HIV.  They are just too non-specific.  I say this by way of indicating that you should not be concerned becasue of your symptoms, they are unlikely to be related to HIV.

Now, on to your questions about testing.  The average time to a positive HIV test is about 2 weeks.  At 6 weeks about 95% of tests that are going to become positive will be, at 8 weeks the figure rises to 98-99% and at 12 weeks the figure exceeds 99%. Thus a test, any commercially used HIV blood test, at any time beyond 6 weeks makes the odds of infection in your own case vanishingly rare (because your exposure was protected).

PEP?  Forget it.  PEP's impact is greater when it is started sooner, preferably less than 48 hours after exposure. More than two weeks beyond the exposure is of little help.

I hope these comment help.  EWH

[friedegg67]

Thanks for your help.  It seems to me that I was protected the whole time.  That's why I didn't seek medical advice immediately after the encounter.  I had totally put the event out of my mind until I was suddenly struck down with this chronic flu.  It just seems too much like a coincidence that it started exactly 14 days later.  It's not psychosomatic as I didn't know anything about ARS until I started researching the symptoms.  I will get tested at 6 weeks I guess and go from there.  Thanks again.

[Edward W Hook, MD]

I understand your apprehension. It is most likely by far however that the timing was just bad luck.  Your test will be negative.  Please let us know about the results

EWH