[Question #10118] 2 week mark anxiety

25 months ago

Hi Drs.

Thank you for this Asha q&a. It has helped me a lot to go over all the questions asked by others and learning from their experiences. I had a potential exposure exactly 2 weeks ago where I met a Csw. We had protected vaginal sex. I clearly remember regretting even meeting as that’s not me but temptation got the best of me. Immediately after the sex I checked for any condom breakage by pressing the condom with my fingers while it was still on me to see any leakage and did not see any breakage. I definitely got the vaginal fluid on my fingers. I wiped myself off with a tissue using the same fingers. I am uncircumcised and that got me worrying. I am at 2 weeks mark exactly. No symptoms yet. I had mild sore throat at day 7. Idk if we can even call it sore throat as it was only there if I thought about it. The left side are of my jaw feels weird today. I see no bumps just some irritation and itchiness. Again could be my anxiety. I have been extremely anxious as they say symptoms starts showing from week 2 and I am constantly checking myself. I plan to do a test at week 4 or week 6 depending on my situation. What do you think are my chances of having any sti?

25 months ago

I guess I would like to add I have been feeling extremely dizzy, fatigued and nauseous for last few days. These could very well be signs of my anxiety and I’m honestly not sure. I did have some diarrhoea issue at day 13 but nothing major

H. Hunter Handsfield, MD

25 months ago

Welcome to the forum. Thanks for your confidence in our services and for reviewing other discussions with questions similar to your own.

My first comment is to congratulate you on the wise decision to use a condom. Once having decided to see a sex worker, you went about it with excellent safety and are at no significant risk of any infection.

You don't mention HIV, but I think that's the infection you are most worried about. You really should not be at all worried. You had an extremely low risk exposure in regard to both HIV and other STDs. Condoms work nearly 100% of the time to prevent HIV. Almost all sex involves contact of a partner's genital fluids with hands, fingers, etc; this does not create any risk at all. In other words, that you got vaginal fluid on your fingers is nothing at all to worry about; this was an entirely safe exposure. You do not need testing for HIV or anything else. And I would suggest you entirely stop "checking [yourself]". There are no symptoms you will possibly get that you will not notice; self examination etc just elevates anxiety and raises the possibility of noticing trivial feelings that mean nothing (which you already have started to do). Just move on without worry. If you have a regular sex partner, you can safely continue your usual sexual practices without putting that person at risk.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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25 months ago

Thank you for your kind words doctor!

It feels great to hear no chances of any std. I guess I am still having issues with food digestion and fatigue. But my fatigue could very well be due to the fact I haven’t stepped outside since the incident out of anxiety and guilt. Definitely lot of what I’m feeling is coming from guilt. I have never been this tired every moment.

My question to you would be

1) does being uncircumcised change anything. I guess I read in some question that being uncircumcised can increase the risk of std.

2) does having no symptom for last 15 days mean no chances of any std even the ones that can transfer just from the contact of skin.

H. Hunter Handsfield, MD

25 months ago

1) Your circumcision status is irrelevant at this point. Being uncircumcised raises the risk of HIV if sexually exposed (although only modestly). But your test results show for sure you were not infected, so the risk of infection at the time of exposure is irrelevant. Whatever the risk, you weren't infected.

2) Lack of symptoms makes acquisition of any STD, including the skin to skin infections (syphilis, HSV2, HPV) less likely, but doesn't prove it. But all things considered, the likelihood is extremely low. Still, you could be tested for HIV and syphilis after 6 weeks if the negative test results would be reassuring. Personally, I wouldn't feel the need if somehow I were in your situation, but it's up to you. (There is no test for HPV, and undoubtedly you've already had it, as have almost all sexually active persons. This event does not raise your risk of HPV any higher than it was previously.)

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25 months ago

Hi dr thank you for your response. Confused about your first point as I have not tested yet. Can you please clarify.

Also do want to mention last night I saw some red marks on my shoulder and freaked out. There were no bumps just reddish skin and it was really itchy. I think those marks made me really nervous and I could feel my temperature rising. I remember waking up in the middle of the night feeling hot but when I measure myself I was at 98.1

This morning I measure myself again and was at 97.8.

I do feel chills throughout my body. I understand this is the last follow up so I would want to ask. If I get myself tested at 4 week mark can that be considered conclusive?

25 months ago

I do want to mention I’ve been feeling chills and my whole body especially face and left shoulder area feels itchy. I do get this random itch throughout my body from time to time and my appetite has gone down a lot. I feel like I’m never hungry and rarely eating. Could all these be anxiety related?

H. Hunter Handsfield, MD

25 months ago

Sorry about the first comment. I didn't re-read the initial exchange carefully and thought you'd been tested and negative. (The first part of my reply makes it clear I actually understood you had not yet been tested. Still, apologies for the confusion!)

This doesn't change the fact that you were at exceedingly low risk of HIV and your symptoms do not suggest you have it. These are very nonspecific symptoms that do not point to HIV or any other particular cause. However, it seems clear that you should be tested for reassurance. This does not mean I believe there is actually any significant risk. On the other hand, the risk isn't zero, just extremely low -- and undoubtedly you'll have a lot more confidence from the expected negative test results than from anything further I can say. As for your final comment, indeed all your symptoms are typical for the physical manifestations of anxiety. And whenever someone suggests his or her own symptoms have a psychological origin, usually s/he is exactly right!

If I correctly understand the timing, it's now a little over 2 weeks since the sexual contact. You could consider an HIV RNA blood test at this time; a negative result would be about 98% reassurance you don't have it. A final antigen-antibody (AgAb, 4th generation) blood test two weeks after that would confirm for sure you were not infected.

That completes the two follow-up exchanges that normally end a thread, but I'll leave this open for one more follow-up question if anything still isn't clear.

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25 months ago

Thank you Dr for the clarification. Just so I understand it right. You mean as there was no exposure to my foreskin it does not matter whether the person is circumcised or not.

I have been trying to get over my anxiety for last couple of days and have had ups and downs. I’m debating whether I want to get tested now or just once at 5/6 week mark with 4th gen test or get tested at all. As you know I’m almost at 3 week and with no major symptoms and would just want to stress about this situation at all.

I guess I would just like clarification on two questions

1) when you say low risk exposure as a condom was used. Why is there any risk. I guess I am finding lots of conflicting views online where people say no risk and some say there’s always a risk. Where does the risk come from? Is it alway condom failure aka breakage?

2) I have been feeling a bit of tingling feeling on one side of my tongue and on close inspection I don’t see any major difference so I’m not sure what this could be but I don’t think this has anything to do with hiv or any other sti.

H. Hunter Handsfield, MD

25 months ago

1) Condoms are not 100% protective against HIV, and unrecognized failures occur. Therefore, even with a condom, the risk is not zero. However, your chance of having HIV is well under one chance in several million.

2) Neither HIV nor any other STD would cause tingling of the tongue. It has nothing to do with your sexual exposure.

Perhaps you would like to know that in the nearly 20 years of this and our previous forum, with thousands of questions from people concerned about sexual exposures that might have risked HIV, not one person turned out to have been infected. You will not be the first. If and when that happens, it will be from a clearly high risk exposure (like unprotected sex with a known infected partner), and not a minimal risk event like yours.

I have advised above when you can have conclusive testing for HIV. Stay mellow as you wait: there is no realistic chance you have HIV and your test results will be negative.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

HHH, MD

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