First off I would like to thank you for taking the time to read my question and for this forum. So on May 21 I (male) had of what I would think a high risk exposure, had vaginal sex with a sex worker. A condom was used and it did not appear to break. A week later I start to have a burning sensation on my pubic area and had to constantly pee. I did not burn when I peed nor did I have any discharge. I was paranoid I had contracted something so I went and got tested everything came back negative but I believe it was to soon to test for anything. The  HIV test was a rapid one, they pricked my finger. I was concerned with frequently having to pee so I went to my doctor and he prescribed me antibiotics but that did not clear it. I was on antibiotics for about 14 days and it did not help, my last dose was probably on June 25th. Still paranoid on not knowing what is going on with my body I scheduled another full panel STD On June 21 ( 31 days after exposure) they used an HIV 4th gen test and everything came backup negative as well. The urge to urinate frequently comes and goes on days but its still lingering. So a few days after I was done with my antibiotics I started to get what seems to be oral thrush (currently still have it), read online this could be because of HIV. This got me scared to I purchased HIV RNA early detection from STDCheck i got my blood drawn on July 3rd, I got the results yesterday and it was non reactive. With these results can we conclude I have no STI/STDs or HIV? Should I go get another HIV test? 

First, congratulations on the wise decision to use a condom during this event. It worked:  you have no infection from the encounter.

HIV first, since that appears to be your main concern. Your symptoms are not typical for HIV; and your negative antigen-antibody (AgAb, "4th generation") blood test a month after the event proved your symptoms are not due to HIV:  it is never possible to have HIV symptoms without detectable HIV antibody, so a negative result always proves symptoms are not caused by HIV. And that result plus your negative RNA test July 3 entirely rules out any possibility you have HIV. You can put that concern aside. Also, what "appears to be oral thrush" usually is just white coated tongue, which isn't thrush and not serious. Anyway, thrush is rare with newly acquired HIV; it's primarily a symptom of advanced HIV infection, i.e. AIDS typically several years later.

And it is clear you have no other STD either. There are no STDs that cause any of the symptoms you describe. Presumably your tests for "everything" included urine for gonorrhea and chlamydia, so you can forget them. The lack of response of your rather vague urinary symptoms to antibiotics also means there was no other bacterial infection either. Your urinary symptoms almost certainly are just genitally focused anxiety, probably due to your STD/HIV fears and/or perhaps stress over a sexual decision you may regret.

You definitely do not need any further testing for HIV or other STDs and can be 100% certain you have no infection from the exposure you have described. Your urinary symptoms will clear up once you fully understand and believe -- emotionally as well as intellectually -- that you have no infection and nothing to worry about.

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

HHH, MD

All blood test window periods are for the time for a test to become positive. "Window" says nothing about how long a test remains positive. For all HIV tests, it's for life.

My white tongue or oral thrush has not gone away, its been over 2 weeks now. I am afraid I have HIV, as last night I had night sweats, woke up to a very damp shirt. How often have you seen people testing positive after a negative 4th gen test at 30 days and an RNA test at 40 day? I'm just a bit concerned.

You also might like to know that in the 20 years of this and our preceding forum, with thousands of questions from people worried about having HIV, not one has yet turned out to be infected. You will not be the first! If and when that finally happens, surely it will follow a truly high risk exposure and not a nearly no-risk event of the sort you have described.

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