On Jun 11th, I had sex for the first time with a girl I met on a dating app. She stated she was clean but had many partners she stated. I'm not familiar with much of sex ed. I protected vaginal sex with her and she gave me unprotected oral sex.  A few days later, I had a tingling sensation and the doctor told me it was balanitis. After using the cream it went away. I did a STD panel, got tested for Chlamydia and Gonorrhea at day 6 and at day 9 did the blood test for HIV, Spyhillis, HSV 1, HSV 2. All came back negative.  

None of your symptoms is typical for any STD. Balanitis usually causes more than just "tingling":  if an experienced doctor diagnosed balanitis, probably there was some redness, irritation, etc, especially if you are uncircumcised. However, oral sex and STDs are not likely causes. In any case, it also is true that no STD would clear up with an external cream; resolution of your symptoms with the cream indeed is typical for balanitis.

Presumably your chlamydia/gonorrhea test was on urine, right? And perhaps throat swab as well? That result is conclusive; for sure you have neither of those STDs (and they wouldn't cause the symptoms you describe). However, the blood tests were too soon. It takes up to 6 weeks for the HIV and syphilis blood tests to become positive, and up to 12 weeks for HSV. However, your negative HIV test does prove your symptoms aren't due to HIV. It isn't possible to have HIV symptoms and not test positive for HIV antibody.

Those comments pretty well cover your two questions, but to be explicit:

1) Your symptoms are not at all suggestive of HIV. However, to be certain and help settle your concerns about it, have an HIV AgAb ("4th generation") blood test in another week or so, i.e. when you reach 6 weeks since the sexual exposure. You can expect a negative result.

2) As for other STDs, you can already be confident about not having gonorrhea or chlamydia. Syphilis also is unlikely, but it would be reasonable to confirm that with a syphilis blood test when you have the HIV test at 6 weeks. Almost certainly it also will be negative. I do not recommend testing for anything else. There is no realistic chance your symptoms are herpes, and in any case the HSV blood tests are not highly accurate, with high chances of false or misleading results.

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

HHH, MD

Hi Dr. Handsfield, thank you for your reply.

After reading your answer, I forgot to mention that I also had smegma buildup which is why the doctor suggested balanitis. Also, it was a urine test for Chlamydia and Gnnorehea  Just to clarify you suggested that my sore throat is not due to HIV since it's out of the timeline window for the symptoms?

I have a few more questions regarding this exposure if you don't mind clarifying a few things for me.

1)  What are the chances of getting HIV through protected vaginal sex?

2) Based on my understanding of other questions, if you wear a condom and are used correctly, you are essentially safe from STI/STDS including HIV correct?

Thanks

1) Without a condom, if the female has HIV, the risk of transmission to her male partner has been estimated by CDC to be one chance in 2,500. If we assume 99% prevention effectiveness of a condom, it becomes one chance in 250,000. If we further estimate a 1% chance your partner had HIV, your risk becomes one chance in 25 million. I hope you would agree that's zero for all practical purposes. You had a very low risk exposure in relation to HIV.

2) This depends on your personal definition of "essentially" safe. The risk is not zero, if only because condoms sometimes fail and often are used incorrectly. Also, they are less effective against STIs transmitted skin to skin (herpes, syphilis, HPV) than those transmitted through genital fluids (gonorrhea, chlamydia, HIV).

Perhaps you'll be interested to know this:  In the nearly 20 years of this and our preceding forum, with thousands of questions from people concerned about risk of HIV, nobody has yet reported they eventually tested positive. You will not be the first. If and when it finally happens, surely it will be from a legitimately high risk exposure (like anal sex with a known infected partner) and not a nearly zero risk event like you have described.

I don't mean to lecture you. But trust me on this:  there is almost no chance you have HIV. Believe it.

I will go tested for my sanity check. But thank you for that information. I guess I had the "common cold" since I had a runny nose and congested nose and coughing.  

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.