[Question #10325] Concerns Regarding Recent Exposure and Symptoms

Avatar photo
23 months ago

Hello Doctor, I'm reaching out regarding a potential exposure incident that occurred on August 17th, 2023. During a massage session, there was full body-to-body contact with a ukranian escort, including genital rubbing with possible contact with vaginal fluid. Notably, there was no penetration. I had several existing pimples, acne, and zits on my genital area due to recent shaving and folliculitis. Following the encounter, I observed that the escort had a full body rash which i didnt notice initially as the room was dark. Approximately a week later, I began developing unfamiliar symptoms, characterized by randomly appearing red raised rashes across my body (chest, back, legs, arms), which would subside in 2-3 days. I also experienced extreme folliculitis in unusual areas like my nose and chest, as well as persistent lower back pain that hasn't responded well to physiotherapy. I took a 4th generation HIV test at 27 days post-exposure, yielding a negative result. today at 37 days post-exposure, I'm contemplating a complete STD panel. Could you advise if this panel would effectively eliminate the possibility of STIs such as HIV or syphilis as the cause of my symptoms, or if it's too early for conclusive results? I'm eager to understand the correlation between my symptoms, the exposure, and potential STIs. Your insights would greatly assist my understanding of the situation

Avatar photo
Edward W. Hook M.D.
23 months ago
Welcome to the Forum. Thanks for your questions although I'm a bit confused.  You state that your exposure was on August 17 but then mention testing days 27 and 37 post-exposure.  

Testing for HIV at 27 days would detect about 99% of recent HIV infections and testing at 37 days would detect virtually all recent HIV infections (4th generation, combination HIV antigen/antibody tests are considered entirely conclusive any time more than 6 weeks after an exposure and although it happens quite rarely, we have never personally seen a person with a negative test at 4 weeks (28 days) go on to develop a positive test.  Further, you can be entirely sure that any symptoms which were present at the time of your tests or before testing were not due to HIV since when symptoms are due to recently acquired HIV the tests are always positive.  

Regarding other STIs, while syphilis can cause a widespread rash, it would be unusual although not impossible to acquire it in the absence of penetrative sexual contact.  As for HIV, if your rash were due to syphilis, a test would be positive.

I hope this preliminary information is helpful.  PErhaps you can clarify the dates of your exposure.  EWH
---
Avatar photo
23 months ago
Hi doc, thanks for you reply. Apologies, I meant July 17th. I had an hiv test 27 days after the encounter in the presence of symptoms and today I had a full std panel. I'm still waiting on my results and will update tomorrow. But I really shouldn't worry about hiv correct? Thus I conclude that my symptoms are not hiv related 
Avatar photo
Edward W. Hook M.D.
23 months ago
I would have no concerns whatsoever about HIV.  I am confident that your tests will be negative.

EWH 
---
Avatar photo
23 months ago
Hi Doc, I just received my results both Urine and Blood are negative at 37 days post exposure. Can i consider my tests conclusive and eliminate that my symptoms are due to an std ? for syphilis both RPR and TPHA is negative. 
Avatar photo
Edward W. Hook M.D.
23 months ago
Yes. I encourage you to accept your test results and move out without further concern. There is no reason for additional testing. 

As you know, we provide up to three responses to each clients question. This is my third response. For that reason this thread will be close shortly without further responses. I hope the information I have provided has been helpful. Please don’t worry. EWH.
---