[Question #10540] HIV question

22 months ago

Hello Dr’s

I had unprotected sex with the same girl from previous questions I’ve raised on here recently. I’ve largely been anxiety free for a while now but have some recent concerns I was hoping you could address for me.

We were both tested last year and both had negative results. Outside of our long term partners haven’t had sex with anyone else. We had sex on Sept 6th and again on October 2nd.

Over the past couple of weeks I’ve had a headache and a tight feeling across the bridge of my nose. My left cheek has been quite sensitive and on some days my throat is sore. I also have a bit of a stiff neck. I initially thought this may be sinusitis.

Over the past two days I’ve been extremely tired and fatigued. Today being an especially low point.

One concern that did come up is that this might be symptomatic of HIV? I know we both tested negative last year but my concern was if her partner is potentially positive but only recently passed this to her? Maybe it could have been passed to me?

I intend to get a test next week which would be 4 weeks after our second get together and 7 weeks after the first.

In your estimation, is this likely to be anything to worry about? Don’t feel that testing is necessary?

22 months ago

Sorry, that last sentence should say “do you think that testing is necessary?”

H. Hunter Handsfield, MD

22 months ago

Welcome back, but was it really necessary? All your questions have been quite similar -- various non-risky (or minimally risky) exposures with the same woman who, I think I understand, also has sex only with her regular partner, as you do. This is an inherently low risk situation until and unless your or this woman -- or one of your main partners -- bring an STD into the relationship. As for your symptoms, they do not even hint at HIV or any other STD. Based on your symptoms and overall risk assessment, I do not recommend testing. However, even when the risk is zero, sometimes a negative test is more reassuring than professional assessment based on risks and probabilities. So feel free to be tested for HIV if you wish; a negative HIV AgAb (4th generation) blood test would be conclusive for all practical purposes (100% for the event 7 weeks ago, 99% for the one 4 weeks ago). If you and she both get tested, then the negative results of course will mean there is no possibility you have HIV without having to think about a second test.

Since you're worried about HIV, I wonder why you don't mention other STDs. If there is any doubt that either your spouse or hers could be having other partners, perhaps it's time for you and her to also be (re)tested for gonorrhea, chlamydia and syphilis.

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

HHH, MD

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21 months ago

Thank you, Dr. We’ve both decided to get up to date testing. I visited an STI clinic yesterday as I had a few small raised red mark on the top of my thigh/groin that I was concerned could be herpes but I was advised by the nurse that it isn’t and is just a skin irritation.

I continue to suffer from a cough, headache, slight congestion and now a very dry mouth. There are some times where I feel a bit sick too (my stomach has been quite uncomfortable but I do have IBS and a hiatus hernia which can also cause issues from time to time. Not sure if this sick feeling is from that or not) There has been no fever or trunk rash so am I safe to assume this isn’t ARS? It’s mainly the timing that has caused my health anxiety to flare up.

Based on your risk assessment what percentage chance do you think this could be HIV?

H. Hunter Handsfield, MD

21 months ago

The symptoms you describe are not typical for ARS; indeed you are "safe to assume [it] isn't ARS". I believe there is zero risk you have HIV and you can expect your and your partner's test results to be negative.

I'll be happy to comment one more time if you would like to let me know both your test results. I won't have any other comments until then. Stay relaxed in the meantime: You don't have HIV!

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21 months ago

We last had intercourse on 23rd October and I got tested 30th October. My results all came back negative. My partner had a test last Monday and we’re awaiting her results within the next week or two.

While I know that the two dates I mentioned have now tested negative, I am still slightly concerned about our most recent encounter. My partner said the physical examination she had (she was swabbed for BV, chlamydia and gonorrhea) left her in a lot of pain. Two days later she had a rash localised to the area she had her blood drawn from her arm. She has a latex allergy and thinks this may have been the cause.

She went to see a doctor 2 days after her tests who advised her cervix was inflamed. The doctor concluded that this pain and the localised rash to the injection site is consistent with her latex allergy if latex gloves were used and gave her an antibiotic injection to pre-empt any infection.

This injection made her throw up just a few hours later. Her nausea has reduced now and the rash is subsiding. Is the doctor’s judgment here correct? I myself have felt a bit sick over the past few weeks and have a very dry tongue. Is this coincidence or could we both be exhibiting signs of ARS or any other STI related condition?

21 months ago

Sorry, just added all these details to see if it changes your previous opinion about a zero chance of HIV

H. Hunter Handsfield, MD

21 months ago

THIS IS A MODIFIED REPLY: At first I missed that you were tested with negative results. Apologies for my misunderstanding. I'm glad to hear your test results were negative. However, the main points this reply are no different.

To your opening question: No, the symptoms you describe for yourself and your partner do not change my opinion or advice -- for sure you do not have HIV, syphilis or any other STD.

However, I still suggest you continue to be tested from time to time for reassurance. Your several questions over the past couple of years all indicate inflated fears despite near zero risk for syphilis, HIV, or any other STD. But you obviously remain concerned about these things. Perhaps you are uncertain about your partner's sex life -- whether she might have more partners than she tells you about. That may be a reasonable concern. And you also make occasional sexual decisions that, although safe, still make you nervous (like hand-genital contact with other men).

Even though the STD risk is near zero in all these situations, it is not irrational for you to have these fears. The way to deal with them is NOT to keep coming to this or other online sources for reassuring advice based on exposures and symptoms. Instead it is for you to be tested from time to time for the common and potentially serious STDs, even when you "know" there was little risk. The negative test results probably will help you a lot more than repeated advice on this forum. Therefore, I ask that you stop asking such questions here -- but instead from time to time have blood tests for HIV and syphilis and, depending on the kinds of sexual exposure since the previous tests, urine and/or oral testing for gonorrhea and chlamydia. The exact frequency is up to you, but every 6-12 months might be about right.

Please take this advice to heart. Best wishes to you.

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H. Hunter Handsfield, MD

21 months ago

Please notice the changes I made to my comments above. Apologies for any confusion or misunderstanding. Best wishes.---