[Question #1086] Possible hiv exposure cognitive symptoms very worried

49 months ago
About a month a go I went to visit TS  escort. I had never done anything like this and always practice safe Hetero sex.   I planned on masturbation and trying oral.  After some mutual oral I was asked to try anal initially I said no but I don't know why decided to try.  The escort took out a condom and opened it got behind me and inserted .  I was so nervous and never did this before after 5 min I noticed the condom was not used . I was upset and ended the visit. The escort claimed having no hiv 
5 days later I felt odd chill bursts on occasion.  Two days later felt symptoms of difficulty concentration and calculating things .  This was day 7 after possible exposure.  Chills were gone but felt feeling of nausea but was still eating . The nausea went  after a couple daysbut the intermittant cognitive  issues would come and go.  Sometime I would feel ok then later I felt odd. Some days I didn't feel good all day and the. The next day I felt everything was ok and then I had odd cognitive issues. This continued on and off for 10 days and has stopped.
I read cognitive issues are a symptom of ars and acute hiv infection. I am very worried and hoped this was herpes or hepatitis. But I don't think this could be caused by anything else but hiv .  I am very worried and not sleeping. I took an oralquick at 11 days and it was negative but I guess that was too early.  During the symptoms my family noticed me not being myself . I seem to be myself now but a nervous scared wreck . I had no fever no lymphode issues no sore throat no diareah. The symptoms seem to come one at a time no exactly all at once.

I did have a couple days of right side adbomial pain a few days ago but seems to have gone. I am really nervous and don't try unsafe things and was caught off in this interaction with out. Noticing.  Are these symptoms common of acute hiv or are.   Right now it has been 28 days 
I know symptoms are not a diagnosis but would like your expect opinions
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

Welcome to the Forum.  I will be glad to comment.  Several elements of your description lead me to suggest that you should be tested for STIs, including HIV.  While most people do not have HIV or STIs and most exposures to infected partners do not lead to transmission, if your partner happened to be infected, receipt of receptive rectal intercourse may lead to infection with problems such as gonorrhea and chlamydia and is a relative high risk activity for HIV.  In addition, that your partner opened a condom as though it were going to be used and then did not is rather strange. Was there any kind of explanation?  Based on these elements alone, I would suggest that you have your throat tested for gonorrhea and your rectum tested for gonorrhea and chlamydia (chlamydial infections of the throat are very rare).  I would also suggest that you have an HIV testing using a 4th generation, combination HIV antigen/antibody tests.  Unalike the Oraquik test that you were tested for which was used to early to give reliable test results, the combination test will provide completely reliable results as to whether or not you got HIV at this time. 

Your symptoms do not change my recommendations or increase my level of concern.  Your cognitive difficulties could well be due to anxiety over the exposure you describe.  Similarly, your rectal symptoms do not lead me to be more or less concerned about herpes or syphilis-certainly your symptoms are not tyical of either STI.

I hope these comments are helpful to you.  EWH

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49 months ago
Thank you for responding.  I will have to test again as nervous as it makes me.  I am looking for an office that does that test.
I also wanted to ask.  I don't know if I mistyped but I didn't have any rectal or throat issues.  Mostly it was cognitive issues that would come and go through out the day or be gone a day and return. I feel they are. Or weremore than my anxiety.
1. Are symptoms like that specific to acute hiv  or ars? Would they typically begin at 5 days but become worse at day 7 or 8 and last  about 3 weeks coming and going intermittently?

2. Is there any way these symptoms could be of herpes or hepatitis other std

3. Is there any other medical explanation for these ?

I am so very nervous and feel there could only be one reason for these and the worst outcome

When I asked why no condom used they did say much.  I followed with are you free of disease and no hiv .   They said yes  and I left upset.  
I don't know if they thought I would use the condom but I really wasn't open to anything risky and got fooled I guess as I never do unprotected penetration and never anything non heterosexual til now. .  I am beyond frantic

Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

No change in my assessment or advice:

1. Are symptoms like that specific to acute hiv  or ars? Would they typically begin at 5 days but become worse at day 7 or 8 and last  about 3 weeks coming and going intermittently?
There are no symptoms that are specific for recently acquired HIV.  About half of persons who acquire HIV experience non-specific symptoms which are similar to the symptoms or the flu or a viral illness. 

2. Is there any way these symptoms could be of herpes or hepatitis other std
Nothing you have described suggests herpes and hepatitis would be most unusual.

3. Is there any other medical explanation for these ?
See my original answer. In addition to anxiety, the sort of non-specific symptoms you describe could be due to any number of usual viral illnesses that most people get from time to time.  My recommendations are unchanged- get tested with a combination test and then believe the test results.  In the mean time there is little to be gained by worrying the way you are.  EWH


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