Hello,I'll be totally transparent in admitting I have been incredibly anxious related to HIV since dating again, and some recent physical symptoms have just completely put me in a tailspin/made me full of anxiety since asking previous questions. To recap, I've recently entered a new relationship; Fall 2023, with a 47 year old heterosexual, low risk man. We had both been tested before the relationship, me right before the relationship and him a few months before. Both negative for the basics, HIV/Hep/Syph/Chlamydia/Gonorrhea/trich. After weeks for protected sex, being comfortable with our testing status, we started to have unprotected sex late October 2024. After our second unprotected sex, I started having burning and a profuse white discharge. As of today, 12 weeks later, I have tested negative for literally every strain of yeast, every STD, BV (the bacteria's most associated with them), but the symptoms have persisted with no relief. I'm seeing a doc this week to talk about vaginal lactobacillosis as my symptoms are MIRRORING this in every way and I've had no answers. My last sexual encounter with this parter was 12/14/23. Last week I woke up with random jaw pain, clicking, popping and an enlarged swollen salivary gland on the left side. This put me into a complete and utter panic, as in my past anxiety riddled google searches, I specifically remembered those specific glands swelling in early HIV. I immediately ran out to my local health dept and got full STD testing again, including a rapid for HIV. Problem here being this is only 5 weeks post my last exposure (34 days) and this rapid likely being a 2nd gen, antibody only test. These results are likely, while negative great, not reliable. Today I did go get a 4th gen HIV duo test and can expect the results within the next two business days. I am just besides myself. Is there ANY merit to this 5 week antibody only test to keep myself calm?

Welcome to our Forum and thanks for your confidence in our service.  I’ll be glad to comment.  Let me start by congratulating you on your approach to your sexual health.  It will serve you well. 

 

The good news is you can be confident that you do not have an STI- today’s tests are among the most sensitive tests in all of medicine and your results will be reliable.  I suspect that  can assure you that your symptoms are not due to HIV for several reasons including:

1. You and your partner were both tested before beginning unprotected intercourse
2. Your symptoms are not typical of HIV ARS.  If any of your symptoms were due to HIV even a 2nd generation test would be positive since the symptoms of the ARS are due to the interaction of HIV antigens and antibodies
3. Your 5 week test results are at least 80-90% conclusive if your test was an antibody only test and over 99% conclusive if you were tested with a 4^th generation, combination HIV antigen/antibody test.  Recommendations that 4^th generation testing is only entirely conclusive at 42-45 days is rather conservative.  Neither of us on the Forum has ever seen or heard of a person with a negative test at 4 weeks who subsequently went on to become positive.  Given the details you have provided, I am confident that your recent 4^th generation test will be negative as well. 

 

As to the cause of your continued symptoms, that is more difficult and as an expert on STIs, I’m not sure my comments will be all that helpful.  I do know however that sometimes after a period of abstinence, new sexual partners can lead to disruption of a person’s normal vaginal flora, leading to bacterial overgrowth and symptoms such as those you are experiencing.  Discussion of this with your gynecologist is a great idea

 

Since the onset of your discharge has it changed in character or amount?  Have you tried any remedies? (sometimes well intended practices such as douching can make problems worse rather than better).

 

Perhaps some of these comments are helpful.  I hope so.    EWH

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Dr. Hook, as always, I appreciate your kindness and how thorough you are with answers. The test today was definitely a duo, so I'm very anxious to get those results back and get this behind me. The test I took at 5 weeks was a Chembio rapid, so it's good to know I'm looking at as high as even 90% negative--how reassuring as I thought it would be much lower than this. I had read that I would definitely be positive if my symptoms were ARS, but I was so anxious and worried that the symptoms came on quickly and matched some concerning things I had read...let's just say I was convinced! If swollen glands in the face were ARS would mean a positive result... I'm going to just keep repeating that to myself! As far as my 12 week long vaginal issue, I'm also convinced now that I've gone through two rounds of STD testing that this is some phbalance issue, but I am so frustrated it's taking so long to resolve. I have changed soaps to a hypoallergenic soap, stopped taking baths, stopped shaving, have been through 2 rounds of diflucan, have tried boric acid suppositories... it is really grating on me at this point and I KNOW it's why my anxiety about HIV is so elevated right now. I'm very anxious and excited to get a second opinion on it as my OBGYN seems stumped as everything is negative... but even my severe anxiety wouldn't manifest a burning vagina, profuse white discharge that has not let up, and a feeling that my underwear is constantly soaking wet. All point to this Vaginal lact. thing I was mentioning below, which is only diagnosed via wet mount. I'm going to bring my literature and specifically ask for this.

Thanks for the additional information.  I agree with all that you said and support you on your ongoing efforts.  EWh---

Dr. Hook, the results are negative. Thank you for leaving the thread open for me to report back, and to assure others seeking reassurance about again, even the most "identical" ARS symptoms! THANK YOU.

Thanks for sharing your results.  While I'm not surprised, I know it will be reassuring to others who visit the Forum.---