Hello dr,

Let me start by saying I really value your opinion.. thx for giving me this opportunity. 

I have been through a complete and total nightmare the past 8 weeks.. i have had SEVERE ANXIETY and depression and i think that's effected me physically and emotionally.. drinking more than i should. .no appetite..iv lost weight.. just want to sleep.. feeling of guilt, hopelessness..ill start by saying I had a high risk encounter. I really don't want to get into the details of it because I hold a ton of guilt and shame.. ill just say unprotected anal was involved..I was on the insertive end..

15 days after exposure I went through quest lab and did a 10 panel std test plus hiv rna pcr test. Came back negative thank God. No symptoms at that time. 

Then about a week after that I started developing angular cheilitis.. that and my tounge is kind of white.. not all the time and it's not painful at all.. just dry sometimes..other than that I never really have any symptoms that would indicate acute hiv.

No fever, no achy joints, I think a lot of what I'm going through is me being in a constant state of panic for going on 8 weeks now..I feel like my body is in a fight or flight mode for that whole time.. could that cause angular cheilitis?.. could being in that state cause my immune system to dip. Is angular cheilitis normally in a later stage of hiv. And lastly how reliable is the hiv rna test 15 day's after exposure.?

Your risk for HIV from the encounter is low.  Apparently you do not know if your partner had HIV or not- most people do not.  Even if he (I presume it was another male) did have untreated HIV (unlikely), the risk for acquistion of HIV from a single insertive rectal intercourse encounter is less than 1 in 1000 (i.e. More than 99.9% of such encounters will not lead to HIV acquistion).  In addition, you have had an HIV RNA test which was negative 15 days after the encounter- results of HIV RNA tests are considered conclusive any time they are taken more than 11 days after and encoutner.  Thus you have further conclusive evidence that you did not acquire HIV.  You need to accept these results.

Most people with angular chelitis do not have HIV.  Angular chelitis however can be a sign of anxiety and resulting lip licking.  I suspect this is what is occurring.  

You have proven you do not have HIV.  I urge you to accpet these results.  I see nomedical or scientific reason for additional testing.  EWH

I hope you will be able to move forward without continuing concern. As you know, this concludes this thread. EWH.