[Question #11095] Follow-up [Question #11048]

17 months ago

Hello doctors,

I am just following up regarding my last inquire [Question #11048], I definitely know I didn't catch HIV from exposure 1 and 2, but I still have concern about exposure #3, which I expand on below. Sorry I came back, but I'm having anxiety and panic attacks that are unreasonable these last days; this is my last time here, I promise :)

3rd exposure with an HIV-positive person taking DOVATO (not sure for how long or whether he takes his medicine correctly since he lied to me initially): I had unprotected receptive oral sex and insertive fisting with a guy. My concern grew when I noticed minimal bleeding from my very dry finger node a few hours after, when I was washing my hands. The opening was sominimal, probably not bigger than 1-2 millimeter(s) and blood was coming from a very dry skin spot on my hand not like an open cut.

Anyway, I recently took a 3rd generation (INSTI HIV antibody test, finger prick) 21-22 days after the exposure mentioned above, and it came back negative. I read online that this result is only 60-70% conclusive for this test type from BioLytical Lab. But I took it to calm myself before going for the 4th gen test later on.

I ask some questions based on the above:

1. The exposure above has a relative risk close to 0.00 for me, right? Sorry, I want medical reassurance one last time.

2. Even if fisting took place with my hand having a minimal bleeding, the HIV risk for fisting is still negligible as most report suggest, correct?

Thank you again.

Edward W. Hook M.D.

17 months ago

This is a repetitive question which was answered in our previous interaction. Repeated the question using slightly different verbiage will not change the answer. Your 3rd exposure was virtually no risk and from a medical and scientific perspective no testing is needed. You don't like that answer so have tested with tested which would not be conclusive at the time you tested. As I said earlier, if you wish to test conclusively to prove that you did not get HIV from your no risk exposure, the you should do a HIV RNA PCR test which will provide a conclusive result when performed any time more than 11-12 days after your exposure. Thus:

1. The exposure above has a relative risk close to 0.00 for me, right? Sorry, I want medical reassurance one last time.

Correct. See above

2. Even if fisting took place with my hand having a minimal bleeding, the HIV risk for fisting is still negligible as most report suggest, correct?

Correct.

There should be no need for further questions. EWH

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17 months ago

Thank you for your answer, sorry that I was repetitive. I didn't find HIV RNA PCR testing in my city. That's why I will do a 4th-gen test in about 2 weeks - month post-exposure.

Lastly, I would like to add some new info and ask my last follow-up questions. 4 days ago (2 weeks or so after the exposure), I started feeling some discomfort under my armpit one day, so I thought it could be swollen lymph nodes, so I touched myself trying to feel the swollen nodes, but I don't feel anything abnormal or enlarged. However, the discomfort and some mild pain from time to time still remains in the area.

3 days ago, I have felt like if I had a mild fever, and I started having mild night sweats. I say mild because it's not that I woke up with my clothes soaking in sweat, but my back would feel hot and have a little bit of sweat in the morning (only in that area). This happened for 2 o 3 days.

Then, I started feeling some sort of muscle or joint pain, but not general in all the body, but just in one area, then in another area and so on, from time to time.

No more symptoms... [see next comment for continuation]

17 months ago

[...Continuation]

Last questions - I promise I won't have any more questions, I just want your reassurance I should stop worrying unreasonably one last time:

3. Could my recent symptoms above be related to ARS? Is there a chance my body will start creating antibodies just now or in the next few days? The exposure was 21 days ago.

4. Given that my 3rd-gen HIV test shows a negative result (60% conclusive) amid those very mild symptoms, should I stop worrying that I contracted HIV? Is it prudent to think it is nearly impossible I caught HIV?

After answering the above, you can close this thread. Thank you for your understanding and patience :)

Edward W. Hook M.D.

17 months ago

HIV RNA PCR is available throughout the world. You have not looked hard enough.

In reply to your questions

3. Could my recent symptoms above be related to ARS? Is there a chance my body will start creating antibodies just now or in the next few days? The exposure was 21 days ago. .

This is NOT the ARS. ARS symptoms are uniformly severe, not mild and include SEVERE sore throat, HIGH fevers, and widespread muscle and joint aches. Further the ARS is DUE TO the presence of antibodies and the virus, this is why tests are virtually ALWAYS positive in persons with the ARS. Your exposure was no risk, why do you persist in thinking you are going to be the only person in history to acquire HIV from a virtually no risk encounter?

Yes, you should stop worrying. It is needless. to worry about situations that have not ever been described in our over 40 years of studying this disease.

Please work to address your guilt and anxiety. More testing and more questions are not going to help. If you cannot move forward on your own, I recommend seeing a professional counselor out of concern for you, nothing more. EWH

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17 months ago

Thank you for your answer, doctor. I understand some patients can be repetitive and going in circles with anxiety like me. I appreciate your professionalism and medical expertise when answering the questions to make us wake up from our scientifically unreasonable fear.

I feel more relieved now, and I will seek mental counselling as suggested. But upon reading your replies, I feel a lot better and very confident I don't have HIV. I will still test with a 4th-gen test because it's free with my insurance, and to be reminded one last time I am HIV-free, to be grateful and always have protected sex only with people I trust.

All the best! You are helping a lot of people here!

Edward W. Hook M.D.

17 months ago

Thanks for your thanks, This will compete this thread which will now be closed. Time to move forward. EWH---