[Question #1113] Help

50 months ago
Hello

I recently had two encounters with men that I was very nervous about. I am married and new to this and on an impulse met 2 different men and had sex with them. The first I had anal sex with and I used a conform. I was the insertive partner and I don't think the condom broke. A few days later I had sex with another man and he performed oral sex on me with no condom.  I am concerned now that one or both may be infected.  I read on line about a 4th generation duo test and got tested this week which was 29 days since my last encounter.  The test was negative. This was on Monday. Yesterday I began noticing a rash on my face which I have never had before. I also have noticed small lymph nodes under both arms and I have a small canker sore that has come up in my mouth.  I have read about the symptoms of early hiv and I now have 3 of them!  No fever so far. I found that the 4th generation test is only 90-95% accurate at 4 weeks.  My questions are

1) could my symptoms be given?
2) is my test conclusive?
3) should I be retested later and if so when?
4) can I return to unprotected sex with my wife?

Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Welcome to the Forum.  You are in the clear.  That is no surprise to me as condom protected sex is safe sex and HIV from performing oral sex on an HIV infected sex partner is extraordinarily rare (so rare it is hard to quantify).  When you consider this, your risk for infection from these encounters is virtually zero.  Your 4th generation test result, which is definitive at any time more than 28 days after exposure serves to verify that you did not get HIV from the exposures you have described.   

As for your specific questions:

1) could my symptoms be given?
Your symptoms are non-specific and, given your test results, unrelated to HIV.  When test results from tests performed at the appropriate time and symptoms disagree, the test results are always right.

2) is my test conclusive?
Yes.

3) should I be retested later and if so when?
There is no need for further testing related to the exposure you have described.

4) can I return to unprotected sex with my wife?
You are in the clear.  No reason related to the exposure you describe to abstain from unprotected sex with your wife.

I hope these comments are helpful.  EH
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50 months ago
Thank you. Just want to make sure that you understood that he performed the oral sex on me. I was the insertive partner.  So I assume that is also low risk?  Just want to make sure your advice doesn't change.  The test I took was hiv 4th generation with reflux.  Not sure what that means but that's what I took. Thanks again 
50 months ago
Hello

I had a follow up question the other day that has not been answered yet. Since that time I have made contact with the guy who performed the oral sex on me.  He tells me that he tested positive for hiv last Friday and that he knows for sure he was negative two months before we met. That news has shocked me and I am scared.  I have read that while receiving oral sex is low risk, his viral load must have been very high since he was recently infected.  I had sex with my wife already after my negative test and am so afraid I may have exposed her.  Please let me know what I should do.  Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Thanks for the clarification.  Your additional information does not change my assessment or advice.  The results of 4th generation tests are conclusive at any point more than 28 days after exposure.  There are no proven cases in which someone has gotten HIV from receipt of oral sex.   EWH


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