I am from India. I have queries and concerns from few of late exposure.

On 31st March, i visited a sex worker. When i met the sex worker, i saw rashes in her body (she told it was climate but i am not sure if she ever got tested for any STDs) which frightened me and i asked only for handjob from her. She tried to climax me but she was not able to as i was turned off seeing the rashes. While trying to give the handjob, i am not sure if there were any rashes in her hand which got exposed to my penis.

Right after that event, i went to a massage parlour where she gave me a massage, she kissed my body, gave a naked body to body massage and gave me a handjob. 

A couple of days back, i have had a similar massage parlour exposure where she rubbed her naked body over me, used her lips all over my body including my naked penis and gave me a handjob.

From yesterday, i have been experiencing fever. My symptoms include fever, extreme tiredness and dizziness,  cough, congested chest, body pain. I read in other response that if the symptoms are due ARS, the test should show positive, so I went ahead with the HIV antibody and antigen testing and it came back negative. I also checked with doctor ( i had not revealed about the these exposure or about the HIV test) and they told its an onset of viral infection. My symptoms are worrying me as it matches with HIV. Reading through few other responses, the advice was the test would be postive after 10 days of onset of symptoms which got me worried as well.

Can you please evaluate my HIV and other STD risk based on above and tell me what course of action should i take. Many Thanks

You can relax:  you definitely do not have HIV. I'll address other STDs below. Most important, the negative test result proves 100% your symptoms are not due to ARS (acute retroviral syndrome, ARS -- i.e. acute HIV infection). Every case of ARV has a positive blood test:  no exceptions, ever. Fever and tiredness can occur with ARS, as well as innmerable other infections, but otherwise your symptoms don't fit ARS -- which does not cause cough or chest conditions, and you also do not describe lymph node enlargements or skin rah. You did not read on this forum that a positive HIV blood test can be delayed until 10 days after start of symptoms; whoever told you so, or wherever you read it, that information is wrong. It is not HIV itself that causes symptoms, but the immune response to the virus -- and that means antibody, which would show up in the blood test. NEVER, EVER RELY ON SYMPTOMS TO JUDGE WHETHER YOU HAVE OR DO NOT HAVE HIV. THEY ARE ALWAYS UNRELIABLE:  EVEN THE MOST TYPICAL SYMPTOMS USUALLY ARE CAUSED BY OTHER CONDITIONS; AND HALF OF PEOPLE WITH NEW HIV HAVE NO SYMPTOMS AT ALL. ONLY RELY ON BLOOD TESTS, and remember that test results ALWAYS overrule all other considerations:  no matter how high the risk of HIV at the time of exposures, and no matter how typical someone's symptoms might be, the blood test is to be believed and the rest ignored.

In addition, the exposures you describe were no risk for HIV, which has never been known to be transmitted by the events you describe -- even if genital fluids are used for lubrication (for the hand job, for example). Further, your symptoms started too late. ARS symptoms usually start 8-10 days after exposure and rarely if ever after 20 days. And as noted above, ARS doesn't cause cough etc. You caught a garden variety respiratory virus, unrelated to the sexual events. (Maybe influenza or covid:  you should be tested for them.)

You also are at little or no risk of other STDs. Your first partner's rash conceivably could mean she had secondary syphilis -- it isn't possible to judge without a lot more information about her, other symptoms, etc. But like HIV, syphilis is rarely if ever transmitted by hand-genital contact. The second event, with body rubbing and kissing, also carried little or no risk for any STD.

From a medical/risk standpoint, you do not need any further testing. If you have a regular sex partner, you can continue your usual relationship without any risk to that person -- except for your respiratory virus. However, I understand that sometimes negative test results are more reassuring than professional opinion, no matter how expert. If you would feel better with negative test results, feel free to have a syphilis blood test 6 weeks after the events described, and maybe a urine gonrrhea/chlamydia test. If you decide to be tested, you can be sure of negative test results.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I will do the testing for syphillis, chlmadiya and gonorrhoea after 6 weeks. For HIV do you think i need any further testing. I was thinking of waiting another 10 more days and do a HIV PCR test. 10 days because to include my most recent exposure which happened couple of days back ( incident included in the above question). Thoughts on this. I will proceed with your advice.

Thank You Doctor for your service

Testing for gonorrhea/chlamydia after 6 weeks risks the possibility of infection that was self cured before you are tested. I truly believe no gon/chl testing is needed, but if you do it, I suggest doing so in the next day or two.

Threads are closed after two follow-up comments and replies, or after 4 weeks, whichever comes first.

Since i have your attention i also wanted to ask one quick question. During the most recent exposure of handjob, the massuer had a sort of a single small cold sore or blister in her lower lip at the end/corner portion. The cold sore looked broken. She gave me superficial kiss over my face and my body with that lip. There was no french kiss involved. Can you please assess any STD risk with the said exposure. Should I be worried about HSV or be tested about it considering i have a regular partner

Thank You Doctor

Well, I'm not glad you had covid, but happy for you that you understand it could not have been HIV. I hope you're recovering without difficulty.

As you anticipated, that concludes this thread. Best wishes and stay safe.