Feb 29th - Initial exposure (protected vaginal sex)

Mar 27th - 1st 4th Gen HIV test from vein - Negative (27 days after exp)

April 12th - 2nd 4th Gen HIV test from vein - Negative (43 days after exp)

April 15th - 3rd 4th Gen HIV test from vein - Negative (46 days after exp)

I did not take any medications for HIV such as PREP or PEP and following your instructions I did not test for HIV again.

On Monday 04/29 (60 days after exp) I started to have weird symptoms in my body such as balanitis (red spots in glans), itchy palms, soles and head (no visible rash). Pain in the lower abdomen / groin area (not sure if caused by lymph nodes), mild diarrhea, mild sore throat, small red bumps (4 in total) in my arms not sure to call it a ''rash''. The itch then turned into a burning (like sunburn) sensation in my back, palms, soles and head. I took antihistamines and they helped a lot so most of the symptoms went away in 5 days. 

I still feel sometimes pain in soles and a little bit of discomfort in the pubis area. I did not have any sexual activity / exposure since Feb 29.  Would you recommend me to test again for HIV at 90 days after exposure? I am currently in the day 70.

The symptoms of initial HIV infection (acute retroviral syndrome, ARS) are not due to the virus itself but the immune response to it. The immune response is reflected in antibody. Therefore, it is not possible to have HIV symptoms and negative HIV antibody tests. And almost always, the virus itself always is detectable itself. The HIV AgAb test (4th generation) includes both -- antibody and virus. It is simply impossible to have HIV symptoms and not test positive. Your negative results are 100% proof a) that any symptoms you have cannot be due to HIV and b) you don't have it (even without symptoms), since results at 43 and 46 days always are positive in infected persons. You do not need to test again at 90 days or any other time.

So all is well. If you remain concerned about your symptoms, see a doctor about them. But they are not HIV -- and they aren't the right symptoms anyway! 

I hope these comments settle things for you. Let me know if anything isn't clear (but please don't ask me to repeat what was said here or in Dr. Hook's reply a couple weeks ago!)

HHH, MD

Thank you so much for your time & response. I understand that having symptoms and test negative would be impossible but these new symptoms happened after all my tests (they started at day 60). Based on this I would like to ask the next questions:

1) It is possible to develop an initial immune response to HIV 7-8 weeks after exposure (ARS)? I am asking this since I don't recall to have this kind of symptoms before in my life and I am wondering if they could have been caused by anxiety since I was under a lot of stress due to this situation. 

2)I forgot to mention that my palms and soles were red & hot to tact (uniform red, they turned pale when pressed) and the pain sensation was like needle puncture the pain and redness intensified during the nights. Can this be classified as a rash? My palms were dry also.

3) What are the symptoms of ARS?

4)Assuming that HIV is not the root of the symptoms, can another STI like syphilis, herpes or chlamydia be causing all these weird symptoms? As I said most of them are gone and only remains discomfort in the groin/pubis area, mild to moderate sore throat and mild pain in the soles. I am wondering this since I had also red spots in my glans but they are cleared now.

Thank you for your time Dr. HHH.

1) No, this never happens. And if somehow it did, the antigen portion of the 4th generation test would have been positive on all previous tests. I'll also add that whenever someone suspects his or her own symptoms originate from anxiety or other psychological issue, usually they are right!

2) These symptoms are nothing like the skin rash of ARS.

3) The main symptoms are various combinations of sore throat, fever, enlarged lymph nodes in several body areas, and skin rash.

4) No STI causes symptoms like you describe.

This will be my second reply. 

1) As I said before, I still have the groin discomfort / pain.  1 week ago I started to experience testicular pain (right testicle)  that comes and goes(dull to mild pain) that gets worse after ejaculation or physical activity (soccer), this pains also irradiates to the lower abdomen, bladder, left testicle and inner thighs, no blood in urine or Hermatospermia but more frequent urination. Should I suspect that this is Epididymitis related to chlamydia or Gonorrhea? 

2) I noticed that I am developing mild folliculitis in areas where I never had folliculitis before (arms and chest), no pus, only inflamed and red follicles . It is folliculitis related to HIV at all?

As of today I did not have anymore exposures (82 days after exposures). I am planning to test again on May 31st (92 days after exposure) since I am having my regular annual check with my primary care doctor. 

I will let you know the results with my 3rd reply and  if it is negative (which I really hope)I expect that this conversation can really help other people with their anxiety related to the HIV.

Thank you again for your time Dr. HHH.

1) The vague sort of testicular pain you describe fits best with anxiety, or with the chronic pelvic pain syndrome (CPPS), or perhaps with prostatitis. Neither of these is an STD. Epididymitis pain does not come and go, and if you had epididymitis your testicle would be enlarged and very tender to touch. I would advise discussing your symptoms with your primary care doc, including the possibility of referral to a urologist.

2) No, folliculitis has absolutely nothing to do with HIV, and it is proved you don't have HIV anyway.

You do not need another HIV test; the ones you have had are 100% conclusive.

That completes the two follow-up exchanges included with each question (not three) and so ends this thread. Please do not be tempted to return again, whether or not you have another (unnecessary) HIV test. Keep working with your doctors and do your best to put HIV and STIs out of your mind.

I hope these comments have been helpful. Best wishes and stay safe.