[Question #11877] HIV risk and testing
 |
11 months ago
|
Good morning. I was referred to your website by a friend and I must compliment you on a great service you provide. I couldn't find a question that was already asked that gave me reassurance so here goes.
I am a 54 year old male and last December I had unprotected vaginal sex with an escort. Internet/website type of lady if that matters? She just climbed on and pushed for the bare sex so to speak and I went with it in the heat of that moment. So I am guessing she does that with lots of men if not all. I did a full std panel a couple weeks later and all was negative. I never had any type of symptoms that I can remember after that and I just put it out of my mind.
A couple days ago I went to my doctor over some concerning symptoms. Constant/chronic mild pressure headache that does not go away for about 3 weeks. It's very mild but it's 24/7. The other symptom being profuse sweating while I work. So much hyperhydrosis that I have to change clothes every hour or so and drink copious amounts of water. And finally, I have a lethargy/lack of energy all the time. So, he did some blood work and it turns out that I am severe anemic but all my vitamins, electrolytes, folate, etc are normal.
He wants me to come back for another blood draw next week for an HIV test. He said that the profuse sweating along with the anemia is indicative of HIV. His statement about that has sent me into a panic. Are these symptoms really indicative of HIV? Do I really need the test? I'm pretty scared here.
I am a 54 year old male and last December I had unprotected vaginal sex with an escort. Internet/website type of lady if that matters? She just climbed on and pushed for the bare sex so to speak and I went with it in the heat of that moment. So I am guessing she does that with lots of men if not all. I did a full std panel a couple weeks later and all was negative. I never had any type of symptoms that I can remember after that and I just put it out of my mind.
A couple days ago I went to my doctor over some concerning symptoms. Constant/chronic mild pressure headache that does not go away for about 3 weeks. It's very mild but it's 24/7. The other symptom being profuse sweating while I work. So much hyperhydrosis that I have to change clothes every hour or so and drink copious amounts of water. And finally, I have a lethargy/lack of energy all the time. So, he did some blood work and it turns out that I am severe anemic but all my vitamins, electrolytes, folate, etc are normal.
He wants me to come back for another blood draw next week for an HIV test. He said that the profuse sweating along with the anemia is indicative of HIV. His statement about that has sent me into a panic. Are these symptoms really indicative of HIV? Do I really need the test? I'm pretty scared here.
 |
H. Hunter Handsfield, MD
11 months ago
|
Welcome. Thanks for your confidence in our services and to your friend for their recommendation.
---
The sexual exposure you describe was almost certainly near zero risk for HIV, especially if "escort" means an expensive encounter: most such female sex workers are low risk -- and even if she didn't insist on a condom in your case, that might be because she knows enough about you to correctly judge there is little chance you had HIV or other STI; she may routinely use condoms for other partners, as do most escorts. And most escorts get tested frequently as well.
As for your symptoms, I can't agree with your doctor: I've never heard of the combination of anemia and excessive sweating (or fever, which might be the cause of sweating) as the main manifestations acute retroviral syndrome (ARS, i.e. initial HIV infection); and onset 6+ months after the sexual exposure is much too late. Could they be signs of an opportunistic infection -- i.e. due to immune deficiency? Even this is really too early: although possible at 6 months, it's unlikely. That said, I certainly agree that any person with such health issues should be tested for HIV, but I would advise that regardless of the patient's sexual history.
So my prediction is that your HIV test will be negative, that something else is going on, entirely unrelated to the sexual exposure. And one other factoid that works in your favor: In the 20 years of this and our preceding forum at medhelp.org, with thousands of questions about potential HIV exposures and testing, nobody has yet turned out to have it. I'm confident you won't be the first: if and when it finally happens, I expect it to be from a genuinely high risk exposure, maybe something like unprotected anal sex between men with hundreds of lifetime sex partners. Such persons still account for the large majority of HIV infections in the US, Europe, and Australasia.
Please return to let me know your test result. And by the way, I would also advise a syphilis blood test: although also very unlikely based on your exposure history, syphilis is known as "the great imitator" because of its ability to cause a wide range of atypical symptoms. In the meantime, I hope these comments are helpful.
And one final thought: If you are able to contact your partner from last December. If you can, find out if she has. been tested for HIV (and syphilis) since December, or if she might be willing to be tested now, in view of your doctor's concern. If her tests are negative, you'll know you were not at risk.
HHH, MD
------