Thank you so much doctors for your valuable services. It means a lot to us from far away places.

Exposure:

I visited a Thai spa and after a dry massage:

- Kissed the masseuse’s body and sucked her nipples.

- Fingered her and got vaginal fluids on my finger (my main concern).

- She touched and smooched my penis once.

I’m mainly worried about the fingering. I din’t have visible cuts, but may have had dry or rough skin or hangnails ( I was hands a lot).

Symptoms:

4-5 days after, I had diarrhea. Consulted doctor after 3 days, and it was treated with medication (Metrogyl 400 mg, Sporolac-DS, PAN 40 mg) and resolved within 2-3 days. I’ve had no fever or sore throat till now (55 days), but noticed two red dots on my chest and neck stiffness around 30 days post-exposure. I don’t see any swelling in neck, but not sure how to know if it’s neck stiffness or lymph node swelling. I’ve been very anxious and under heavy stress, experiencing severe night sweats and almost got panic attack.

Testing:

I took the "VITROS HIV Combo Test" at 23, 28, and 33 days post exposure. All non reactive.

VITROS HIV Combo Test

Human Immunodeficiency Virus (HIV) 1 & 2

Serum, Chemiluminescent Immunoassay

The VITROS HIV Combo test uses 3 recombinant antigens derived from HIV-1 envelope (env 13), HIV-1 group O envelope (env 70-3)and HIV-2 envelope (env 31). The VITROS HIV Combo test also uses antibodies to HIV p24 antigen to enable detection of HIV p24 antigen.

Questions:

1. What is my HIV risk from this exposure?

2. Is the VITROS HIV Combo Test a 4th gen test? How accurate is it at 33 days?

3. Can my diarrhea medications affect the test result?

4. Have you seen or heart cases where a negative result at 33 days turns positive later?

 

First quick reply then more detail. Your HIV worries are over. You were at zero risk, but the risk level no longer matters. It is not possible to have HIV symptoms and test negative by any HIV test. None of your symptoms is possibly caused by HIV. There is no chance you have HIV.

More detail:  First, the chance a partner like your has HIV certainly is less than 1% and probably less than one chance in a thousand. Second, the exposures you describe have never once been known to result in HIV transmission. That includes fingering, with or without cuts or scrapes on the fingers. Second, diarrhea alone would never be the only symptom of HIV; and your other symptoms also don't fit. Third, again considering the diarrhea, HIV symptoms cannot start sooner than 7-8 days after exposure. Finally, as already stated, your negative test results prove that your symptoms are not due to HIV.

The only remaining shadow is a minor one:  although the HIV antigen-antibody (AgAb, 4th generation, combo) tests are nearly conclusive at the times you had them, on rare occasions they take up to 45 days to turn positive. Honestly, if I were in your situation, I would not retest -- but simply for final reassurance, you might want to have one more AgAb test 45+ days after the event.

Those comments pretty well answer your questions, but to be explicit:

3. There are no medications or health problems of any kind that have any effect on the reliability or timing of any HIV test.

So all is well -- no worries at all. It's entirely optional to consider another test at 45+ days. My advice about it does NOT mean I believe there is any chance at all it will be positive. I do not. This would strictly be for additional reassurance, if you need it, from the negative result.

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

HHH, MD

Thank you so much, doctor. I'm truly mentally exhausted and can't go for another test. My mind played some nasty tricks with me, leading me into a pit of anxiety. I appreciate your analysis that helped me contain it a bit. Thank you.