[Question #12049] Possible HIV exposure

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10 months ago
Hi! So i had a recent sexual encounter with a guy about three and a half weeks. We used condoms for penetrative sex and not for oral sex. He assured me he was on prep and showed me his results from a month and a half ago. Next week from the encounter, I developed a sore throat ( no pain or difficulty swallowing, just a hot, scratchy feeling), nasal congestion and swollen lymph nodes on my groin and some areas of my neck (two under my chin and one right side if my neck).
At 9 days from the exposure i got tested for strep and did a full std panel with early HIV RNA detection. It came back negative. Symptoms persisted though so I did a second HIV RNA test at 20 days post-exposure, it came out negative too. That has calmed my anxiety and panic attacks although today, i went to have a visit with my general doctor; I explained the situation and she told me she doesn’t think I have HIV but that the risk is always possible. Specially since my lymph nodes are generally inflamed. She scared me a little. She did some tests for COVID and Mono and im waiting for the results. I wanted to ask how confident i can be with my results, specifically the HIV RNA tests. I’ve seen those only become conclusive after 33 days. I plan on doing a DUO test at 30 and later 45 days too. 
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Edward W. Hook M.D.
10 months ago
Welcome to our Forum. Thanks for your questions.  I'll be glad to comment.  You ask how confident in your test results.  The answer is that while your 9 day HIV RNA PRC tests are good news although not conclusive. On the other hand your 20 day PCR results are conclusive and should be believed. These result both prove that your symptoms were not due to HIV and that you did not acquire HIV form the exposure you describe.  It is time to look for other causes on your symptoms.  

I do not see a need for further testing how ever, if you choose to test more, I am confident that your 30 and 45 day tests will be negative. 

Please don't worry.  EWH
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10 months ago
Thanks! 

I really appreciate the prompt response. I found myself falling into a dark place mentally and this really helped me out. Im really in the hopes its not any underlying serious condition. I’ve read syphilis presents lymph nodes too but after this encounter I took post exposure doxycycline so that has me calmer. I notice symptoms aggravate when im feeling stressed or anxious so it probably has be related to that or some recent infection. The reason I dont suspect mononucleosis is because my partner hasn’t showed any symptoms. 
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Edward W. Hook M.D.
10 months ago
You need to work with your doctor to sort out what this is. Mononucleosis or a related disease as far, far more common and more likely than Syphilis, which is a relatively rare disease. In addition, the doxycycline you took is highly effective for preventing syphilis. Further, if you had syphilis, you would have had a sore at the Site of contact. 

Rather than trying to guess what it might be or worrying needlessly about STI my is to work with your doctor to address the cause of this. EWH.


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