[Question #1247] Possible HIV Symtoms

49 months ago
Hello, so I asked a question a couple of days ago and I know you guys say to wait 6 months or so to ask another question but my anxiety has build up, I also forgot to ask a couple of questions. So around 25 Days ago I performed  unprotected Cunnilingus/fingering on a girl with unknown STD status, no other sexual activity was done. I had an HIV test back in April just as a general STD screening and it was negative.no other sexual activity was done after the negative HIV test until this insident.  after 2-3 days I started to develop flu like symptoms night sweats, chills, mild fever and a sore throat, also my right tonsil was swollen.  After a couple of weeks I started to feel better however I have been feeling really tired, I feel like my lymph nodes are bothering me in back of my ears and under my armpits, no fever,  still have a sore throat with one swollen tonsil. Headaches and loss of appetite. I also had and STD screening after the exposure which was 6 days after for urine/blood test for Syphilis/Gonorhea/ Chylamadia. HSV 1-2 test about two weeks after that and I know that early/ not accurate but it was a IgG test and came back negative for everything above. Initially I though I contracted herpes but no sore or lesion in the 25 day period. I am worried it is HIV? Or any other STD. Would a HIV test be accurate after 25 days and would you recommend taking one. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Welcome back. But I'm sorry to see your fears continue after such a low risk event and despite the reassurance you had from Terri last week.

Cunnilingus is safe sex, with very low risk for all STDs and zero risk for some, including HIV. There has never been a reported case proved to have been transmitted by cunnilingus, in either direction. Also, your symptoms are not typical for HIV and, most important, started too soon. HIV cannot cause symptoms sooner than 7-8 days and usually it's 10-20 days. These symptoms almost certainly are due to a garden variety cold virus. The timing fits with catching a cold from your partner, but it could have been from anyone else you were around in the few days before onset.

As for herpes, for the reasons discussed by Terri. Even if your partner had genital HSV2, the chance you would have caught it were probably under 1 chance in 10,000 or lower; and your symptoms are not typical for a new HSV infection either.

Your urine gonorrhea test results are meaningless. You cannot catch them by oral exposure and have them show up in the urine. But both gonorrhea and chlamydia are very unlikely after cunnilingus (probably zero risk for chlamydia, very low risk for gonorrhea), and they also would not cause your symptoms. In any case, the only way to detect these STDs orally is to have a throat swab test. However, the risk is too low to really warrant such testing and I don't recommend it. I also recommend against any further testing for HSV.

From a strictly medical standpoint, there is no need for HIV testing. However, since it's on your mind, I'm sure you'll continue to worry until and unless you have been tested. But not quite yet. Wait only another 3 days then have a 4th generation ("duo", "combo", antigen-antibody) test at 4 weeks, which will be 100% conclusive. Assuming this is your only possible exposure, it will be negative.

Finally, if your symptoms persist and you want additional reassurance, see a doctor. But I don't find them at all alarming in this situation.

I hope this has helped. Let me know if anything isn't clear. Best wishes--  HHH, MD

---
49 months ago
Thank You for your reply, to hear this from such a highly awarded and decorated Dr. whose been doing this for 40+ years gives me hope, I will take the test and keep you updated on my situation.  Thanks and best regards. 
49 months ago
Hey Dr. H 
So the only tests that are offered from my Dr. At Kaiser are the ELISA test, they don't offer the 4th Generation test you were telling me to take. Will the ELISA test be conclusive at 28 days? 
Thanks and best regards.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
ELISA is a technology, not a test name, and is used by most HIV blood tests. It may still be a 4th generation test. The issue is whether it is a standalone HIV antibody test (i.e. 3rd generation) or antigen-antibody (4th generation). It could be your doctor doesn't understand these differences; if not, ask the Kaiser lab. Even if they more routinely do the 3rd generation test, I would think they do 4th gen tests on request. If not, you could probably find it at your local health department.

If you have an antibody-only test, the result will be conclusive at 6+ weeks (42 days) instead of 4 weeks.

In any case, it really doesn't matter much. You don't need HIV testing after such an exposure, and if positive, it would be from some exposure other than this one. So the other option is to just forget the whole thing and move on with your life!


---
49 months ago
Thank you for your reply Dr.

I haven't been sexual active for 2+ years and only had sexual intercourse 1 time(protected) and that was in 2014. I got a HIV test done in 2016 and it came back negative. From then on this is the only other sexual activity I have done. So if you were in my shoes, would you be worried of HIV or any other STDs. I'm just scared of a positive result from this exposure.what are the chances of catching it from this exposure? 
Thanks and best regards 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
For sure I would not be tested for HIV or any other STD if somehow I were "in your shoes" with your sexual history. Your "what are the chances" question is the same you have already asked, just different words, and I see no reason to repeat myself. Re-read my reply above and your previous threads.

You're obviously obsessed with a sexual decision you regret. Deal with that as you need to, but don't confuse it with HIV/STD risk from the event. They aren't the same. Do your best to accept the reasoned, science based reassurance you have had and go on with your life.

Repetative anxiety driven questions are not permitted on the forum. This is definitely your last one about this exposure, tests, etc. If you try again, the question will be deleted without reply and without refund of the posting fee. This policy protects people from themselves (to not spend good money when the answers won't change) and because such questions carry little educational value for other readers, which is one of the main purposes of the forum.

---