Hi,
I hope you are doing well.

I am married and I do not have sexual contact with anyone other than my wife.

I work as a lab courier. I transport medical specimens from doctors’ offices to the lab. The specimens are sealed inside biohazard zip bags. Sometimes I wear gloves, sometimes I do not.

About a week ago, I developed flu-like symptoms: fever, cough with phlegm, muscle aches, headache, and sore throat. Most symptoms have resolved, but yesterday I noticed a swollen lymph node on the right side of my neck. It is tender to touch, and my wife can feel it too.

I took an INSTI HIV antibody test on Friday, and it was negative. I plan to test again next Friday.

I understand that my risk for HIV or any STI is essentially zero, but I still feel anxious and worry about a small chance. Given my job and symptoms, should I be concerned?

The flu felt more intense than anything I’ve had before, especially the cough, which was severe for about three days. Could the coughing or recent illness be causing the swollen lymph node?

Should I retest for HIV again?

Thank you.

First, there is zero risk for HIV from handling such medical specimens; nobody in the world has been infected in this manner -- regardless of cuts or wound on the hands.

Second, your symptoms do not fit with a new HIV infection as much as you think. When acute HIV symptoms are described as "flu like", that only means fever, muscle aches, and headache. And although HIV can cause generalized (body wide) lymph node inflammation and enlargement, it never causes only a single enlarged node. Further, acute HIV infection doesn't cause cough.

Third, it is impossible to have HIV symptoms and test negative with an HIV antibody test. The symptoms of acute HIV infection are not caused by the virus, but by the body's immune response -- which includes antibody. Negative antibody testing shows that any symptoms at the time are not due to HIV.

You caught a garden variety cold -- or, in view of their severity, maybe influenza or covid -- but for sure not HIV. There is no need to test for HIV again, at least not on medical grounds. Of course you are free to test again if you wish -- strictly for reassurance, not because of any possibility you have it. (On the other hand, have you tested for influenza or covid? Those tests would make a lot more sense.)

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

HHH, MD