[Question #14043] HIV ARS and STI

1 months ago

Hi Drs, five weeks ago I have protected oral and sex at a Chines massage parlour in Australia. A week after I developed a line under one side of my glans penis, resolve with topical cream (temporarily). Condom didn't break as far as I know, 1 week later, developed mild sore throat and slight post nasal drip (intermittent) and small unusual matches (5mm and half dozen pimple 1-2mm in my mouth, Mild body aches at week 2. Up till now Week 5 no fever. Max temp 37.2C. Milk headaches except week 2 stiff. neck pain at base of skull and burning sensation at night only, couldn't sleep many nights.. Facial skin around nose/mouth is slightly inflamed. Very dry eyes and mouth and small white patch on gum above one or two teeth. Most worrying my vision change one day in week 3. Screen text blurry and colours seemed odd but normal non screen viewing and colours Tested negative for Chlamydia, Gonorrhea and syphilis at end week 4. The doctor at the sexual health clinic said my penis didn't have a chancre rather a gland but it still looked red (cream has helped). Will test for HIV at 6 weeks. I know symptoms prove nothing and I need to test (waiting fr 6 weeks). Am concerned I have HIV due to all my symptoms. and vision issue. It doesn't seem to fit standard ARS patterns ie very high fever and sore throat.

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum. Thank you for your confidence in our services.

You really needn't be worried about HIV. First, the exposure as described was no risk for HIV -- at least there has never been a reported case acquired from an exposure like this. Second, it is true that your "symptoms prove nothing": more to the point, neither the symptoms themselves nor their timing fit with a new HIV infection. (Some of them sound psychological in origin -- like anxiety magnifying minor symptoms or even normal body sensations that otherwise would not be bothersome and maybe not even felt.) Finally, it sounds like your sexual health doctor reassured you and I agree you describe nothing that suggests a chancre or other symptoms of syphilis. In any case, I'm glad to hear your negative test results as well.

Did the sexual health doctor not advise HIV testing at this time? The standard tests detect 98-99% of new HIV infections at 4 weeks; had you been my patient I would have tested you; and then a second time at 6 weeks to confirm the negative result. In any case, at this point you should go ahead with an HIV blood test, ideally an antigen-antibody test (AgAb or "fourth generation" test at 6 weeks. You definitely can expect a negative result: do your best not to worry as you wait!

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

HHH, MD

---

1 months ago

Dear Dr Handsfield, thank you for your prompt and comprehensive reply. Apologies for the typos but had issues submitting my question. Lauren has been amazing and very patient in fixing my question submission issue.

You are correct re mental health. I am currently on medication/care for C-PTSD, which doesn't help. A few follow up comments/questions if I may:

1. Testing was offered but I declined as I wanted to wait till I reached 6 weeks as I had read accuracy would be higher. I couldn't face two tastes and the wait in between,

2. Prior to the last incident I had vigorous massage/massage which I stopped as it caused pain at my penis head. It became inflamed after that but seems better after applying topical cream for a few weeks. But seemed to reappear when I stopped applying cream. The sexual health doctor said my groin lymph nodes were normal and I couldn't feel any in my armpits.,

3. My concern is the condom may have broken and I wasn't aware, and given the mild sore spot caused me greater risk. I asked the massage worker and she said she was negative but I am dubious. My motto has always been - no condom no sex,

4. The small patches in mouth (not matches) seemed to be transient but my throat still looks inflamed and has a mild moving ache.

5. My headaches were bad at night for one week only (stress related I guess) and I took my temperature dozens of times; sometimes mid 35C but rarely above 36.2 at night. Daytime highest average was 36.7,

Anyway, I will test soon. My sudden vision change has been my biggest concern.

Thanks for your time, patience and expertise..

H. Hunter Handsfield, MD

1 months ago

Your anxieties are leading you to overthink everything. None of these factors changes my judgment that you were not at risk; do not have HIV; and that most of your symptoms are the result of anxiety and worry. You describe no symptoms fits well with HIV.

In the 22 years of this and our preceding forum at medhelp.org, with thousands of questions from people worried about HIV after a potential exposure, none eventually tested positive. You will not be the first. If and when it finally happens, surely it will be from a genuinely high risk exposure (think unprotected anal between two men or with a known infected partner) and not a near zero risk exposure of the sort you had. You'll be fine.

---
---
---

1 months ago

Thanks Dr Hansdfield,

I appreciate your time, expertise and assessments.

I will test and move on.

Many thanks

H. Hunter Handsfield, MD

1 months ago

Thanks for the thanks. I'm glad to have helped.

That completes the two follow-up comments and replies included with each question and so ends this thread. Best wishes and stay safe.

---