[Question #1669] Dr. HHH: I need help. I am going insane about HIV

80 months ago
Facts : June-Aug 17, 2014(possible last exposure..could be before), my  girlfriend cheated on me with a guy she worked with. They had sex at least 10 times. A couple of times without a condom. Guy is white 20-25, high school educated, has sex with women although had admitted that he has once had sex with a guy in the past. Going through his facebook, he looks like an average educated guy with good friends and family around.
I then went on to be in a year and a half relationship with her. She is now my ex.

To jog my memory back to 2014, After I found out about this, I did not let her back in until she got tested. She got STD screening in between  3 to 4 weeks  (24 days) (from the last possible day they could've had sex) at my university's student health testing center. Everything came out negative.  We went about with our lives.After 34-40 days she had ARS like symptoms (fever, cough, sore throat, stuffy nose) but I never realized these could be related.
2.5 years from then, I am now worried I may have HIV.  
 I hadn't thought about this  and it randomly came to me last week and I am worried out of my life. All I think about is this.  I have been trying to message this guy and looking at his profile on facebook all day because I am so scared while neither of them look any bit concerned. I have been reading how HIV tests are not accurate at 3 to 4 weeks. And how ARS can happen after 5 weeks!
I am really really scared and PTSD, OCD symptoms. All these blogs online are scaring me. It is crippling to the point that I had to leave work today because I couldnt think about anything else. The thought of this has taken over my life and I a getting more and more worried trying to jog my memory ba
We dont talk but she seemed almost unphased at the idea of getting the disease when I mentioned it while arguing with her about her infidelity in 2014.
In 2011 I had a similar OCD, anxiety, depression about HIV when I was freshman in college and my condom broke. It is back again.
Please help.

H. Hunter Handsfield, MD
80 months ago
Welcome to the forum. Thanks for your question. FYI (and for others who may be thinking of posting questions), it is only by chance I am replying and not Dr. Hook. We take questions randomly without regard to requests for one or the other. Our styles are different but our knowledge and advice never are.

I'll just say quickly that it is very unlikely your ex partner had HIV, both on the basis of sexual history and symptoms. Cough and stuffy nose are not ARS symptoms. She had a cold. Further, you have found misinformation on the web about HIV testing. If she had a 4th generation (antigen-antibody) HIV test, it was conclusive at 4 weeks and almost so at 3 weeks. If an antibody-only test, it was still 90% reliable. There is almost no chance she had HIV and even less chance that you do.

But the main question is this:  What are you expecting from this forum? The way to know whether or not you have HIV is not from expert opinion, but being tested. I can only give probabilities, but a blood test will tell for sure. Do it and then return and let me know the result, which I am sure will be negative. There isn't much point in further discussion until then:  no matter what additional information you can provide, almost certainly it will not change my opinion or advice.

And for goodness' sake, stop reading "all these blogs" or doing other online research. You're obviously being drawn to information that inflames your fears and missing the reassuring information that also is available.

I look forward to hearing from you when you have been tested. Stay mellow in the meantime. It will be negative. 

Best wishes--  HHH, MD

80 months ago
Thanks for your time DR. HHH. My mother is an infectious disease doctor herself. I'm just so traumatized that i see statistics of number of infections per year in the USA, and number of people not knowing.   I did not even think about it for 2 years as I assumed the test she did would be conclusive.   I read something you wrote that ARS symptoms occur almost always within 10 to 20 days. Her symptoms were around 40 days .. 
Almost randomly-- last week as I started tracing back my memory lane, I am randomly starting to ask a lot of "what if's" and thinking of the worst case.  Some research on statistics  and I find myself  mentally depressed.  A year later---I have a genital wart and I am constantly checking for more symptoms all around my body and any change.  There are so many friends in college who never think about such a possibility. They have much more casual sex (on birth control)- but I have panic attacks over it.    
When my ex was on birth control and she didn't get her period exactly on the day, I would start hyperventilating with situations in my head.  I know you've said to go test-- but based on the information I provided, am I overreacting ? ?  I don't recall myself getting any extreme fevers or sore throats or rashes through my 1.5 years with her. 
I don't want to annoy you but 
I am so so worried that I'm having the fear of testing.
Please advise
H. Hunter Handsfield, MD
80 months ago
Are you "overreacting"? Yes indeed. But that doesn't mean you shouldn't be tested. Almost certainly my reassuring words won't be enough:  probably you're going to continue to worry about this until you know for sure you aren't infected. Anyway, CDC recommends that everybody age 13-64 be tested for HIV at least once, regardless of known risks. This is obviously a good time, when it's on your mind. As for fear of testing, I have no patience for such irrational nonsense -- and I'm sure you understand that's what it is. It isn't the test that gives someone HIV. You have it or you don't, and if you do, of course you have a responsibility -- to yourself, your potential sex partners, and your family -- to know. And research shows that when someone delays HIV testing (or any other medical screening procedures, e.g. women contemplating mammograms), anxiety and stress always decline after testing, even if the test is positive for whatever dreaded disease is at hand. The stress of worrying about it always is worse than having the answer, even if it's the answer you fear. Suck it up and just do it.

Presumably your genital wart has been professionally diagnosed, right? And you're on treatment for it? If not, do that as well.

Further, all this, including the non-monogamous nature of your past relationship, before it ended, means you should also have a urine test for gonorrhea and chlamydia and a blood test for syphilis.

None of this means I believe you have any chance of having HIV, and the likelihood of these other STDs also is low. But when testing for one, usually it should include all -- and of course better safe than sorry. Presumably you haven't been discussing all this frankly with your mom, but you might consider it. Unless she is incredibly naive for an ID specialist, she knows or assumes you have been sexually active, and she also knows your personality better than anybody. In the event you decide to discuss all this with her, I'm confident she would agree with all I have said. (You could even print out this thread as a framework for discussion.)

Each question comes with two follow-up comments and replies. I suggest we hold off on your last one until you've been tested for HIV, if you do it; and other STDs, if you get tested for all. I look forward to hearing from you again at that time, and/or if you speak with your mom -- but I won't have any further comments or advice until then. In the meantime, I hope this discussion has been helpful.

80 months ago
Thanks a ton, doc. Got rapid tested and within 5 mins they said I was negative. I appreciate your advise. 
H. Hunter Handsfield, MD
80 months ago
I'm very glad to hear you were tested. I'm glad to have helped. Best wishes and stay safe.