[Question #2206] Trust my results?

47 months ago
Hello, I have had a rather risky past but have since vowed to change my habits. I used to have sex with CSW's but have ALWAYS used condoms. Having said that, here's what happened. 1.5 years ago, I had sex with two CSWs in Tretes Indonesia (1 hour away from Surabaya).  The condom broke with one of the girls during vaginal insertion. The other girl was on her period, but the condom didn't break. I forgot to pinch the tip of the condom with her, but it didn't break. I suspect that it only broke with the the other CSW because she was dry, as I never had condom ruptures in the past (the condoms were pre lubricated but I guess that isn't enough).   1 year after exposure, I began having symptoms of high anxiety, muscle tension and aches, post nasal drip, and some dermatitis on hands and sole soles of feet. Do symptoms normally show up 1 year after exposure and last for months upon months?  I have done 3 HIV tests. The first was a NEG oraquick oral
Hiv1/2 test done at home (1 year after exposure). The second and third tests were 4th generation HIV 1/2 ag/AB tests done 1.5 years after exposure by quest diagnostics. Both came back non reactive. Am I safe?  I'm terrified that I maybe picked up a rare undetectable strain in Indonesia, but I did some research and it seems that even in Indonesia they use the same tests, which seem to work there. I'm a huge hypochondriac but want to make sure I don't need more tests
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
Greetings. Welcome to the forum. Thanks for your question.

I think you recognize the main problem here, with "I'm a huge hypochondriac". You truly should not be worried. The HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition. If testing is done sufficiently long after the last possible exposure -- which is 4-6 weeks for the 4th generation (Ag/Ab) tests and never longer than 3 months for all other tests -- the results are 100% reliable and always overrule exposure history and symptoms.

"Rare undetectable" HIV strains are an urban myth. That simply does not happen with the 4th generation blood tests, in Indonesia or anywhere else.

So all is well. For sure you do not have HIV. Unless and until you have additional possibly risky exposures, you should not be tested again.

I hope this information is helpful. Let me know if anything isn't clear. Best wishes and stay safe--

HHH, MD

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47 months ago
Thank you so much for the reply. As for my most recent exposures, my last sexual encounter was with a woman of unknown status in Peru last July. I did not mention this, however, as the condom was properly used and did not rupture to my knowledge (she was on her period but the condom seemed intact). Regardless, my two 4th generation HIV tests occurred six months after this incident anyway, so the exposure was accounted for. Also, I got tested for syphillis, HSV 1 and 2, HEP A,B, and C, chlamydia,  and gonorrhea and all came back NEGATIVE (again, six months after last sexual encounter, but 1+ year after Indonesia incident). I will seek professional help regarding my hypochondria, as a doctor I spoke with suggested that most of my symptoms could be psychological, as my standard bloodwork was normal (blood count, liver and kidney function, etc. Indeed, my current symptoms are occasional loose stools (maybe once a week) and muscle tension, which she said could be stress related. These symptoms seemed to have popped up after a bad bout of food poisoning in Peru, and have made me obsessed with my health ever since.  Just one more question

1.) I tested negative for HIV 6 months (4th gen) after my peru sexual encounter. Are my GI issues (continuing for almost a year) that occurred 2 days after the sex (thus probably due to food poisoning since I ate raw fish) and have continued ever since related to HIV?  I've been told that it's probably post infectious irritable bowel syndrome
2.) Can I stop worrying about HIV?

 Thank you so much for the help and I have made a promise to never again sleep with CSWs. Too much stress!
47 months ago
Just to clarify, the 4th gen tests  were done at least 6 months after Peru sex and over a year after Indonesia sex
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
This additional information does not change my opinion and advice. You indeed can stop worrying.

I agree with your docto, that most of your symptoms are consistent with physical manifestations of anxiety, or anxiety magnifying trivial symptom or normal body sensations that you otherwise would ignore or not notice. GI symptoms are rarely if ever the main symptoms of a new HIV infection, and HIV symptoms cannot start sooner than about a week after exposure.

I would caution you about making hard-to-follow personal pledges. The large majority of people who make such vows fall off the wagon. At least keep condoms handy so they are available in event of a future unsafe sexual choice.

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47 months ago
Thank you so much doctor. And yes, I will always keep condoms handy.   You truly do a wonderful service to the community, and I will go on with seeking psychiatric assistance for my anxiety. You can close this thread and have a wonderful day!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
Thanks for the thanks. Best wishes.

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