[Question #2658] Continue testing?
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95 months ago
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Doctors, Thank you for providing this Forum. 6 weeks ago, I had unprotected vaginal/oral sex with an exotic dancer. She indicated that she is tested often, even tested for “everything” one week following that night, and all negative. I tested for all STDs on day 11 & 19, and all results were negative. I had a 4th Gen HIV lab test at 11, 15, 19, & 37 days past exposure, all negative.
A few days after the encounter, I felt a burning sensation in Urethra, which I thought might be a UTI. Urinalysis results indicated that was not the case, and the feeling has subsided. I also had diarrhea exactly one week after the encounter, and a couple of times since (both right after trying to work out.). I have experienced other symptoms sporadically (sore throat - 2 days, nasal congestion - a few days, cough - 2 days, stomach rumbling, nausea 1 day, mild/moderate night sweats - 2x, chest tightness, loss of appetite, weight loss - a few lbs, trouble sleeping), but have not had a fever, chills, aches, pains, sores, lesions, rashes or severe headaches. The anxiety and stress levels have been through the roof since day 1, which could explain some/all of the symptoms.
Given the negative results so far, and that despite the ongoing chest tightness and stress I feel relatively healthy, is it time to put this behind me or keep testing? Greatly appreciate your insight!
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Edward W. Hook M.D.
95 months ago
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Welcome to our Forum and thanks for your questions. I'll be pleased to comment.
From a sceintifc perspective, if your partner did not have an STI, then she could not infect you. Thus, if she was telling the truth (and most people do tell the truth when asked), you are in the clear in terms of risk. In addition, your tests for common STIs reliable at both days 11 and 19 and there is no need for further testing. As far as HIV is concened, the current recommendation is now that test results for 4th generation, combination HIV antigen/antibody tests are not definitive until 6 weeks following exposure however this recommendation is new, expanding the prior recommendation that such test results were definitive at 4 weeks after exposure. the basis of this change in recommendations is that there are a very few instances in which tests have become positive between weeks 4 and 6 but the number of cases in which this has occurred are miniscule. Neither Dr. Handsfield nor I have ever seen such a case. Thus I suspect that your 37 day test is accurate and will not change but if you wish to follow "official" recommendations, you should have one more test at 42 days. Were I you, I would not bother.
Finally, the symptoms you describe ae not the typical symptoms of early HIV infection. They could reflect a coincidental problem but some of your symptoms (particularly stomach tightness, loss of appetite, etc. are consistent with anxiety. further anxiety can heighten mild symptoms which might be otherwise overlooked if you were not worried about your recent exposure.
I hope these comments are helpful. I see no need for further concern or testing. although you may choose to have one additional HIV test at 6 weeks (42 days). If you do, I am confident that it will be negative. Beyond that I would not worry. EWH
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95 months ago
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Thank you so much for your reply, Doctor. I am really trying to get past all of this, but the mind is such a powerful thing that all I do is worry every moment. It's been the worst six weeks of my life, and I just want to move on.
I originally thought I would need to wait a full three months to know for sure, which would have been almost unbearable. That said, I am glad I tested at Day 37, which as you mentioned would seem to represent a definitive result based on current guidelines. I am now at Day 43.
Logically, it would seem like almost a statistical impossibility when you factor in all of the variables: odds she was infected despite testing negative, odds of contracting virus in this situation even if she was infected, and odds that a Day 37 4th Gen would be negative but further tests would be positive.
I still experience the occasional nausea, stomach problems and chest tightness, but as you indicated these are more than likely the result of extreme anxiety. I am worried people will begin to notice the weight loss, especially if it continues.
I realize this may require a separate thread (or may not be an appropriate inquiry within the forum), but assuming we can rule out all other possibilities, did I simply pick up some kind of "weird bug?" I know it's not the right venue for that type of question, so I apologize. But would appreciate your thoughts if you can.
I hope I can follow your advice to not worry. Your help is greatly appreciated, Doctor! (I wish my PCP was as compassionate.). Thank you!
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Edward W. Hook M.D.
95 months ago
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You do not have to start a new thread to ask your follow-up question. We permit a total of three replies for each question.
Your query about the possibility of having acquired a "weird bug" shows that your anxiety is working overtime. You have, for all practical purposes, more than effectively ruled out STIs from your encounter. In asking about some "weird" bug, you might as well be asking if you could have been infected with an alien life form. In other words, while I cannot assure you that you did not acquire something no one else has had before, it is just not a reasonable concern. At his juncture, if you are having trouble moving forward, what you need t do is seek counseling, not more testing. I say this out of concern for you nothing more. I hope you understand this. It is time for you to address your guilt and anxiety and move forward and no amount of additional testing is gong to change that. EWH
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95 months ago
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Thank you, Doctor. I know you are 100% correct. The science and logic are definitive. If I had not gotten sick following the incident (which now would appear to be just really unfortunate timing to get a cold), I would not be experiencing this level of anxiety. The fear of being really sick (and the implications that would have on life) is overwhelming. (Even though I recognize that today's treatments are effective, and side effects minimized.). Along with that is the regret over being careless, as you referenced. And also - how could I be so unlucky? (as referenced earlier.)
I have begun to investigate counseling as you had suggested. Being a "worrier" anyway, I was clearly ill-equipped to handle this, and the underlying anxiety issues need to be addressed (since I will surely face stressful times throughout my life.). Living alone is another contributing factor to the fragile mental state (as with so many.)
I know this is my last opportunity within the thread, but I have really appreciated the opportunity to communicate with you. I believe this to be helpful in my situation, particularly when so many parts of the day are now potential anxiety triggers. Why did I get sick when I had been so healthy for so long? Did I compromise my immune system somehow to become more susceptible? Will I experience diarrhea, nausea or chest tightness today? Should I worry that the guidelines have changed from 28 days to 6 weeks? Do I need to worry about Hepatitis and it's antibodies window? (Even thought that would seem even less likely since no blood was involved.)
I know I'm all over the place with this, but any additional feedback you have will help. The lab is open today, but it remains doubtful that another negative would change anything (as you pointed out.). One thing is for sure, I will never again put myself in this position.
So grateful for your wisdom and patience with me, Doctor. Thank you.
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95 months ago
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Doctor, I first wanted to apologize for the rambling nature of the most recent post. I did want to provide an update that, as you had predicted, the 45-day 4th Gen Duo test is negative. This should put the matter to rest, despite my PCP's initial indication that a conclusive result could not be achieved for months. I have to attribute his position to a lack of understanding of current testing methods and associated window periods. I am still waiting on additional Hepatitis results, but as I mentioned earlier, this would seem to me to be an even less likely scenario under the circumstances. (He has a similar view of window periods for this as well.). I would love to be done with all of this testing, and move forward with my life, but I fear it may still linger for a few months. I wanted to thank you for keeping the post open and allowing me to provide an update, and also for not indulging my last post. As you have indicated in other threads, when the concerns are clearly anxiety-driven, it likely does more harm than good to address them. My deepest gratitude to you, and all involved with this forum.
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Edward W. Hook M.D.
95 months ago
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Glad to hear of your recent negative test- it is definitive and now should provide you with the information it needs to move forward without further concern. As far as your earlier question suggesting that you might have done something "wrong" or unhealthy leading to a flu-like illness that lasted longer than you were accustomed to, this is most unlikely. some viruses cause symptoms longer than others and I suspect your worry about HIV heightened your awareness of your symptoms.
I hope my comments have been helpful. It is now time for you to stop beating yourself up and move forward. I hope you will. ''As you know, as this is my 3rd reply, this will conclude this thread and the thread will be closed later today. Take care. EWH
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