[Question #2830] Follow up: HIV Anxiety

42 months ago

Dear Doctor,

I wanted to update you. Since my state of not well being was still going on (especially around the genital area, but also persistent dizziness, sore throat, cold sweats, eyes burning, anxiety), I went back to my hometown and scheduled a visit with a very respected Dermatologist expert in STD. He told me once more that no sign of herpes at all was present, but that my redness and burning sensation on the penis were provoked by a seborrheic dermatitis, not at all linked with an STD and not to worry about that intercourse. I also visited an ophthalmologist since my eyes were burning (and I was afraid to have auto-inoculated herpes): he also said no herpes at all, but probably more linked either to my dust mite allergy, either to the dermatitis.

On the moment I was relieved but all of a sudden I started seeing things in a different perspective: what if all my symptoms were linked to HIV?

I had unprotected oral and protected vaginal intercourse with an expensive CSW from Vietnam met in a bar: I understand oral is not at risk for HIV, but what if the condom slightly slipped during the vaginal intercourse leaving my penis partially uncovered and I did not notice it? I remember when I withdrew my penis I lost my erection and had to be careful the condom not to slip and remain in the vagina. The CSW seemed to be obsessed with hygiene and safe sex (shower, mouth wash, condom check, etc.), but what if the dermatitis put me at greater risk of infection?

Here is the history of my symptoms:

2 days after: headache, fatigue, general not well being.

4 days after: penis redness, sore throat.

6 days after: dizziness, cold sweats, white tongue.

Now we are at almost 6 weeks since the intercourse, I never had fever (the highest temperature I had was 36.5 C (97.7 F) axillary on the 7th day, when I was constantly checking my temperature), my genital symptoms are gone, but dizziness, sore throats and cold sweats are still there (some day more, some day less). I am very very anxious. My psychiatrist told me to start again my Zoloft cure.

What is your point of view Doctor? Should I really worry about HIV? What can my symptoms be related to? Maybe another STD? I still cannot believe I put myself in this situation and I feel guilty.

A big thank you for your great help and patience.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
I'm sorry to that your anxiety is continuing, almost certainly an emotional reaction to a sexual decision you regret.

HIV never explains symptoms like these.  Also you were not at risk for HIV:  condoms work, so the vaginal sex carried no risk; and it is rarely if ever transmitted by oral sex (there has never been a proved case of HIV transmitted mouth to penis). So even if your partner had HIV, which she probably did not, you were not at risk.

Since you're worried about HIV, have a blood test, preferably an antigen-antibody ("4th generation") test, which is conclusive any time 6 weeks or more after the last exposure. You definitely can expect a negative result. (Do not have an oral fluids test, which is not conclusvie until 3+ months.)

No other STD causes symptoms like these either. They are not due to any infection from the sexual exposure you are so worried about. Your symptoms are most typical of the physical manifestations of anxiety, stress, or depression.

Please note the forum does not permit repeated questions on the same topic or exposure. This being your third, it will have to be your last one; future new questions about this exposure, testing, and your fears about HIV or other STDs will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

Best wishes and stay safe--  HHH, MD
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42 months ago

Dear Doctor Handsfield,

I am truly grateful for your answer and please forgive my state of anxiety.
My rational side knows you are right: I should stop panicking and move on. But my irrational side keeps worrying about two elements:

1) the persistent sore throat (more than 5 weeks now): my doctor had a look at it today, saying it is probably some viral infection or allergy (no significant swollen lymph nodes).

2) the fact that during the protected vaginal intercourse I lost the erection and the condom slipped up a bit leaving part of the penis shaft uncovered (it was still covering my glans when I pulled out).

My psychiatrist agreed with me to start again Zoloft treatment. I will get an HIV test as soon as I feel strong enough to psychologically face a potential bad news. I won't post new questions about this episode and the next time you’ll hear from me will be for the test results. In the meantime, please I would really appreciate if you could comment my last two worries above.

A big thank you for your help.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
I agree with your doctors and your own "rational side". Even without erection loss, the penis often slides within the condom during sex, or pulls out leaving the condom behind in the vagina. When these things happen, protection is still considered complete. HIV touching intact penile skin is not a risk for HIV infection.

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41 months ago
Dear Doctor,
I just experienced a severe panic attack. I went to see my Doctor and got tested for HIV and Syphilis. Results in 5 days (I'm in Shanghai. Impossible to have them faster). He told me not to worry.
I will keep you posted and hope I can destress a bit in the meantime.
Thank you for all your support.
Best regards.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago
No comment. Feel free to post these test results when available, but I won't have anything more to say until then -- at which time this thread will be closed.

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41 months ago
Dear Doctor Handsfield,
I received the test result (HIV Combo Test at 7 weeks): negative. From what I read in the forum, it should be conclusive.
I sincerely thank you for your great help and expert support; I also apologize if anxiety took over my rational side more than once.
Best regards,
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago
Yes, that result for sure is conclusive. Thanks for your thanks about our services -- and I'm glad you're setting down emotionally.

Best wishes and stay safe.
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