[Question #3264] HIV Risk

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90 months ago
exposure 70 days ago.Fingered her and immediately masturbated self after. She fingered my butt for a few minutes and she may have fingered herself immediately prior, that is my biggest fear. No penetration.Had some blood on toilet paper next day. Have 3 palpable less than 1cm post. cervical nodes. testing:5th gen 19 days neg. PCR/RNA 26 days neg. 4th gen 36 days neg. oraquick home swab 68 days neg. Please tell me my risk and if tests are conclusive, I am married man and in panic
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90 months ago
To clarify, when i said no penetration I meant no penile to vaginal or anal penetration. Her finger penetrated me. Also I felt the first posterior node at 30 days, obviously i dont know when it was first palpable, may have been earlier. Ultrasound showed it at 9mm, the other palpable ones much smaller. 2 on right side one on left. if it wasnt for these i probably would have accepted my test results. I am very scared that her nails may have cut me and then her fluid went from her fingers to my cut. After rna results, i was dumb and had sex with my wife and my wife a few weeks later complained of sharp pains in her lower abdomen...I'm a complete mess and terrible person but I more than learned my lesson and need to know my reality. 
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H. Hunter Handsfield, MD
90 months ago
 Welcome to the forum. Thanks for your question.

 This was a zero risk exposure for HIV, which is not transmitted by fingering, massage, etc. In addition, it is statistically unlikely your partner haD HIV.  Your symptoms also do not suggest HIV. 

 But the exposure and your symptoms really don’t matter anyway. Your test results prove 100% you were not infected.  HIV testing always over rules exposure history and symptoms. Even if you had a very high risk exposure or typical symptoms, the test results are conclusive. So no worries and no need for further testing

I hope this information  has been helpful. Let me know if anything isn’t clear. 

HHH, MD
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90 months ago
Dr.,

Thank you so much for responding. If you haven't noticed, I've asked this on other forums. you are not a psychologist, I recognize and respect that, but I am a MESS. We are sure that IF she had fluid on her fingers and immediately, within seconds, inserted them into me AND cut me, this couldn't be a risk? I have 2 daughters and a wife and I'm just terrified. It would help me, if you didn't mind, if you explained the science behind the tests a tiny bit. I get the general gist of them all, but i'm trying to rationalize it this way - if my symptom 'node', shwoed at 30 days, but RNA wasnt present at 26 days and antibody not present at 36 days, could symptoms even start? Also, wouldnt antigen be detecteable at 19 OR 36 days? Lastly, if hypothetically i was pos, with RNA at 26 undetectable, would intercourse with my wife at 15/16 days have been safe anyway? Very sorry, but research into post. cerv nodes is scary especially since i havent been sick all year. Thanks so much, i'm really in bad shape. 
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H. Hunter Handsfield, MD
90 months ago
You are asking the same questions as above in different words. Either you don't believe or don't understand my reply above, or what it means. Your test results PROVE you did not catch HIV. Therefore, questions about whether your partner had "fluid on her fingers", or anything else about the exposure, are irrelevant. You could tell me you had knowingly injected HIV infected blood into your veins and my reply would be the same:  the test results tell the truth. And cervical lymph node swellings, even if you have it, also cannot possibly be due to HIV in view of your tet results.

And your "hypothetically" question is meaningless. It is not possible to be HIV positive and have RNA undetectable at 26 days. In any case, because you definitely did not catch HIV, it is not possible that you have put your wife at risk.

Perhaps you would also like to know that in the 14 years I have been doing this and other online forums, with thousands of questions about HIV risk after various exposures, not one person has ever turned out to have caught HIV. Not one. You won't be the first. If and when that happens, it will not be from a trivial risk event like yours, but almost certainly someone with a substantial risk. And certainly not someone with blood test results like yours.

If you remain "really in bad shape" despite this reasoned, science based advice, I would suggest professional counseling. You clearly are reacting emotionally to a sexual decision you regret. Deal with that aspect as you need to, but try to separate those feelings from the issue of infection risk. They aren't the same.
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90 months ago
Thank you,in no way do I mean to sound like I don't respect your experience or expertise. I value the ability to get on a computer in New York City and talk to an expert. As you alluded to, there are more factors at play. If I was a single man with no responsibility I probably would be far more relaxed about this situation.

But, the situation remains what it is. I admit you may be right (I hope you are) that my guilt is clouding me. I have seen 3 separate Dr's, spent over $1500, one infectious disease specialist, and they confirm these 3 posterior lymph nodes are clearly palpable which is unusual, but none of them were concerned about them. It's just when I look up medical journals and Posterior cerv nodes, HIV comes up with rubella and Mono and other diseases I don't have. I just read the CDC saying that sex toys CAN transfer the virus, so I don't see the difference with it being on a toy and on a finger. I would value your opinion more than theirs but I forgot to make that point.

Lastly, the science. I know that the 4th gen changed from 4 to 6 weeks in regards to conclusiveness. What about my combo makes it conclusive? I'm thinking it's because if RNA was not present at 26 days that would mean antibodies fought it down, so they WOULD be present definitively at 36 days? I am relatively educated despite my state of mind right now and I think an expert like you cliffnoting the reason would be incredibly beneficial and be my best chance at finding peace. Prob goes without saying for 2 months I've lost 15 pounds and am a ZOMBIE. I know how lucky I am to get that explanation, and in advance since its my last post, THANK YOU. 
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H. Hunter Handsfield, MD
90 months ago
You need to work to accept your doctors' advice and expert opinions (4 of us!) and stop searching the internet about all this. Like other anxious persons, you are obviously being drawn to information that exacerbates your fears and missing the reassuring information that also is present. I will not answer these additional irrelevant questions about risk of transmission or symptoms, for the reasoons already stated in both my replies above.  

The combo test is conclusive because exactly as you state, it is the antibody that clears HIV antigen from the blood. Therefore, everyone with HIV more than a few weeks duration has a positive test because everyone has antigen or antibody in the blood (or both, for a few days). The combination of negative RNA plus the AgAb (combo) test is solidly conclusive. (The business about 4 weeks vs 6 weeks is when this is the only test done. The combination of tests you had, including RNA, make your results conclusive even though you're still a bit short of 6 weeks.

It's time for you to move on. Re-read my recommendation above about counseling, which I suggest from compassion, not criticism. Your thought processes on all this are frankly abnormal and it seems clear you're going to need professional help to accept and believe the rational, science based advice you have been given. Do not be tempted to start a new thread with these same questions. Repeated anxiety driven questions are not permitted and another from you on this same exposure and your HIV concerns would be deleted without reply and without refund of the posting fee. That said, I do hope that one of these days these this discussion will sink in and help you move on.
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