[Question #3304] Scared to death

36 months ago
Dear doctors.On 26/9/1/17 under of alcohol and had vaginal intercourse with black strep girl, it was protected with condom, the condom didn't break maybe wasn't put perfectly ,didn't manage to cum removed it & masturbated 4 some minutes, she spit twice on my dick, that's all, since then had major symptoms including tingling numbness in 4 limbs burning sensation with painful urination 4 some days,  sores in mouth on off, changes in nails, joints pain still ongoing, no fever,  most importantly I lost weight especially in my face- around eyes&mouth, first combo test in tel Aviv famous hospital& hiv center negative after 8 weeks, second combo in Haifa at almost 16 weeks negative, can i be a case report of late seroconversion?? Im scared to death, gonorrhea syphilis chlamydia pcr negative. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome to the forum. Thanks for your confidence in our services.

You describe a sexual event with no significant risk of any STD. Intercourse was condom protected, and hand-genital contact is no risk, even if saliva (or even vaginal fluid) is used for lubrications. Your symptoms are not typical for any STD and especially not for HIV. Most important, all standard HIV tests -- including those done in Israel (and really anywhere in the world) -- are absoltely conclusive after 6 weeks and certainly after 16 weeks. With the standard tests, there is no longer any such thing as "late seroconversion":  it simply does not happen.

The main problem here obviously is your emotional reactions to a sexual decision you regret. Don't confuse those feelings with infection risk -- they aren't the same. Deal with the former as you need to, perhaps with professional counseling. But you truly can disregard the latter and move on without worry about HIV or any other STD from the event.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

---
36 months ago
Thank you dear Dr. It seems so far that nothing could reassure me, I admit that there's a psychological or perhaps psychiatric element cause of the huge persistent stress.. But I must tell you that I always had a big round face and since the event I lost considerable amount of facial volume, facial wasting indeed and this was confirmed by a dermatologist!, I read in thebody. Com about hiv causing apoptosis of facial fat cells.. What's your opinion in that regard? , I'm only 4&half months from the event, I'm really confused, shouldnt I do an hiv viral load test??  What are the chances for the duo test to miss twice??!! Have you ever heard or seen a duo turning positive after such a long period? I don't feellike becoming an international case report you know.. Thanks in advance  dear Dr... 
Ps. I don't belong to any of the groups that might  seroconvert later.. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
HIV doesn't cause lipodystrophy (altered body fat) except in very advanced infection, i.e. overt AIDS, typically in people who have had HIV for many years; and even then, would never be the main or only symptom. And as I said, test results overrule any and all symptoms. You'll need to continue to work with your doctor about the cause of this and other symptoms, but it isn't HIV.

There is no such thing as "groups that might seroconvert later". The notion of delayed seroconversion refers to development of anti-HIV antibody, and when all HIV trests were antibody tests, in rare cases people with things like advanced cancer, chemotherapy, etc might have delayed antibody production and thus delayed positive results. Even this was very rare. But the modern tests detect the virus itself (more particularly, p24 antigen). With current tests, persons who might have delayed antibody devleopement might actually have accelerated antigen detection, i.e. even earlier positive test results.

I urge you to stop searching the internet about all this. Like many or most anxious persons, you are being drawn information that inflames your fears and missing the reassuring information that also is present. Trust me on this:  it is simply impossible you have HIV. There is no point in searching further about it.

---
36 months ago
Dear Dr. I'm aware of everything you wrote and I much appreciate your experience and opinion, this progressive lipoatrophy what I'm experiencing is simply driving me crazy, I want so much to move on with my life but I'm "losing my face" which is my social ID dunno how to explain in English, it is not a sole symptom I have left ankle pain and left wrist pain plus transverse strange white lines just before my nails tips (all of them) that simply wasn't there before accompanied by painful nails , maybe I sound dramatic&pretty regretful I don't deny this by any means, my relationship with my wife, my social life & my career are already destroyed & a total mess cause this "thing" had took a huge tall of me so far , I'm desperate, again I'm talking about huge halls around&under eyes, temporal wasting, prominent change in my face contour much smaller cheeks and empty  "wholes" in my forehead and in my skull just behind my ears, It is just weird, IT WASN'T THERE BEFORE, IT'S ADVANCING EVERY WEEK and I can't find any explanation for it  apart from potential relationship with that one time unfortunate exposure, thanks for your help and great explanation dear DR HHH and forgive my poor English please  :( 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Sorry, I can't help further. You're describing some symptoms that are disturbing, which I understand. But this is an STD/HIV forum, and these symptoms are not due to HIV. You came here for reassurance about HIV. I have tried my best to give it to you, but all you do is argue, based on an emotional reaction and a sexual exposure you regret. It seems you're trying to win a debate by convicing me you have HIV. Sorry, I don't agree. You don't have it. Suck it up and move on.---