[Question #3672] Oraquick and Persistent Symptoms

36 months ago
Hello again. In the last question I asked, I said that my Oraquick in home result was negative. I am not sure if you are familiar with the Oraquick in home HIV test but you basically swab the upper and lower gums once (takes about 4 seconds to swab) and wait for results after 20 min. For a positive result, there needs to be 2 lines present at C and T. When I took the test, I didn't see a line at T so I assumed it was negative. I took a picture of the results. The next day, I looked at the pictures again and zoomed in on my results and saw a microscopic grey line on T.  The line doesn't look like the examples that the test presented (not sure if the line has to be colored red?). I freaked out and took the same test again twice and both times they came up negative and couldn't see any line on T, even after taking a picture and zooming in on the results. As mentioned last time, my exposure was protected sex w/ a CSW in January.  About 2 weeks ago I got a mild fever that lasted for about two days followed by sore throat and swollen lymph nodes. I also have this rash on my palms that have bee goin on for about 3 months. The dermatologist said that there was like bleeding underneath the skin but didn't worry about it. I think she said it was petechiae. So my questions: 
1.) Should I have to strain to see a positive result in Oraquick, or would it be clear that it would be positive?  What could the minuscule unclear line on T mean? 
2.) Should I test again?
3.) Can a mild 2 day fever appear about 12-13 weeks after exposure occur because of HIV? 
4.) Do symptoms of HIV come and go or occur all at once?
5.) I have a painful lymph node on the right side of my neck. Can this indicate HIV?
6.) Is petechiae a symptom of HIV? These red dots in my palms have been going on for about 3 months now.
7.)The Oraquick test says its 92% accurate at detecting HIV. Is this finding for people who test after 3 months or before 3 months? 
8.) Can HIV symptoms appear at 3 months?
Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome back to the Forum. I'm sorry you continue to worry about your low risk exposure despite Dr. Handsfield's counsel.  I agree with his earlier comments.  In answer to your questions:

1.) Should I have to strain to see a positive result in Oraquick, or would it be clear that it would be positive?  What could the minuscule unclear line on T mean? 
The Oraquick was not designed to be scrutinized in the way you describe.  your results are negative and should be believed. 

2.) Should I test again?
Further testing is a waste of time and money. As I indicated above you should believe and accept your test results.

3.) Can a mild 2 day fever appear about 12-13 weeks after exposure occur because of HIV? 
No, this is far too late to be evidence of an HIV infection acquired 12-13 months earlier. 

4.) Do symptoms of HIV come and go or occur all at once?
When persons with recently acquired HIV develop symptoms, the symptoms all come on at about the same time.

5.) I have a painful lymph node on the right side of my neck. Can this indicate HIV?
No.  If the swollen, painful lymph node has been verified as abnormal by a health care provider, you should look for other causes.  Your tests prove that you did not acquired HIV.

6.) Is petechiae a symptom of HIV? These red dots in my palms have been going on for about 3 months now.
No.  Same general answer as to 5 above.

7.)The Oraquick test says its 92% accurate at detecting HIV. Is this finding for people who test after 3 months or before 3 months? 
Before 3 months.  Your test results should be believed....really!

8.) Can HIV symptoms appear at 3 months?
No.

You really need to accept that you did not get HIV from the low risk encounter you described.  It is time to stop worrying and move on.  EWH

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36 months ago
I am just concerned abut the rash in the palm of my hands that wont go away. They are like little tiny red dots.  Its been there for like 3 months. I went to a dermatologist and she told me that there was bleeding under the skin of my palms, but not to worry. I am going to another dermatologist to seek another opinion on Friday. So my questions:
1.)Would HIV cause bleeding under the skin, like what I described? 
2.)Can sore throat with HIV appear now if my exposure was in January?  I am a concerned about a sore throat I am having now. Also I feel pain in my right lymph node.
3.) Also, would a positive result in Oraquick be obvious to notice? 
4.)Thee CDC says that condoms are only 63% effective against HIV in the riskiest scenario, is that true? In what scenario would condoms not protect against HIV? A lot of people say proper condom use, but not sure what that means specifically. 
5.) How is it possible for the majority CSW to not have HIV if they have sex everyday multiple times? 
6.) Are HIV rates in Eastern European countries high for CSW? My exposure was in Germany with a Romanian woman. Condoms were mandatory in the brothel. 
7.) What are HIV symptoms at 4 months?

Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
I presume your dermatologist should have also told you why you were bleeding  under your skin.  I can assure you however that HIV does not cause this sort of symptom.  Thus, in answer to your specific questions:
1.)Would HIV cause bleeding under the skin, like what I described? 
No.

2.)Can sore throat with HIV appear now if my exposure was in January?  I am a concerned about a sore throat I am having now. Also I feel pain in my right lymph node.
No this is too late for the sore throat which is a symptom of recently acquired HIV infection to occur.

3.) Also, would a positive result in Oraquick be obvious to notice? 
Yes

4.)Thee CDC says that condoms are only 63% effective against HIV in the riskiest scenario, is that true? In what scenario would condoms not protect against HIV? A lot of people say proper condom use, but not sure what that means specifically. 
I am not sure of where you took this quote from.  When condoms are used properly and do not break, they are more than 99% effective for HIV prevention.  Proper condom use includes putting the condom n before penetration, leaving space at the tip, and wearing it throughout sex.

5.) How is it possible for the majority CSW to not have HIV if they have sex everyday multiple times? 
Multiple studies have verified this statement.  HIV is just not as common as you seem to think it is.  Further CSWs, because of their professional risks, often tend to take precautions against HIV including using condoms.

6.) Are HIV rates in Eastern European countries high for CSW? My exposure was in Germany with a Romanian woman. Condoms were mandatory in the brothel. 
High is a relative term.  HIV rates vary according to the setting.  For instance while HIV is somewhat higher among drug using CSW working in Eastern Europe to sustain their drug habits may approach 5-10% (which is a very high HIV rate), workers in brothels are often routinely tested and, as you point out, are required to use condoms.

7.) What are HIV symptoms at 4 months?
Most such infections are asymptomatic.

I really think you are overthinking this.  EWH
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36 months ago
Hello. The quote from the CDC that said that condoms are 63% effective is this : "People who report using condoms consistently reduced their risk of getting HIV through insertive anal sex with an HIV-positive partner, on average, by 63%, and receptive anal sex with an HIV-positive partner, on average, by 72%".  I am aware that I engaged in vaginal sex, and not anal sex. However, I am curious to know why condoms are not that effective for anal sex?
Also, I went to a different dermatologist today and she also said that the rash I had in the palms of my hands was nothing to worry about. I think she told me that what I had in my  palms was bleeding blood vessels under the skin from perhaps an activity such as weightlifting. She also told me that the rash does not look an STD rash. Should I consider myself HIV negative now, or seek further testing after my Oraquick tests I took at home? I am hoping a positive in Oraquick would be easy to notice and Im not missing it and think its negative.  
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Thanks very much for the follow-up.  I was not aware that you lifted weights.  This sort of stress could certainly break small blood vessels.  My advice is for you to believe your OraQuick results.  The OraQuick tests were designed to be very difficult to do incorrectly.  the results would be clear and easy to read.  Believe the results.

Regarding the CDC statement that you quote, anal sex is a far more risky than genital exposures.  Estimates are that when a partner has HIV, unprotected receptive intercourse leads to infection about once in every exposures whereas with genital infections the risk is far less- in the range of one infection per 1000-2000 sex acts.  In addition, I am confident that the quote you mention is from data collected in studies which were not designed to measure condom effectiveness.  There is no doubt that condoms fail more often with rectal sex (as well as with new partners) than with vaginal sex.  Further, data on self-reported condom use in studies whose purpose was not specifically to measure condom effectiveness, problems with self report are notoriously inaccurate.  People do not want to acknowledge that they did not use condoms when they knew they should or to acknowledge that they did not use them correctly.  this phenomenon is well described in a number of well designed scientific studies.

As you know, we provide up to three responses to each set of questions.  This is my 3rd response.  I hope my comments have been helpful.  This thread will be closed in a few hors.  Take care and please believe your test results.  EWH 
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