[Question #5939] HIV risk/scare/testing

19 months ago

i had unprotected sex twice with a new partner. he’s a 23, white heterosexual male who claims he has only slept with 6 women and 5 of the six were relationships. before we had sex, i asked his status and he said he had gotten tested a few months back and was clean for everything and that he had only had one new unprotected encounter since and it had been about a month ago. it is now 12 days since this exposure and i have experienced some symptoms that i think are due to stress over this whole situation. these include: mild diarrhea, mild headaches, twinges where my lymph nodes would be (although i think this is from being hyper aware because none of my lymph nodes appear to actually be swollen) and the biggest one has been muscle tension. i feel a lot of muscle tension/tightness along my throat, neck and upper back. 

  1. i have no other ARS symptoms just the muscle pain. is ARS muscle pain usually widespread or could it be localized to one area? and typically how severe is the pain? could it just be from the stress of the whole situation? i admit i’m extremely worked up about this whole thing and riddled with anxiety. 
  2. is an RNA test the same as a PCR test? i have seen from other posts on here that at day 10 of testing the results would detect about 80% ; so if i got tested with the RNA test at 14+ days would that result be 100% accurate? and would i have to follow up with a 4th gen test at 4 or 6 weeks?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

Like many people today, you seem to have an inflated view of HIV risks. I'll bet not 3 people in the US in the past 10 years have acquired HIV in a situation similar to yours. The likelihood your new partner acquired HIV during the single sexual exposure since his negative HIV test is probably under 1 chance in a million. And your symptoms are not in fact suggestive of a new ahaiv infection. Acute HIV infection can include muscle pain, but rarely if ever without sore throat, fever, orbivously enlarged lymph nodes, and often skin rash. It's the pattern of symptoms that matters, no single symptom. Equally important, even all the classical symptoms are identical to those of any number of minor viral ifections.

1) Those commetns pretty well cover your first question: these symptoms do not suggest ARS. I'll add that whenever someone suspects their own symptoms have a psychological or emotional origin -- stress, anxiety, etc -- usually that is in fact the case.

2)  From a medical/risk standpoint, HIV testing isn't necessary in this situation. But if you're going to do it for reassurance, the RNA test (yes, same as PCR) would be around 90-95% conclusive at 2 weeks and nearly 100% at 3 weeks. For 100% conclusive testing, you would also need an antibody test (or antigen-antibody "combo", "duo" test) at 4 weeks.

Alternatively, speak with your partner and suggest that he have another HIV test (specificaly antigen-antibody) now. If negative, you will know you were not exposed and could stop worrying without having any testing of your own.

So truly, do your best to stop worrying. There is no realistic chance you have HIV.

I hope this response is helpful. Let me know if anything isn't clear. I also hope this helps you move forward in a new, romantic relationship.

HHH, MD
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19 months ago

hello doctor! i thank you for your speedy reply and being someone i can trust and confide in. 

i guess the real “risk” here in my head is just that i slept with someone and took his word on being clean. this is a mistake on my part and something i won’t ever do in the future. if he didn’t actually get tested like he said, what do you think the risk would be after sleeping with such a low number of women? 

just for my own personal knowledge, 

  1. it is still early (12 days) could it be possible to only be experiencing muscles pain before other ARS symptoms arrive? or do they always arrive together? btw my muscle pain actually seems to subside once i wake up from sleep, further making me think it’s just from tension- but i’m still curious.
  2. because you think this is so low risk, i’m guessing i should just stick it out until the 4 week mark (possibly 6 week mark depending on my anxiety) and then get a conclusive answer then from a 4th gen test. 
  3. i have spoken to him. have all but begged him to go and get tested, just so i can have some peace of mind. he’s 100% open to that (although he finds the whole situation funny because he’s 100% sure he’s clean) but has had difficulty taking time off of work and now with a hurricane coming it’s makes it even more difficult to go. i will go on my own and get the results for the sake of my sanity. i understand i have one reply left (?) i would love to hear back from you on this one and then use my last reply to update you on results, if that’s ok. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
It seems your partner is responsible and reliable; people rarely lie about these issues (being tested, the results) when asked directly, although you know him and I don't, so of course are in a better position to judge his truthfulness, body language, etc. Anyway, my advice is to sit tight until he gets retested, presumably soon after the storm passes. (As I write this, the media are reporting it may be heading out to sea, with lesser impact.)

1) There is no likelihood at all that these symptoms are ARS. Your own suspicion of the actual cause almost certainly is correct.

2) I suggest you not be tested at all, if your partner follows through and gets retested in the next week or so. In the exceedingly unlikely outcome that he has a positive result, you can get tested yourself.

3) See my advice comment above. Let's make this our last exchange until/unless you report either your partner's repeat test result or your own. I won't have more to say until then. OK?
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18 months ago

hi just an update along with a few questions. i went at 4 weeks post exposure to get tested and everything including HIV came back negative. (my partner was dragging his feet and just seemed unwilling to go so i gave up on him). 

  1. i know you say six weeks is conclusive, but given my exposure risk and the negative 4th gen test at 4 weeks, is it safe for me to put this behind me and move on? 
  2. my results came back negative for gonorrhea and chlamydia (vaginal swab test). if i had either of these in my throat, would it have shown up from the test i had done or do i specifically have to get a throat swab? but if i was negative for them vaginally, it would be likely that i’m negative for them orally as well, right? 
  3. i would like to know the difference between a swollen lymph node and a muscle/tension knot. i had a small enlargement (pea sized) on the back of my neck that seemed to flare up last week but has since gone done. but now i have one on the side of my neck that is very tender to the touch. both are small and not visible and i actually have to feel around a bit to find them. (i will say that all the muscles in my neck seem to be tense/more pronounced) does this sound like the swollen lymph nodes you’d find with HIV or a muscle knot? 
18 months ago
also, sorry to ask another question! but, i’ve read on here where you say that if a person was having ARS symptoms then an HIV test would be positive. i had had the first swollen lymph node before and during the time i got tested. so if the test came back negative, could i for certain say that this swollen lymph node or muscle knot or whatever it is, is not due to HIV?  thank you so much. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
1. Assuming you had AgAb test, and given the low risk of the exposure, you can consider your 4 week result conclusive. As for your last/follow-up question, you correctly understand:  the negative result proves your symptoms are not due to HIV. (But HIV would never cause just a single lymph node to be inlarted or inflamed anyway.)

2. Vaginal swab testing only detects genital infection. A throat swab is requried to diagnose or infection. But oral gonorrhea goes away on its own in a few weeks, and generally doesn't cause symptoms. So I wouldn't worry about it.

3. Evan if it was a lymph node, pea-sized isn't abnormal and not worth worrying about.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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