[Question #6082] Worried in Dubai

19 months ago
Hi Doctors

I have had very bad anxiety due to the threat of possible deportation and there is little to no support system here. All the doctors just advise is to test again.

I had an exposure with a CSW in Thailand in June. We had protected vaginal sex but i believe i performed oral sex on her, though I was very drunk and cant be certain. Though sex was definitely with a condom.

10 days later i felt unwell (bit of cold, not flu and still went to work) and developed a white coating on my tongue, which i still have (16 weeks later).

The tests I have had are: (all done in Dubai)
16 days post exposure - HIV RNA PCR Test - Not Detected
61 days post exposure - 4th Geneation Combo - Negative
86 days post exposure - P24 / Antigen Combo - Non reative (.175)

1. I am worried that due to the laws in the UAE, the labs wouldnt report accurate test results because of the hassle of deportation etc. Is that just my anxiety and me being stupid? Doctors and Labs wouldnt purposely give false results would they?

The first 2 tests were done by a lab CAP accredited, and the last one was done by a lab JCI accredited. Both meet standards here.

2. The biggest issue for me is this white coating on my tongue. I have had it since 10 days. It doesn't scrape off. Online it sounds like it could be Oral Thrush or Leukoplakia. Would these occur 10 days-14 days post exposure? Or are these more associated with long time HIV infections? 

When I google mine doesnt look as bad as the photos, but i have had it for nearly 3 months. 

3. I believe the healthcare here is world class. Would my results be conclusive?

I keep picking up coughs and colds and though it maybe my anxiety, I havent felt right or 100% since the possible exposure. Though I have not had a fever, severe flu or a rash.

Please can you give me any advice/guidance/re-assurance?

Thank you very much.

19 months ago
Further explanation to point 1

What I mean in regards to giving negative results as to avoid the hassle of deportation etc. Is that I tested outside of my visa renewal. So clinics here charge big fees (i have paid over $1200 on 3 HIV tests and 2 full STD tests). They could keep giving negative test results out, as eventually if positive, the government visa renewal would pick it up at the time of renewal. At that point, you are arrested and any cries of 'i tested here and was negative and paid x' will fall on deaf ears. So it would be lucrative and hassle free for labs this way.

Again maybe my irrational thinking but a few forums online (i know you can find anything if you look hard enough), said this was a possibility. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

The bottom line is that it is completely certain you do not have HIV. The important information is in your test results and their timing. The tests you had are among the most accurate diagnostic tests ever developed, for any medical condition. The results overruale all other considerations:  no matter how high the risk of HIV at the time of exposure, and no matter how typical the symptoms for a new HIV infection, the test results rule and prove you weren't infeced and the synptoms are caused by something else.

And anyway, your expousre in Thailand was basically zero risk for HIV anyway:  condoms work, and HIV has never been known to be transmitted by cunnilingus, i.e. vaginal-oral exposure. And your symptoms aren't suggestive of HIV either. White coated tongue has innumerable causes, including the common cold, and in itself does not suggest HIV. But as I said, even if did, your test results are conclusive.

Those comments answer most of your questions, but to be explicit:

1. I've never heard of clinics or doctors in Dubai or anywhere else witholding true test results and cnanot imagine it happens. Given the deportation regs, I imagine the penalty for something like htat would be severe.

2. See above about coated tongue. It means nothing in regard to HIV. And coated tongue usually does not indicate thrush and never hairy leuikoplakia. Even if you had HIV, these problems are rarely part of the early symptoms, mostly occurring after months or years in people with overt AIDS.

3. The tests are the same all over the world and I agree the quality of HIV testing is no different in Dubai than anywhere else.

A final comment about deportation because of HIV:  I don't see the concern. If someone has HIV, they need immediate expert health care to assure a long, healthy life. It isn't available to infected foreigners in UAE and other countries with simnilar policies, so the infected person has to go home for care anyway. While the circumstances might be embarrassing, they are a necessity and therefore this is never a valid reason to a) not get tested for fear of the result (which you did not do) or b) to be worried about deportation as consequence if infected. That said, I understand your concerns -- but in any case you had weren't really at risk and have not had typical sympotms.

So all is well. You don't have HIV. I hope these comments are helpful. Let me know if anything isn't clear.

19 months ago
Thank you so much, Dr Handsfield for your quick reply.

That all makes sense. Thank you. I think it was the coincidence of having the coated tongue so close to the potential exposure. Combined with googling it all pointing towards HIV and/or Aids. 

The deportation aspect isn't the act of deportation itself. Its leaving the life ive made, relationships, career, having to explain to people I guess.

I will be determined to put faith in my results and given the anxiety I have had I will not put myself in such a situation again. 

Thank you once again for replying so quick. It has helped put my mind at ease.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Of course I understand the concerns about deportation, but it makes no difference in my advice about it. In any case, it's not an issue now.

Thanks for the thanks. I'm glad the discussion was helpful.---