[Question #6608] HIV anxiety

14 months ago

Wondering if you could review my symptoms and share your knowledge on whether these are manifested out of health anxiety, or acute HIV? 

Unprotected sex with bf (we are hetero couple) for 4 months. 

Started having STD anxiety in the beginning, and he says he is clean, healthy. I ordered oraquick HIV test and will test soon. 

Negative HIV my whole life 


Background of last 3 months:

No recurrent fevers

No drenching sweats

No rashes 

No mouth sores or genital 

No STDs- checked in November and recently (did not check for HIV) 

No thrush 

No gastrointestinal issues 


Dec 11- 14 (one month after ejaculation inside) 

White spots on tonsils (strep negative) 

Low fever for 24 hours only, about 99.4 (low grade) 

Some sweating (not drenching) at night 

Red throat

Swollen lymphs in neck

Tired

Decreased appetite for 48 hours 


Dec 28- 1/5

Pain in groin and legs/ lower back (have disc issues, but infrequent leg pain prior) 

Bad burning in back of throat

White spots again, went away in a day after using baking soda gargle 

No fevers

Received meds for acid reflux (LPR) 

No motivation/fatigue. Lacking my normal zest for life. 

Pressure in head/face like sinusitis  

Weight loss in 4 months, about 8 pounds


Recent appointments:

Dentist- mouth all normal 

Pap smear- normal 

CBC- normal as of 1.13

white blood count fine and lymphocytes normal range

Negative for CMV/EBV and mono 


Depression symptoms and anxiety however due to obsession with HIV, and constant out of it feeling. I am consumed by HIV anxiety, and its affecting my work and daily life. 


Thoughts? 



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
14 months ago
Welcome to the forum. Thanks for your confidence in our services. I'm happy to help.

The bottom line is that almost certainly you do not have HIV; my reasoning is below. But I strongly endorse your intent to have an HIV test; the negative result undoubtedly will be more reassuring than anything I can say. However, it should not be the oral fluids test (Oraquick), which is the least reliable of all available tests. It can take 3 months for positive results (all other tests are 4-8 weeks) and even then it misses 2-3% of HIV infections. You should have an antigen-antibody (AgAb, "combo", "4th generation") blood test.

Apparently are in an ongoing relationship. Have you discussed your fears with your boyfriend? What has he said? Has he been tested for HIV and/or other STDs? If not, why not ask hin to do it now? If negative, you'll know you weren't at risk. In this situation, many couples get tested together, for mutual reassurance.

In any case, it sounds like there is little chance your bf has HIV. Harder to say about other STDs, but probably he doesn't have any active transmissible infection (apart perhaps from HPV, but everybody gets genital HPV and mostly it's harmless. I won't go into detail on HPV now, but let me know if you have any concerns about it.) Your symptoms are not suggestive of HIV or any STD:  every symptom you describe has many potential causes, mostly more common and not nearly as serious as HIV or other STDs.

Putting it all together, I'm pretty sure you don't just have "depression symptoms". Of course I can't diagnose anything from this remove, but it seems likely you indeed are clinically depressed, to a level that requires medical intervention and perhaps treatment, whether with drugs, counseling or both. (Among other things, the phrase "No motivation/fatigue. Lacking my normal zest for life" could be used to teach medical students about depression. By the way, it's nice your CBC is normal, but it says nothing one way or the other about HIV or STDs.

In summary, my advice is: 

1) Discuss things with your bf and consider mutual testing. 
2) At a minimum, see a doctor or clinic for standard STD and HIV testing, including an AgAb HIV test. I predict negative results for all.
3) Also speak with your doctor about how you're feeling in general and whether further evaluation and maybe treatment for underlying depression, or perhaps other mental health issues, are of concern.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD


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14 months ago
Thank you Dr. Handsfield for your reply. Noted, I will have an antigen-antibody (AgAb, "combo", "4th generation") blood test to ensure an accurate result. 
I have spoken to my bf, and he has not been tested. I will ask him to consider, since I have decided how important it is to test regularly. 
I recently started seeing a clinical psychologist per my PCP, and it is helping. 
The sudden onset of the overall feeling of not being well in the last two months, the fatigue and back pain seems to have worsened my overall outlook on life.  
The sore throat also is almost constant, which I believe is due to the acid reflux issue. 
Prior to the symptoms, I was very active and virtually pain free. I suppose the anxiety that something was chronically wrong, especially since my lymphs are never swollen and now are, has exacerbated these symptoms. 
My obsession with googling systems is a bit out of control and out of character for me as well. 
Thank you so much again for your reply. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
14 months ago
I’m very glad you’ve spoken with your partner and are in counseling, and that you will have a proper HIV test.

You might have a misunderstanding about HIV risks. Of course it isn’t necessary for people in mutually monogamous relationships to be tested regularly for HIV.

Your additional comments don’t modify my concern about depression or other psychological explanation for your symptoms and your apparently excessive worry about HIV. Please discuss all this with your counselor, especially if these thoughts continue after you receive your negative test result.
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14 months ago
Thank you. To confirm however- you don't feel that the below symptoms, which have been ongoing  for 10-11 weeks following unprotected sex, are associated with ARS? 

Mild sore throats on and off 
Swollen lymph nodes
Fatigue
Back/Leg pain 
Weight loss 



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
14 months ago
ARS can be associated with these symptoms, but so are a hundred other conditions, all much more common than HIV. Sore throat "on and off" implies these symptoms have been going on for a few weeks. ARS doesn't last more than 2-3 weeks. 

Have your HIV test. Since it is more than 6 weeks since the exposure on your mind, that test will be 100% conclusive. When it is, please do address your symptoms with your doctor. I remain concerned about depression.

That completes the two follow-up exchanges included with each initial question and so ends this thread.  In the exceedingly unlikely event your HIV test is positive, please return to the forum to let us know. But please don't post another question on these symptoms and your HIV fears if the test is negative. I guarantee we would do nothing more than reinforce the fact that you don't have HIV, no matter what symptoms or other circumstances you might describe.

I hope the discussion has been useful. Best wishes to you.
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