Hello,

I had an encounter with a Trans Escort at the end of November 2019, protected insertive anal sex (I was on top). The condom did not break from what I can recall.

About 30 days after the encounter I experienced ARS symptoms that lasted about 10 days consisting of:

- High Fever (101-103 F)

- Headache

- Night Sweats

- Painful Armpits

- Dry mouth with white tongue

- Insomnia

After the above-mentioned symptoms subsided I had two painful lymph nodes swell up behind my ear each lasting about two weeks until they returned to original size. The pain/discomfort in my Armpits is still present (going on 60+ days), the doctor was able to palpate several swollen nodes and has referred me for an ultrasound.

- 5 W - RNA Qualitative TMA – Neg

- 6 W - Insti HIV 1/ HIV 2 3rd Generation POC – Neg

- 7W - 4th Generation Ag/Ab Test and full STD Panel - Neg (except HSV type 1 - positive)

- 8W - 4th Generation Ag/Ab Test – Neg

- 9 W - 4th Generation Ag/Ab Test & RNA Qualitative TMA – Neg

- 13 W - Insti HIV 1/ HIV 2 3rd Generation POC – Neg

- 13 W - 4th Generation Ag/Ab – Neg

-15 W - 3rd Gen Insti POC - Neg, 

HIV 1 RNA PCR QUAN - Not detected

HIV 2 RNA/DNA PCR QUAL - Not detected 

1. Doctors, could the above-mentioned tests have missed an HIV infection?

2. Some sources say that HIV tests will be positive if symptoms are present, is this true?

3. Could HIV be hiding in my lymphatic system and because of this not showing up on the test?

Please help me figure this out.

Thank you

Welcome to the Forum and thanks for your question.  I’ll do my best to help.  You do not have HIV.  The flu-like symptoms you experienced occurred late for the ARS and even more importantly, each of the 7 tests you have had since week 7 is conclusively negative for HIV.  There is simply no way that tests for HIV antibodies (including HIV-2), for HIV antigen, and for HIV RNA would all be negative if you had HIV. It is far more likely that your flu-like illness was a coincidental, non-STI illness of the sort that most people get from time to time.  In answer to your specific questions:

1. Doctors, could the above-mentioned tests have missed an HIV infection?

   Absolutely not.

2. Some sources say that HIV tests will be positive if symptoms are present, is this true?

This is true, both HIV RNA tests and 4^th generation HIV tests will be positive if your symptoms are due to HIV.

No

If your swollen lymph nodes are troubling you, it is time to look for other, non-HIV, non-STI causes.  I hope this information is helpful.  EWH

1.  With all due respect to your doctor, I believe she is being overly conservative.  There is no further testing needed to rule out HIV.

2.  Yes, a regular test for chlamydia would also detect lymphogranuloma venereum.

3.  Hepatitis C is not acquired sexually with the rare exception of persons engaged in receptive rectal intercourse.  Lymph node swelling of the sort you describe is not suggestive of LGV.

4.  No to both questions.  Believe your results!

5.  HSV-1 would not be expected to cause lymph node swelling of this sort.  The only possible STI which might cause lymph node swelling of this sort is syphilis and if you had syphilis it would have been detected by your 7 week STD panel.  As I said above, , if this lymph node swelling  is troubling you, I would suggest you look for other, non-STI causes of the swelling.  Lymph node swelling can be caused by a vast number of problems/illnesses, most of which are NOT STIs.

Hope this helps.  EWH