[Question #6989] HIV

8 months ago
Docs,

I hope all is well. I’m slightly embarrassed to be back here again, but I am desperately struggling to get over this. I reached out last year with some technical questions about HIV tests. I thought I was over this, but I can’t shake it. 

About 5 years ago I got a blowjob, and 6 years again I had very brief vaginal sex lasting no more than 30 seconds. 

Ever since the blowjob I have experienced severe symptoms I cannot get over. Although ever since the night of the blowjob, I assumed the woman had HIV due to her repetitive strep throat. 

Here are my symptoms:

-Seb derm on nose approximately 6 months after blowjob. Controlled with head and shoulders

- Pityriasis Roses approximately two years after event. 

-Flat warts back of hand/knee. Awaiting dermatalogy appointment to confirm. 

-Loose stools from day one. These stopped after our last talk for about 4 weeks. Also stopped smoking cigarettes. Returned once I started to worry again. 

-Random hives from being suddenly allergic to things (laundry detergent)

Lost about 20 lbs. although I now work in a warehouse besides a desk job- so I don’t consider this a symptom really

I think those are the major things. 

Regardless- I have had 6 negative tests!!!!!

2 Oraquick at home at 3 months
1 oraquick finger prick test at 2 years at planned parenthood
1 rapid alere determine at hiv center at 3 years
1 lab 4th gen test through stdcheck at 4 years
1 qualitative RNA test through stdcheck at 4 years

Everything I read online about these things states immunocompromised bodies. 

I’m scared to death. This is ruining my life. I’m not my old self. 

I would be fine if all these symptoms would not pop up. 

I’m not sure where else to go. I’m worried about having a new strain of HIV that is not detectable by tests as it has not been discovered. 

No one believes me. What else can it be?? What else do I need to do?

I’m making a appointment with a Infectious disease doctor to hopefully get over this. 

What are your guys’ thoughts?

My wife can not stand me asking her
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Thanks for your continuing confidence in our services.

You misunderstand (or may not know) some basic facts about HIV infection, symptoms, and testing. Here they are. First, every symptom associated with HIV occurs more commonly in ohter medical conditions, and that includes all the ones you mention. Even without testing, the symptoms you mention are not particularly suggestive of an HIV infect. (And for what it's worth, none of the symptoms you mentioned is particularly worrisome, and contrary to what you think you learned online, none usually reflect any sort of immune deficiency. My closing comments below return to your apparent obsession with online searching about all this.)

Second, the HIV blood tests are, both individually and collectively, among the most accurate diagnostic tests ever developed, for any medical condition.

Third and most important, on account of these two truths, blood test results -- when done sufficiently long after the last possible exposure -- always overrule all other considerations. No matter how typical the symptoms seem to be for HIV/AIDS (as I said, yours are not typical), and no matter how high the risk of HIV at the time of exposure (and your risk was nil), test results overrule those concerns. Your results prove without doubt you do not have HIV.

As for your exposure, there has never been a scientifically proved case of HIV acquired by mouth to penis transmisison. A past calculation by CDC was that if oral to penile transmission occurs at all, the best estimate of frequency is once for every 20,000 exposures. That's equivalent to receiving BJs by infected partners once daily for 55 years before transmission might be likely. In other words, zero for all practial purposes.

I don't blame your wife for "not standing" you r continued obsession with this. After the repeated science-based reassurance you have had (probably from your own doctors as well as this forum), your statements "I’m scared to death. This is ruining my life. I’m not my old self" denote a psychological obsession that is truly irrational. Seeing (another?) ID specialist will not help:  you will not hear anything substantialaly different than what I have said above and in your previous thread. No amount of science based reassurance is going to end your worries. You're clearly going to need professional counseling. Rather than the ID doc, ask your primary care provider to refer you to a mental health professional. I suggest it from compassion, not criticism.

Finally, in response to "Everything I read online about these things", here is a repeat of the closing paragraph in our last exchange 9 months ago:  It's time for you to let it go, including no more web searching. Like many anxious persons with internet access, you're obviously being selectively drawn to information that reinforces your fears. (The famous statistician Nate Silver, of fivethirtyeight.com, wrote a book, The Signal and the Noise. In it he covered this topic with something like this, an apprxomiate quote:  "Give an anxious person a comptuer with an internet connection in a dark room, and soon he'll be convinced his cold is the bubonic plague.")

I hope you find these comments helpful and that you'll heed my advice about counseling. I also suggest you share this discussion with your wife -- who, I suspect, will agree with all I have advised. Best wishes and good luck with it.

HHH, MD
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