Dr. HHH: As background: I masturbated another man, and then used a paper towel to wipe off my hand and then stupidly  reused that towel on my genitals. I also mentioned potential irritation from trimming my scrotum with an electric grooming tool just before the incident. I was unable to get an erection (even in the mornings!) for several weeks and felt a stinging toward the tip of my penis. I read on WebMD that low sex drive and penis pain are early symptoms of HIV. Then the cold night sweats started. They continue to this day, and they are terrifying. I also have diarrhea, dry mouth, a canker sore, and a swollen lymph node behind my left knee. The other guy told me he tested negative in a rapid antibody test, but has not returned my messages about the antigen test, which makes me wonder if he is getting extra HIV confirmation tests before disclosing anything. So now I am limited to my own tests, which include a neg. 4th gen at 26 days, neg 5th gen Elisa at 39 days, and at 46 days: a neg. 4th gen. Alere Determine rapid test and a follow-up blood test using CMIA, which I presume is 4th generation since it's from the same place as the first test. Are these tests conclusive? Does this put me in the 90th percentile? 95th? 99th? What if I wake up tomorrow with a fever or sore throat? Or is it not exact science? Could 46 days be 52 days for someone with a healthy immune system or someone who is slow to develop antibodies? Are there ever positive cases where antigens are not detected until 7, 8 or 9 weeks after? You said last time that HIV-induced night sweats would have created antibodies, so I hope that is true in the case of my body. They have been occurring more than a week, so it presumably would have been picked up in the last test. Thank you again for considering my additional questions. Obviously it has been weighing heavily on me, but I don't want to be overly optimistic about this 46-day test if it's not an exact science.

Dr. Hook, I am a little surprised to hear you would have advised me not to get tested. Sure, there has never been a documented case involving hand-to-genital contact, but there is still a chance of infection, right? Especially if I wiped the paper towel over the tip of my penis?

On that note, does the head of a circumcised penis count as a mucous membrane, or are we only worried about seminal fluid making its way into the urethra (which still has a possibility, right)?

This is the WebMD article I mentioned, which is what originally tipped me off to the possibility of HIV. https://wb.md/3cdelnG. Please read it. It's brief. It says that my lack of erection for three weeks could be due to hypogonadism, which could be caused by HIV. The discussion about bacterial prostatitis also explains the stinging in my penis in week 3 and 4, as well as the dull pain in my left testicle, which still somewhat persists even in week 7.

As I mentioned earlier, I have also had extreme dry mouth, numbness/tingling in my hands and feet and pain behind my left knee, where there is a lymph node. I also get light-headed easier than normal, and whenever I do any mild amount of exercise, I find the sweat on my forehead is cold and my body feels a mix of hot and cold. I also get hot flashes throughout the day for no reason. The cold night sweats have mostly gone away, but I still sweat more than usual in my sleep.

It seems like you are convinced that I do not have HIV. I would love to believe that is true, but then how do I make sense of these unusual symptoms? Anxiety only explains away so much, and the timing is too coincidental, especially since I am unlikely to catch a cold by staying at home and wearing a mask outside of the house. Are there any other STI’s these symptoms could be linked to?  

As background, I am 35 years old and I've tested negative for chlamydia, gonorrhea, UTI, trich and syphilis. I went through the usual course of Hepatitis B vaccinations in childhood and adolescence, but aside from my stomach trouble, my symptoms don’t seem to match Hepatitis B.

Please feel free to comment on all of my questions, but I will also enumerate some to make sure they did not get lost in the fray.

1)    Is a circumcised penis head a mucous membrane?

2)    Please comment on the WebMD article about hypogonadism/bacterial prostatitis. Would this delay HIV antigens from showing up in an AGAB test if it was sequestered in my prostate/testicles?

3)    What should I make of my other symptoms such as dry mouth, light-headedness, night sweats, cold sweats, hot flashes, pain behind left knee (where there is a lymph node)?

4) Has anyone ever tested positive after the 45-day testing window for AGAB tests, aside from people on PREP or PEP? Is a test on day 46 conclusive?