[Question #7389] Help with a 7 week high risk encounter and STD STI HIV and HSV testing

6 months ago
Good afternoon experts: facts and subsequent question below:
SEPT13 - broken condom while performing anal sex on sex worker. Noticed possible fecal matter on penis. Washed immediately after with soap and water. Start major worry/anxiety
SEPT16 - full STD STI HIV panel without HSV test. All negative. Slight sore throat starts. Some general achiness in arms.
SEPT23 - slight sore throat stops.
SEPT28 - note dry mouth and dry lips still achy arms.
SEPT29 - STD STI HIV and HSV performed. All negative. Still dry mouth & chapped lips. General achiness.
OCT06 - Oraquick HIV test taken. Neg. Still dry mouth & dry lips. Pain starts radiating down rear of both legs and buttocks. Itchy and inflamed anus possibly to due to hemmroids.
OCT09 - started feeling "burning spots" all over feet, legs, penis, testicles, arms, and trunk of body. Itchiness continues all over body.
OCT14 - (4 weeks since) STD STI HIV and HSV2 Igg tested all negative. Continue to have dry lips, dry mouth, burning sensation, itchy feeling, achiness, pain in rear legs.
OCT29 - dermatologist inspected body for possible sores associated STD/STI imperfections. None found. Derm says all is good. Itchiness stops - taking benadryl. Burning feelings are not as frequent. have dry lips and dry mouth leg pain.
NOV03 - (7 weeks since) STD STD HIV HSV 1 & 2 (<0.09) Igg tested all negative. No sores or alike. Still have dry lips, dry mouth, pain in buttocks, pain in the inner thighs, and pain on buttocks while sitting. Noticed general skin sensitivity.
NOV06 - saw urgent care doctor for pimples on chest and butt. Ruled acne and possible stress because of recent 1st testosterone shot on OCT 30. (I have low testosterone 206)

How conclusive are these negative results of each test at 7 weeks even with those "symptoms"? Are these symptoms of any STD STI HIV? Are these caused by nerves or low T ? Tests were: HIV Ag/Ab with Reflex 4th gen duo/Chlamydia by NAA test/Gonococcus by NAA test/Trich by NAA test/RPR Syphilis - non reactive/HSV1&2 IgG
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Welcome to the forum.  Thanks for your confidence in our services.

None of your symptoms suggests any STD. I'll come back to herpes -- but all your other tests are absolutely conclusive. For sure you did not acquire gonorrhea, chlamydia, syphilis, chlamydia, or HIV. (Trichomonas was impossible anyway; not carried in the rectum and never a problem in men having sex with men. Maybe the only STD that is exclusively a heterosexual issue; trich is harbored only in the vagina.)

It takes up to 4 months for the HSV blood tests to become positive. OTOH, the chance of herpes from any single unprotected anal sex exposure is under one in many thousand. That fact, plus absence of symptoms to suggest herpes, are sufficient evidence. No STD specialist would have recommended testing your for HSV in this situation. Even though your current test results are not yet conclusive, I suggest you just stop worrying about it and not have any further testing.

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

HHH, MD
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6 months ago
Dr. handsfield,

First and foremost, I respect your opinion greatly as I have read and seen alot of your work. I appreciate your skill and hardwork in this field for those of us whom are simply looking for answers to traumatic events.

Secondly, would it be safe to resume unprotected sex with my female partner? Even with the pain in my inner thighs, pain in my buttocks, dry mouth, dry lips, burning spots etc? Should I still wait the 90 days and retest? Refraining untill then...

Your words bring great relief to my otherwise chaotic and anxiety laced lifestyle. And my confidence in your services are so great!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Thanks. I'm glad thse comments helped. I hope these settle the issue for you.

The symptoms you describe are not typical for HIV or another STD. Ninety days advice for HIV testing is old news, going back 10-15 years to older HIV tests no longer in use. Assuming your HIV test was an antigen-antibody (AgAb, "4th generation") test, it was nearly conclusive at 4 weeks and at 7 weeks absolutely proved you don't have HIV. Beyond 6 weeks after exposure, this and similar tests overrule all other factors:  no matter how high the risk of HIV at the time of exposure, and no matter what symptoms are present, the negative result rules out HIV.
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6 months ago
I'm sorry Dr. Handsfield, I should have specified HSV testing. As this is really my area of concern, Herpes seems to be the area I am most concerned about.  Even with my "symptoms" Im most worried about the likely hood of me having contracted HSV and passing it.

Would it be ok to continue unprotected sex with my female partner, or wait untill I can confirm with a 90 day HSV 1 and 2 IgG test?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Herpes doesn't cause the kinds of symptoms you describe. There is no need for further HSV testing and no need to avoid sex on account of these symtpoms.

That completes the two follow-up comments and replies included with each qquestion and so ends this thread. I hope the discussion has been helpful. 
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