[Question #788] Testing

53 months ago
Hello. I have had a potential high risk exposure (unprotected sex) with a women of unknown status. I don't believe anything happened that night, but had to much to drink and do not recall much of the night. I had std swab test, which came back negative and HIV 4th generation ( quest lab) at  28 days and 89 days both negative. My concern is my tongue has been consistently coated white for 2 months. I've been under a lot of stress and have had restless nights within minimal sleep for almost 6 months, so not sure if it is from that. Can I consider my results conclusive or do I need further testing. Thank you very much.
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago

Welcome to our Forum.  I will be glad to comment. 

Before I answer your question about test performance, let me comment you on your characterization of sex "with a women of unknown status" as high risk.  I think you may be overstating your risk- here in North America less than 1% of all women have HIV and that includes women who are IV drug users or commercial sex workers which are subgroups who may have somewhat higher risks for having HIV.  If you do not know that the woman was an IV drug user or CSW, I would not call it a high risk exposure. 

Having commented on the concept of risk, let me assure you that the results of a 4th generation HIV test is definitive at any time more than 4 weeks after an exposure of concern and with two negative tests at 28 and 89 days after exposure you can be completely confident that you did not get HIV from the exposure you are concerned about. No reason for continuing concern and no reason for further testing.

I hope these comments are helpful. EWH

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53 months ago
I was in Las Vegas, so my concern is that she was a CSW but I assume this does not change your opinion because of my test results? That being said, does my white tongue concern you at all? If not, your opinion is very valuable to me and I will finally be able to move forward. By the way, you guys run a terrific forum and truly appreciate your help. Thank you Dr. Hook!
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago

No, I would not worry about a white tongue at all.  If you are concern that it is a problem, your dentist is the one to ask and, if you have seen a dentist since you noted your while tongue and he/she didn't mention it, it is not pathological.  Many (most) people do not look at their tongues until they begin to worry. 

Also, regarding your partner in Las Vegas, is you did not give her $$, she was not a CSW.  Even if she was, the proportion of CSWs there who have HIV is very, very low. 

Believe your tests.  You are in the clear. 

Stay safe.  EWH

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53 months ago
Thanks again. I think it's time for me to move forward. 
53 months ago
For stds, I did a swab test which was negative for cylmidyia and gonnerhhea  but have notice a clear discharge in morning. Should I be concerned that I have something else.
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago
No, I would not worry further.  A small amount of urethral discharge is normal if one looks closely enough, I suspect that is what you have noticed.

This is my third response to this thread.  As per forum guidelines, this thread will be closed later this evening.  EWH
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52 months ago
Okay. I've notice this discharge along with 2 swollen glands in my right groin. Just concerned it could be something else. I'll try and move forward t
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
That is the correct course of action.  EWH
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