So to summarize, my last sexual exposure was almost a year ago in July of last year. It involved me going to a csw who engages in BDSM. There was no penile-vaginal penetration, but did involve sex toys which were used anally with a condom and fingering with gloves. My first test was in November of last year followed by tests in December and January all of which came back negative. 

In March, i had contracted covid even though i was fully vaccinated but luckily had no symptoms. Shortly after this, i started to become quite anxious about HIV, and if my multiple tests had missed it. This anxiety was further enhanced by recurring mouth ulcers and I currently have 3 around the inside of my mouth. Over the last 2 weeks I have been trying to make myself believe that even after so many negative results I do not have it, however this has clearly not worked. I have also tried to muster up the courage to go and take 1 final test and put this all behind me , however the slight thought of it coming back positive has stopped me to do so...

Questions,

1- Am i overthinking this to extraordinary levels?

2- If i finally muster the courage to go and take the test, is there any chance of returning positive even though I have not had any exposure and my last test was 6 months out from the incident?

3- Have you in your professional capacity, ever heard or seen of a case turning negative to positive with no new exposure?

I would highly appreciate your advise and opinion on this matter, as it is literally sucking the soul out of me!

The exposure you describe was virtually no risk. HIV and other STI‘s are not transmitted from person to person on inanimate objects such as sex sex toys except when they shared immediately within the context of the same encounter.  Even then, transmission of infection is extraordinarily rare.  Further, any infectious material which is present is typically removed With routine cleaning and anything that is missed during cleaning becomes almost immediately non-infectious due to exposure to environmental temperature, dry, etc.  Further, fourth generation, combination HIV antigen/antibody tests provide entirely conclusive results at any time more than six weeks following an exposure. Thus, You are a test from November, December, and January absolutely prove that you were not infected.  

Recurring mouth officers or “aphthous ulcers” are common and are certainly seen in persons with HIV although most persons with aphthous ulcers do not have HIV. Based on your testing, I am confident that your recurring mouth officers are not related to HIV contracted at the exposure you described.

Thus, in response to your questions:

1.  I can understand how your misfortune had acquiring COVID-19 despite vaccination might raise concerns  (About 4% of vaccinated persons do you want to acquire COVID-19) however I do think you are over thinking this and encourage you to believe your tests. They are conclusive. You did not require HIV from the exposure you describe.

2.  Further testing is not necessary however should you opt for an additional test, I am confident it will show that you were not infected at the exposure you’ve described.

3.  Neither in my own practice or in reading the medical literature and attending scientific meetings have I ever heard of a person who had a negative test at more than six weeks following an exposure go on to subsequently develop a positive test unless they had been taking anti-HIV medication in the interval.

I hope this information is helpful although I do understand your anxiety and concerns, I am confident that you did not acquire HIV from the exposure you described. If you have additional questions or need clarification, please use your up to tow follow up questions for that purpose. Take care. Please don’t worry. EWH

Recently I met a transgender masseuse/escort. I had an erotic massage with her. During the session, the csw performed analingus on me as well as fingered me anally with bare hands. Also she rubbed her penis (without a condom) against my anus however there was no penetration. Before the session started I was in the right mind to ask about her sexual status and she showed me recent reports as of the 3rd of July for a full std panel including HIV and all results were negative. She also informed me that she has been of PREP for quite some time now(approx 2 years i believe), She says she gets tested every month. 

Is the above scenario considered a risk for HIV and require testing? Has there ever been a documented case of transmission from any of the activities listed above?

I hope this information is helpful. Again, I apologize for the delay in responding.

 In regards to the activities that took place, could you comment on the penis head rubbing against the anus(without a condom) as well? 

As you know, we provide up to three responses to each client’s question. This is my third response and therefore concludes this thread. Take care. Please don’t worry. EWH