I’m back to the forum again, silly me. Due to a serious back and shoulder pain 3 weeks ago, I called for a home massage at my home. The masseuse gave me a normal massage at the beginning, and was flirting with me at the end, and due to my silliness and a bad self-control, I accept her offer on giving me hand job ONLY but her being naked. 

During the massaging process, all towels, massage oil, and tissue to wipe off are from my home. Everything seems clean enough, and according to the answers I got from all previous threads, I knew hand job is a no-risk act. 

But at the end after finishing wiping off my penis with tissues, I saw a used tissue aside with some red coloured prints on it. I freaked out, I asked her is the red print blood, but she said it’s her lipstick which she wiped her mouth at the beginning. (Not sure is this tissue also used while I wiped off my penis). 

After she left, due to my anxiety and strong OCD, I checked very detailed on the tissue and it really does looks like lip stick (not red as blood and I knew blood usually “sink” through the tissue), and I also saw some make up coloured stuff on the tissue as well. But due to my anxiety I’m still worried what if it’s really blood. 

It’s now 24 days after the massage, I keep reassuring myself by reading the answers I got from you before and the knowledge I got from my past experiences. And today, due to some dizziness my GP ordered a CBC to check is there anything going wrong. This makes me freak out again. Everything is normal but a slight rise in the total lymphocytes (higher than any of my previous history, but still normal in both range and percentages), but I’m sure you understand, due to my OCD and anxiety I’m worried again. 

I’m still waiting for 4 weeks and 6 weeks to do a HIV combo test now, so I wanna ask some questions to have a peace in mind. 

1) I’ve red many threads in this forum, but I see different answers. Not talking about my case, but normally if a person was infected by HIV what c

1)I’ve red many threads in this forum, but I see different answers. Not talking about my case, but normally if a person was infected by HIV what changes will occurred in a CBC? ( I’ve saw threads that Dr. Handsfield saying there’ll be a slight elevate on lymphocytes, but also threads that Dr. Hook answered saying there should be a slight decrease on lymphocytes during ARS. Just wanna have a clear answer on this. )

I would want to add that I experienced a sudden muscle pain in both of my thigh and arm muscles around 1.5 weeks after exposure, also some pain in the joints.  No any other symptoms, and I red some other threads just now seeing reply saying that ARS normally won’t come alone. Would glad to have a short answer on this as well. Many thanks!

As discussed in your two previous threads a year ago, HIV is not transmitted sexually except by intercourse:  if you're penis doesn't enter another person's vagina or rectum, you'll never get HIV. Even oral sex is little or no risk, which was the main issue discussed previously. By extension, it should be obvious that hand-genital contact is risk free. In addition, statistically there is little chance your massage partner has HIV anyway.

And let me get this straight: you were worried about your symptoms, your GP reassured you nothing probably was wrong, but you became even more worried because he requested a CBC for reassurance? And I doubt that in reading other threads you found truly conflicting information from me and/or Dr. Hook about the risks of events like this. If you found "different answers", probably it was only in the wording or in the details of responding to a particular situation that had significant differences compared with others.

"I really want to know normally what changes will be seen on CBC during acute HIV infection...."  You correctly report what both Dr. Hook and I have said before:  perhaps an elevated lymphocyte count, but usually the CBC is entirely normal, as it was in your case.  All numbers in CBCs, including lymphocytes, vary naturally within the normal range:  that your level is higher than it was some other time means absolutely nothing.

The symptoms you describe now don't even hint at HIV.

From a medical or risk assessment perspective, you do not need HIV testing. However, I'm certain that my advice alone isn't going to resolve your fears, so you should have an HIV blood test for reassurance purposes. DO NOT interpret this the way you did you when your doc ordered the CBC: just as that recommendation did not imply he thought anything was wrong, neither does this advice mean I believe you have any chance of having HIV. I do not. If you decide to follow through on this advice, have an antigen-antibody (AgAb, i.e. 4th generation) HIV blood test 4 weeks (for 98% conclusive result) or 6 weeks (100%) after the event.

If you would like to let me know that test result when you have it, I would be happy to comment again at that time. In the meantime, trust me on this:  you can and should ignore all other symptoms you may develop or other "what if" questions that might come to mind until then. They will not indicate you have HIV.  OK?

HHH, MD

1) I just red some response from either you or Dr. Hook saying that even masturbation with other’s secretions on hand is still a risk free act, is this really true? I mean in my case I’m 100% sure she has no secretions on her hand. 

2) Also as I mentioned, I saw a tissue with red prints on it, and according to what she said it’s lipstick. Not sure will this be a weird question, but there should be a significant difference between lipstick and blood on a tissue right?

 (Cause I remember previously when I wiped my fingers with tissue while checking my blood sugar on the self testing kit or any rapid HIV test kit, the blood I wiped “sink” through both side of the tissue, the color is bright red and firmed and wet. But on the red printed tissue I mentioned in my case, the color isn’t bright red, but it’s more like purplish red and not firmed at all, also it doesn’t “sink” through the tissue, which means it’s not wet at all). 

An elevate on lymphocytes you m mentioned, does this mean an abnormal elevation? Or an obvious rise on percentage of lymphocytes? 

I also saw many information online saying that if a person is infected by HIV (although all mentioned CBC isn’t important and not all people will have changes in CBC) but other than lymphocytes, there shall be a rise on Monocytes and a drop on platelets. Is this correct? 

4) Will ARS symptoms usually comes alone or simultaneously? Cause other than my muscle pain ( it actually goes away after 2-3 days), I have no any other symptoms. Does this mean there’s a strong evidence my muscle pain has no connection to ARS? 

I checked my body temp everyday, swallowing saliva very often too check is there a sore throat, checking regularly is there any body rash, touching all the areas that has lymph nodes (neck, armpit and groin), everything is extremely normal. No diarrhoea at all too. 

As I said above, "...you can and should ignore all other symptoms you may develop or other "what if" questions that might come to mind..." -- which is exactly what these questions are. 

2) It probably wasn't blood. If it was, there would be no risk.

3) There are no other expected abnormalities on CBC with acute HIV infection.

4) When ARS causes symptoms, typically several start more or less simultaneously, at least within a day or two of each other. I am confident your muscle aches are not due to ARS.

Ignore your normal lymphocyte counts! And what if they were significantly up? Any trivial immune reaction (minor cold, a skinned knee, etc, etc, etc) would do the same thing.

Feel free to report an HIV test as your last and only additional comment on this thread. Otherwise, the thread will be closed.

And please get professional attention for your OCD.

My last question now in before the thread is closed will be:

Beside on talking about my case, if a person involved in a high risk act and would wanna get tested early: Will a HIV ag/ab test + an RNA-PCR test will do on 27 days?

Will both ag/ab test + RNA test be conclusive on a 4 week count since it had an RNA test to support the results? Or do I still need a 6 weeks count to go for conclusive results?

 (Why I use 27days rather than 28days here, because in my case I would want to do it immediately on next Monday, which is one day ahead from 28 days. But for the above question, please assume the person is involved in a high risk act and not my silly hand job case). 

Please take another look at my closing comments in the second of your two threads in the past (about a year ago, as I recall). This is your last question along these lines. Since your last was a year ago, I gave you the benefit of the doubt, but not again:  To repeat the warning you received a year ago:  The forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.