Hello Doctor

 My English is weak and I use a translator.

 I'm sorry to come back again but the obsessive is back again I want to close this thing and normal life.

 Briefly

 A high-risk relationship without a condom with an unprotected oral and vaginal sex worker.

 An infection with gonorrhea has been cured.

 Genital herpes infection was confirmed by clinical examination, the test after 92 days was positive for hsv1 igg.

 post hiv tests

  49 days

 59 days

 81 days

 92 days

  Antibodies only. I do not know which generation. The lab employees have no information. They say 6 months is definitive.

 (The fourth generation test is not available in my country, Egypt)

 Symptoms: I feel swollen lymph nodes under my armpits, a rash, small red dots, and some are skin-colored. Weight loss after 90 days.

 questions

  1 - Is there a chance that the result will change after the 90-day test if the analysis is from the first or second generation? The medical services in my country do not trust them.

 2- Can I have sex with my wife without a condom, I am very afraid, she is pressuring me to have sex without a condom.

 3- Does Valtrex Suppression 500 delay HIV or herpes antibody testing

 4- My doctor says that there is a possibility of transmitting infection to the fetus inside the placenta if the wife is exposed to herpes infection.

 5- Is it possible to rely on herpes tests after 90 days?

 HSV - 1 IgG.  positive

 HSV - 1 IgM.  negative

 HSV - 2 IgG.  negative

 HSV-2 IgM.  negative

To summarize my understanding, you apparently acquired both gonorrhea and genital herpes from the sexual exposure 3 months ago. Sorry you've had to go through that experience. But the good news is a) the gonorrhea is cured and will not come back, and did no long term harm; and b) your genital herpes is caused by HSV1 and not HSV2. That's good:  most people with genital HSV1 infections have few recurrent outbreaks (although they could occur) and infrequent asymptomatic shedding of the virus. That is, the virus is infrequently present in the genital area, and sexual transmission to partners is rare. You'll need to be aware of possible recurrent herpes outbreaks and, if any occur, to avoid sex at those times. But all things consdidered, the herpes is not likely to be an important issue for you. (More comments about herpes below in reply to your specific questions.)

You remain concerned about HIV, but you need not. There is no possibility you have it. The HIV antibody tests are 100% reliable any time more than 8 weeks after exposure, and your negative result at 90 days is 100% proof you were not infected, and that HIV is not the cause of your possible enlarged lymph nodes.

To your numbered questions:

1) No. Your HIV test results will not change. It is not necessary to test again at 6 months. Of course you are free to do so, but if somehow I were in your situation, I would feel no need for it.

2) Yes, you can safely have unprotected sex with your wife, as long as you do not have symptoms of recurrent genital herpes. Basically that would be symptoms similar to your original herpes symptoms (blisters or sore in the genital area), but milder and not lasting more than a few days. There is a slight chance of transmission of HSV1 to your wife in absence of symptoms, but it is very low; in most couples in this situation, the partner never becomes infected.

3) You probably do not need Valtrex suppression. Such treatment is important in preventing transmission of HSV2, but sexual transmission of genital HSV1 is so infrequent that treatment probably does not add additional benefit. That said, treatment is entirely safe, without side effects. And no, there are no medications or health problems that delay HIV antibody development. The Valtrex has not interfered with your HIV test results so far, and will have no effect if you have repeat HIV testing in the future.

4) Your doctor's information is only partly correct. First, HSV1 genital infection uncommonly infects a fetus or baby (called neonatal herpes). Still, you will need to take precautions. The greatest risk of neonatal herpes occurs when the mom catches genital herpes in the past 3 months of pregnancy. Therefore, when she is pregnant, you will need to be especially careful to avoid infecting her at that time -- maybe to have no penile-vaginal intercourse toward the end of pregnancy. Finally, if your wife DOES catch your herpes before being pregnant, there will be little risk to the baby. Herpes does NOT ascend internally to infect the baby in the uterus; the risk is during vaginal delivery in the presence of an active HSV infection.

5) On rare occasions, it can take 4 months (120 days) for HSV antibody to show up as a positive blood test. You might consider having another test at that time, to make sure the HSV2 test does not become positive. It is very unlikely to do so.

I hope these comments are helpful. Let me know if anything isn't clear. (Dr. Hook commented on possible problems with Google Translate. If you are not 100% certain you understand these replies, consider having a friend with good English skills confirm your understandings, in addition to Google Translate.)

HHH, MD

Thank you doctor, I think I understood your answer.

 But I have some comment on the tests

 I know that first and second generation tests are not used in most countries of the world.

 But what if the test was done with the second generation Elisa technology, will your advice remain at 8 weeks or 90 days?

 What worries me most about gonorrhea infection, I read that it increases the risk of infection with HIV

 Do I need other tests to explain my symptoms Skin rash, slight intermittent burning in urine, pale face

"Skin rash, slight intermittent burning in urine, pale face" A hundred different conditions could cause such symptoms, all more common than HIV. For sure HIV is not the cause. If they continue, discuss with your doctor.

That concludes this thread. Please note that the forum does not permit repeated anxiety driven questions on the same topic. This being your second, it must be your last about this sexual exposure and your concerns about HIV. Repeated questions of this sort are subject to being deleted without reply and without refund of the posting fee. Thank you for your understanding. I do hope the discussions have been helpful. Best wishes and stay safe.