[Question #9320] STIs Concern / Risk - Specially HIV

33 months ago

Hi doctors. 7 months ago I had a sexual encounter with a female street prostitute in Colombia (I clarify this because Ive seen in your responses that there are important differences between high end escorts and street prostitutes). The encounter was protected oral sex for a few seconds and protected vaginal sex, maybe 5-6 minutes overall. After that Ive been having several symptoms that really dont let me move on from this exposure. Starting from testicular pain (4-5 days after exposure. Its still hurting sometimes and acompany by high thigh muscle pain). Also had numerous flu like symptoms, tonsilitis, pharyngitis, some weigh loss, and lost of GI issues (diahrrea, abdominal and stomach pain and such). After the incident Ive done a lot of testing for main STIs almost on a monthly basis, but I will list just some of the times of testing:2 months post exposure I did:Herpes 1&2 Blood testHepatitis C & B RPRHIV Ab/Ag testClamydia blood testUrethral swab test for a list of bacterias including clamydia and gonorrea.ALL NEGATIVE4 months post exposure I repeated all the tests mentioned. ALL NEGATIVEI abstained from sex from my long term girlfriend for 6 months (because of scare of late seroconversion or something for Syphilis and HIV, also indicated by some of my doctors and found online) and at 6 months I repeated all the blood tests for Clamydia, Herpes, Syphilis, Hepatitis and HIV = ALL NEGATIVEI even did a RT-PCR HIV 1 test at almost 6 months and came back undetectable. Also did FTA-ABS test, also negative.At almost 7 months I did a urine test for clamydia and gonorrea (and some other bacteria) and at 7 months I did another HIV test, but this time I went to another lab that didnt offer the 4th gen test so I got a Abs only test and a Antigen P24 test seperately. The urine test and HIV came back negative.Im extremely worried because everytime I test, another symptom come up. After my 6 month HIV test, I started having night sweats (first time in my life) waking up in th

33 months ago

Tests Ive taken at 2, 4 and 6 months:

Herpes Blood test

Hepatitis C & B

HIV Ab/ Ag test

RPR

Clamydia blood test

Tests at 2 & 4 months:

Urethral Swab

Test at 6 months:

FTA ABS

RT-PCR HIV 1

Test at 7 months:

RPR

HIV 1/2 Antibody only test

Antigen P24 test

Why do I keep having symptoms??

Is there a risk for HIV 2 for my exposure?

What else could I do?

After 6 months I resumed sex with my partner and 1-2 weeks later she started having symptoms like night sweats and sore throat.

33 months ago

Sorry docto one last thing just to clarify, All these test were done at a lab with blood taken from my vein.

Also did urine test for STIs at 7 months.

All the test I have mentioned came back negative / non reactive / undetectable

Edward W. Hook M.D.

33 months ago

Welcome to our Forum and thanks for your questions. Thanks as well for your commitment to safe, condom protected sex- even with higher risk "street" commercial sex workers, condoms used throughout sexual encounters reduce the risks for all STIs, some (such as HIV, gonorrhea, chlamydia, hepatitis) to virtually zero and for some (such as syphilis or herpes), while they do not totally eliminate risk, the greatly reduce risk. The proportions of persons who acquired STIs while using condoms is very, very low, approaching zero.

I will not review your test results one-by-one as they are all negative and have been taken at times when your results are reliable and conclusive. You did not acquire an further STI (including HIV) from the exposure you describe above. FYI, when health care providers are evaluating patient symptoms, they use tests to both make diagnoses and to prove that the problems tested for are not present. Because some STIs (HIV in particular) can cause such a variety of symptoms, tests for HIV are used in this way-i.e. to eliminate the possibility of HIV as a cause of symptoms. Your testing has proved that you did not acquire an STI. No further testing is needed and to continue to test for STIs would be a waste of time and resources.

Please note, I am not questioning your symptoms- there are many possible causes. Your testing for HIV and other stis however proves that your symptoms are not caused by HIV or other STIs. At this time I would urge you to work with a trusted clinician whom you feel you can communicate with and look for other, non-STI causes of your problems. EWH

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33 months ago

Thanks for your answers and believe me Im doing my best to move on from this, but everytime theres a new symptoms or something else and theres always that small possibility of this tests failing.

1) My doctor told me if in the extraordinary case I was exposed to HIV 2, it could take 9-12 months to present detectable antibodies levels, is this correct?

2) One of my biggest concerns is that the labs Im using (I live in a third world country) are not up to the standards of testing and reliability could be an issue. Is this something that should be a concern or I can be sure Im getting good tests?

3) The lab assure me I was getting a 4th gen test for HIV. Could this test have versions of less reliability? I understand they use some other method than ELISA to test, and only if the results are positive they confirm it with ELISA method. Does this affect something?

4) There are A LOT of opinions regarding Syphilis testing. The last test I took was 4 weeks after getting 10 days of Augmentin, does antibiotics of this kind or any else affect the test? RPR is a good reliable test?

Edward W. Hook M.D.

33 months ago

Straight to your questions:

1) My doctor told me if in the extraordinary case I was exposed to HIV 2, it could take 9-12 months to present detectable antibodies levels, is this correct?

I'm afraid your doctor is incorrect. Tests would provide conclusive results of tests for HIV-2 at 6-8 weeks. Further, when symptoms are present, even with HIV-2, tests are always positive.

I would not worry about this. The performance of lab tests for HIV globally are superb.

No, you can believe your test results. There are many different formats of tests for HIV but they all perfrom equally well

The RPR is an excellent test. Further, as an FYI, 10 days of Augmenting would have cured syphilis is present.

Please believe your test results. EWH

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33 months ago

Thanks doctor. Just a few final questions:

1) There are a lot of theories out there about people not testing positive for HIV for quite a while. And while I know most of this is virtually a myth as Ive seen in this forum, there are always some any other case of someone who actually failed to test positive for whatever reason and potentially miss an early detection. Do you think theres ANY way that my 6 months o 7 months post exposure tests can be wrong for any reason, and that I could test positive later on lets say maybe 1 year after exposure? Any reason at all

2) You mentioned that Augmentin would've cure if Syphiis was present. I understood only a shot of penicilin could guarentee a cure of this disease. This isnt true?

3) Could antibiotics affect in any way the tests I took? As I mentioned I took antibiotics 4 weeks between doing RPR test and urine test for Clahmydia and Gonorrea.

4) In the case of Hepatitis and Herpes test, is 6 months enough time to detect any of this?

5) Should I for any reason abstain from sex with my partner any further? I resumed sex after getting 6 months negative tests on everything, but then I got new symptoms and she starting feeling ill as well so Im really worry.

6) Is there anything else I should be looking into that maybe Im not seeing this far? Any other STI or something

Thanks

Edward W. Hook M.D.

33 months ago

Final responses:

1. By “out there” I presume you mean the Internet. Such statements are wrong. There is simply no possible way that you could have HIV from the encounters you described. Believe your test results. Please!

2. Recommended therapy for Syphilis is a single injection of benzathine penicillin, a long acting penicillin. However, Augmentin contains amoxicillin which is a form of penicillin. The Augmentin you took would have cured Syphilis.

3. No way

4. Yes.

5. I see no reason from What you say to abstain from unprotected sex.

6. There is no evidence whatsoever that this is an STI. You need to put those concerns aside and look for what is truly causing your symptoms by interacting with a trusted clinician.

This completes this thread. Please don’t worry about STI’s from the counter she described. EWH

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33 months ago

Thanks doctor. If I may ask one last question.

How effective is the HIV RT-PCR test at almost 6months post exposure? I understand theres a possibility I have undetectable viral load even if Im infected. Is this true? How could I be sure Im HIV free?

Edward W. Hook M.D.

33 months ago

For you RT-PCR will add nothing to your evaluation. Like your tests for HIV, it will be negative, proving once again that you did not get HIV from the encounter you described.

This completes this thread which will now be closed. EWH

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