- Testicular pain

- Split and weak stream while urinating

- Pain/discomfort while sex and after ejaculating specially in testicles

- Colds and flu symptoms that dont go away (Had a case a swollen tonsils and sore throat almost monhtly. Goes away and then come back)

Ive had a lot of tests past few months but most recently: Urine test at 7 months, all negative. RPR and Ag/Ab HIV test at 6 months, both non reactive. All of these done in a lab with urine sample first void in the morning and blood from my vein.

Questions:

1) What could be causing my symptoms? Most of them start maybe a week after the encounter. Specially testicular pain and symptoms around that area

2) Ive had a few rashes, now I have a rash in my chest, could this be Syphilis? How sure can I be about my negative RPR at 6 months?

3) How sure can I be about this HIV test? The method used was QEIA and I cannot find info about that method online. Results are always quite fast like a few hours later, is this a rapid test? I understand rapid test are not as accurate as other tests. Hypogammaglobulinaemia can cause false negative, how can I know I dont have that? What about Ag-Ab complex formation?

In response to your specific questions:

If you were tested with a licensed test for HIV any time more than 42 days after the exposure, your results are conclusive.  

I hope these comments are helpful.  In addressing this, my suggestion if to take one of two paths.  One would to see a urologist and discuss the possibility of the Chronic Pelvic Pain Syndrome (CPPS) which is well described ion Wikipedia.  It is not an STI but is common following risky encounters.  Alternatively, and to be honest, perhaps less productively, would be to see an infectious disease specialist to look for other causes of your symptoms.

Again, I hope these comments are helpful.  The symptoms you describe do NOT suggest an STI despite the proximity of your exposure tp their onset,  EWH

- Chlamydia trachomatis

- Neisseria gonorrhoeae

- Mycoplasma genitalium

- Mycoplasma hominis

 - Trichomonas vaginalis

- Ureaplasma urealytium

- Ureaplasma parvum

All this were "non detected"

This would rule out your suggestion of additional tests right?

1) You mention CPPS is not a STI but is common after a following a risky encounter, why is this?

2) About my RPR test, I dont actually know if it was before or after the rashes, but it was 6 months after encounter. If the rashes appeared after this, should I test again??

3) I took the HIV test in the most "famous" and big private lab in my country. What worries me is that the test costs around $7 dollars and that seems cheap, isnt it? My main concer with HIV is that I keep feeling sick and have all these recurrent colds and sore throats, maybe my immune system is compromised somehow?

4) Cant my urine test have shown some false negative? I read chlamydia could cause testicular pain and some of my symptoms.

5) Could you address some of the possibilities of false negatives HIV test I mentioned in my original question?

1.  As described in the Wikipedia piece I suggest you look at, the cause of CPPS is unknown.  Please read the piece i suggested

2.  If you had syphilis, at six months an RPR would definitely have been positive.

3.  Even with a compromised immune system an HIV test performed at a reliable lab, which sounds to be the case for you, would be positive.

4.  As I explained above, there are many possible causes of some of the symptoms you reported.  The purpose of testing is both to establish and to rule out possible causes.  Your negtive chlamydia test rules it out as the cause of your discomfort.  

5.  Hypogammaglobulinemia is a rare, severe illness characterized by lifelong, recurring severe infections.  You could discuss the possibility with your doctor but I sincerely doubt that you have it and, even if you did not produce antibodies to HIV, the antigen detection portion of your HIV test would be positive.

You need to accept that your symptoms are not due to HIV or STIs.  EWH

1) My HIV test was indeed done in a reliable lab and I'm pretty sure the test is also machine automatize. I know this would be kind of repetitive but I just need to understand the reassurance that my six months post exposure HIV test is 100% conclusive and I wont be surprised with a positive result later on. If you look into some HIV forums online about people who actually are living with the disease you encounter numerous cases of people stating how the diagnose was not as straight forward as one would think, a lot of them stating that they tested negative for several months before finding out with a RNA test or because they were finally hospitalized and another tests were done. That's my main concern and I would ask you, how are we so certain about Ag/Ab results when we see all this cases and testimonies of people actually living with HIV were the test alone didn't quite made the cut. How can this cases be true? Can I really rely on my negative test of 6 months?

2) To be specific, I've had 3 cases of tonsillitis in the last 3 months. Does that seems normal for you? I know is far too long for ARS but maybe if my immune system actually being compromised by a already settled HIV infection? Any ideas?

3) Kind of repetitive as well but I just want you to know along with a RPR negative at 6 months I also did FTA-ABS at 6 months and was also negative. Can I absolutely rule out syphilis or in any way I should test again?

4) In your first answer you mentioned "urinary frequency" as one of the symptoms, but I didn't mention that. Is what one of the symptoms that would make a stronger case of what? CPPS?

5) Could the use of antibiotics such as azithromycin and amoxicillin could blunt test results for RPR and urine test for all the bacteria I mentioned? Causing a false negative result? (I took this maybe 3-4 weeks before having the urine test for all this bacteria) Could one or more of this bacteria be actually present and the antibiotics altering the test? Maybe this could explain my symptoms

Thanks again for your work and patience while answering this questions. Really helping me out.

Sorry forgot last question:

 Anxiety is a contributor to some cases of CPPS.  When persons are concerned about an encounter, there is a tendency to become "hyper"-aware and to notice otherwise normal sensations which would be overlooked or discounted if the person were not anxious or perhaps feeling guilty.

1.  HIV antigen/antibody tests are amongst the most reliable tests in all of medicine.  Results are conclusive at any time more than 42 days (6 weeks) after an encounter and remain positive thereafter.  The information you cite may be incorrect or related to the tests used years ago.

2.  Recurrent tonsillitis is not a sign of immunodeficiency.  It is a reason to see an ENT clinician to determine if you need your tonsils out.

3.  The RPR and FTA-ABS tests diagnose syphilis by looking for different types of antibodies to the bacteria that causes syphilis.  Your negative tests conclusively prove that you do not, and never have, had syphilis

4.  Urinary frequency may be present in CPPS or urinary tract infections.  It is not a sign of STI.

5.  These antibiotics might cure an infection if present but if persistent symptoms were due to infection, tests would be positive.

6.  HIV 2 is rare, even in countries where it is relatively common such as India or West Africa.  The antibody test in current tests for HIV is used to diagnose HIV-2.  Your symptoms are not suggestive of HIV-1 or HIV-2.

This will complete this thread.  You really need to move on.  If you cannot control your ongoing concerns, I suggest you seek counseling to address them.  Take care.  EWH