[Question #9670] Response to Question #9665

30 months ago

Hello again Dr. Hook,

I know you told me there isn't a need to return to the site. But I had few doubts. Also had few things to say.

Firstly, I had to mention that I did get sick around January. I had diarrhea constantly. Had some gastro issues as well. Sore throat too. But all these subsided after few days. Could these be related to HIV/ARS. Would this change your assessment?

Talking about the present, I've been sick for a week now. I wake up super fatigued, with headaches, muscle aches, sore throat and joint aches. No amount of rest is helping me out and it gets me worried. I started getting new symptoms like dry mouth, diarrhea and nausea as well. I've lost my appetite as well. I'm getting chills too. The doctor who examined me earlier did say that my tonsils are swollen but said there is no infection after seeing the CBC. I feel some kind of swelling under my neck, armpit and the groin. I am unable to walk with these joints aches and muscle aches. The fatigue makes me wanna sleep all day.

I read from somewhere that the risk of one unprotected insertive vaginal exposure is 1/2500.. Is this only for circumcised men? I am not circumcised. I don't see myself getting better but worse. I'm just getting more symptoms as we speak. Would I be that unlucky to get it from this low risk? Would I test negative if I get tested? I know I would move on if it is negative. But I'm scared to get tested. Would your assessments change? I'm constantly worried if I'll test positive. I'm not sure if her ex partners were negative either.

H. Hunter Handsfield, MD

30 months ago

Welcome back to the forum. I'm taking this question, but I reviewed your recent discussion with Dr. Hook. I agree with all he said.

The answers to these questions should be obvious from that discussion. The exposures described did not put you at risk for HIV, assuming your regular partner -- the only person with whom you had unprotected sex several weeks ago -- doesn't have HIV. As for your symptoms, they are not typical for acute retroviral syndrome (ARS, i.e. initial HIV infection); and as Dr. Hook advised, they came on much too late to be ARS from that exposure. And it remains the fact that your subsequent sexual exposures could not possibly result in HIV infection.

Being uncircumcised roughly doubles the risk of catching HIV, but first you have to be exposed. And "double" doesn't actually mean very much: the risk from unprotected vaginal sex with an infected partner would still be only 1 in a thousand instead of 1 in 2500. And that was too long ago anyway.

Dr. Hook's closing advice was that you consider HIV testing, despite the near zero risk you have it. I agree. Clearly repeated reassurance on this forum is not going to be sufficient to settle your fears, but a negative HIV test should do so. A negative HIV antigen-antibody (AgAb, "4th generation") blood test at this time would prove your symptoms are not caused by HIV and that you were not infected during the unprotected exposure last December. You also could ask your partner to be tested for HIV; if her test result is negative, you will know for sure you were not exposed.

I have zero sympathy with "I'm scared to be tested." It isn't the test that gives someone HIV; you have it or you don't. I am convinced you do not, but if somehow you are infected, you have an absolute, unavoidable responsibility to yourself and your partner to know it and get treated. And research and clinical experience are that when someone is afraid of testing and finally does it, anxiety always decreases, even if the result is positive: the uncertainty is more stressful and anxiety producing than the "wrong" result. (This is the same for all tests for potentially life threatening diseases: women with breast lumps who fear mammograms, colonoscopy for persons at risk for colon cancer, etc, etc.)

Therefore, I will be happy to comment again if and when you have been tested for HIV and return with a follow-up comment to tell me the result (or if your partner is tested and you would like to report her result). But I will have no other advice or comments until then. Do it soon: threads are closed after 28 days. In the meantime, I hope these comments are helpful.

HHH, MD

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30 months ago

Hi Dr. Handsfield,

I'm still not sure if she is negative. Here is why. She did test negative in March 2022. But before the test. In march itself, she was with a girl who used a dildo on her. During that exposure, the girl had used it on her before immediately using it on my partner. Wouldn't that be a huge risk? She did get a yeast infection after that exposure. Now if she got HIV from that, wouldn't the test in March not detect it? That means we still don't know if she's negative or not. Wouldn't that put me at high risk? Anyway, I've convinced her to get tested tomorrow. I'm really afraid if she'll test positive doctor. Is there any chance she'd test positive? Especially after the dildo incident.

30 months ago

Hi doctor, she'll be getting tested tomorrow. I've started getting painless mouth ulcers as well. Which is yet another symptom. My anxiety is off the roof thinking about tomorrow. I had to go to the doctor again from my throat. And he still refuses that its HIV. He told me its very very rare to get HIV from a single exposure. He told me to take a test For Syphilis too just in case. Would I test positive doctor? What do you think? Dr. Hook said he's confident that its not HIV. After I heard about the dildo incident, I'm not so sure. I spoke to her ex partner. He said he had checked himself after their exposure. He told me he's clean. But I'm not sure when he got tested. It all comes down to if she's negative tomorrow.

H. Hunter Handsfield, MD

30 months ago

As I said, I will comment again when you report your HIV test or your partner's, preferably both. In the meantime, the answers to these questions all are a loud NO. They do not elevate your risk of HIV or change my opinion or advice. (What in heaven's name makes you think using a dildo is a risk for HIV????)

This thread will be closed after one more reply, no matter what it is; and because repeat questions on the same topic or exposure are not permitted and this is your second, there won't be any more.

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30 months ago

Hi Doctor, Maybe I might have phrased it wrong. What I meant was.. Before my partner's test in March 2022. She had a sexual encounter with another girl in March itself. The other girl used a dildo on my partner. But before using it on my partner, she used it on herself. They shared a dildo basically. That's what I meant. And since the dildo wasn't very clean, my partner ended up getting a yeast infection then. The other girl used it on my partner immediately after using it on herself. Since the other girl's vaginal fluids were still on the dildo. Wouldn't it be a HIV risk when the same dildo was used on my partner? And then increase my risk as well? Also, I have a lot of mouth ulcers now. Since yesterday, I've been having a lot of painless ulcers inside my mouth. That got me extremely worried since I read that it is one of the biggest ARS Symptom. Please do correct me if I am wrong. Also, it was mentioned that the ARS Symptoms do not occur after 31 days. Why? Is there any scientific reason behind it? Mine started after 40 days I suppose.I do not feel any better. And if the tests come out negative, I'll have to see a local infectious disease doctor to actually figure out what is wrong with my health. I apologize for constantly asking about the same exposure doctor. I have understood that it is a low risk exposure. But each time I remember a detail, I feel it should be assessed. I hope I test negative since my doctors, you and Dr. Hook are confident that its not HIV. Take care doctor. God bless both of you.

H. Hunter Handsfield, MD

30 months ago

The more detailed dildo history does not suggest HIV risk, shared or not. If your partner's friend is not an injection drug user or sex worker, there is almost no chance she has HIV. And no, oral ulcers are not "one of the biggest" ARS symptoms, but one of the least common. And it remains true that ARS symptoms cannot start later than about 10 days after infection; it has to do with the biology of HIV replication and the immune response to it (which is the cause of symptoms, not HIV itself).

You have been advised about the way to get yourself beyond your irrational worries about having HIV. Your partner's negative test, when you learn it, is not going to free you of this obsession: clearly you are going to continue to believe you might have HIV until you have your own negative test.

Perhaps you'll also like to know that in the 19 years of this and our preceding forum, with thousands of questions from people worried they had HIV -- including hundreds who were "convinced", as you seem to be -- not one has yet turned out to be infected. You will not be the first. If and when it happens, it will not be from a trivial risk exposure like yours, or with atypical or mis-timed symptoms.

That concludes this thread. As noted above, repeat threads on the same topics are not permitted; any more from you along these lines will be deleted without reply and without refund of the posting fee. The policy is based on compassion, not criticism; experience shows that continued replies tend to prolong anxiety rather than relieving it. And ASHA does not wish to collect fees for questions with repeated or obvious answers. Finally, such questions have limited educational value for other users, one of the forum's main purposes. Thank you for your understanding. (But I'll make a deal with you. If you test positive, please return to let us know and we will return your posting fee. I am confident this will not happen.)

I'm sorry you're having such trouble accepting and believing the reasoned, science based reassurance you have had, both on this forum and from your own doctor. But I do hope our comments have helped a little bit.

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