Your concern is reasonable; certainly some aspects of this could suggest HIV, syphilis, or mononucleosis;  no other STD comes to mind. Therefore, my first response is to confirm that his recent tests included an HIV blood test. If so, and if negative, it proves with 100% certainty he does not have HIV. It is not possible to have symptoms of acute retroviral syndrome (ARS, i.e. initial HIV infection), or any ongoing symptoms of HIV or of the infections that result from immune deficiency, and not have detectable HIV infection. So if he was tested, HIV isn't an issue.

Another factor arguing against HIV is the repeated or ongoing nature of those symptoms, apparently for several months. ARS doesn't do that:  symptoms of ARS -- which can include enlarged lymph nodes ("glands") in the neck, fatigue and sore throat -- start within 1-2 weeks of catching the virus and clear up within 2-4 weeks. It doesn't cause ongoing or recurrent symptoms after that. Infectious mononucleosis, which can be sexually transmitted (and also transmitted through saliva and hence by kissing), but like ARS typically lasts only a few weeks. Do you know if he was tested for it? Secondary syphilis causes lymph node enlargements, but usually not sore throat; in any case, assuming he has had a negative syphilis blood test, that also can be ruled out.

Strictly for him, not likely to be an issue in terms of sexual safety -- is whether he has some other sort of immune deficiency (i.e. other than HIV). If he continues to have recurrent symptoms along these lines, he should consider seeing an internal medicine specialist or infectious diseases specialist. This probably is very unlikely, but something to keep in mind.

Finally, all this of course assumes he has in fact been tested for HIV, syphilis, and perhaps mono. If not, of course such testing should be done right away, before you decide to be sexually active with him.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I asked him if he was tested for hiv and syphilis at his most recent check, and he said yes, but he was little fuzzy on the details when I probed - I asked if it was a blood test, he said "I think so"....where do they draw the blood? "I think my arm." I asked to see the results, he said, "I'm not sure how to get those" ...since it was urgent care, not his doctor. I did not ask exactly how long ago this STD test was either, but he denies having any new partners since.

I think he said he was tested for mono, but that was also negative. He has mentioned going to the doctor a few times for STD checks in the past and starting antibiotics then discontinuing after getting negative test results.

I found it odd he would take antibiotics after last's week 3-4 day acute illness, I'm not sure if he was prescribed something or not. 

We have only been kissing and he we did engage in "light" mutual masterbation (he fingered me, I touched his penis), is there any HIV risk with that?

Do you think having sex WITH condoms or unprotected oral sex is too risky at this point?

Would an HIV finger prick or Oral swab test be accurate if it was in fact or previously ARS?

Do you think it would be unreasonable for me to ask him to test again (with me, as I was going to do it too before sex). I"m not sure how to frame this in a way that is not accusing him of lying but also expresses the need for safety if that makes sense?

Thank you!

That said, it sounds very likely he was tested for both HIV and syphilis; and if the result of either had been positive, he would have been contacted by the clinic where the test was done, or by your local or state public health department. Still, you'll have to make your own choice about going ahead with intercourse. Condoms are extremely good in preventing HIV, but not perfect:  they do break sometimes, can slip off during sex, and so on. However, there is for sure no HIV risk with your sexual practices so far:  HIV is not transmitted by fingering, hand-genital contact, or kissing.

HIV finger prick blood tests are very good, but I would avoid the oral swab test. It misses 2-5% of HIV infections. (See the thread immediately before this one, no. 9772.)

You know your partner and I do not; I cannot judge his likely response to being asked to be retested. We're STD/HIV experts, not psychologists or relationship counselors. That said, if he resists a sensitive and caring request, and doesn't care enough to do it if only to please you, maybe it raises a red flag about the future of a relationship with him. But only you can decide that.

Thank your perspective, I may ask him to re-test with me as a "fresh start" .....So to clarify the rapid HIV prick test at this point (based on what you know about him) would be accurate? If it is negative, we are good to go? 

Thanks!

Oral sex and condom protected vaginal sex are highly safe, with little or no risk of HIV, but some modest risk of other STDs. Based on the time frame, there is no realistic possibiiity his lymph nodes etc are due to HIV. But of course that assumes it has been the same condition all along, and that he hasn't had more recent sexual exposure and thus at risk of HIV acquired in the week or so before onset of his current episode.

That completes the two follow-up exchanges included with each question and so ends this thread. I hoe the discussion has been helpful. Best wishes and stay safe.