[Question #9850] Symptoms after sexual encounter

28 months ago

Hello, 34 male here. On 1/27/2023, I had unprotected sex with a girl I knew for a short period of time. I sucked her breast and tried to insert my peins in her vagina but I ejaculated before penetrating her. I tried to penetrate her vagina but my peins was not fully erect and I may have penetrate her by the tip of my peins only. It was very brief and we stopped in minute or two. After a week or ten days my symptoms started. (Tingling on peins tip with no rash to this day, eczema on my hands, itchy rashes on pubic area but goes fast, loss of appetite and nausea, random body rashes that comes and goes, low sex drive,fatigue and headache, and feeling lethargic). I went to urologist and he prescribed me doxycycline for five days and took urine and swap sample from my the inside of my peins. Met him after five days and he told me that all the result was fine. Got full std panel after four weeks of exposure all were negative including combo hiv test. Now the fatigue and headache disappeared but I still feel random pins and needles everywhere including my peins but with no rash, random itchiness, white tongue, dry skin, low sex drive, and frequent urination and soft dark stool. I took another hiv test on the day 62 and it was negative. I want to know your opinion.

28 months ago

I may add also after a month of exposure I had pain in my shoulders and armpits but now it is gone after two months. I went to 3 doctors and done a blood work they said I’m totally fine and the girl that I had the encounter with I still talk to her and she is healthy and I ask her to do tests but refused saying she is fine.

H. Hunter Handsfield, MD

28 months ago

Welcome to the forum. Thanks for your confidence in our services. Also thanks for a very clear description of the sexual exposure, your symptoms, and your medical evaluation and treatment.

I agree with the three doctors you have seen. It is clear you have no STD from the events described. There are no STDs at all that cause the various symptoms you describe. I think you're most concerned about HIV, which is understandable -- it's by far the most dangerous. And some (but not most) of your symptoms could occur in people with recently acquired HIV infection. However, the negative HIV blood test 2 months after the event proves for sure you did not acquire HIV and that something other than HIV explains your symptoms.

Why am I so sure? First, the standard HIV blood tests (either the AgAb [4th generation] and standalone antibody tests [3rd generation] always are conclusive by 6 weeks and 8 weeks, respectively. Second, the symptoms of ARS (acute retroviral syndrome, caused by new HIV) are not caused by HIV itself, but by the immune response to the virus, and the immune response is measured by anti-HIV antibody. Therefore, it is not possible to have symptoms from HIV with a negative HIV blood test. Period -- never any exceptions.

You were at little or no risk for HIV anyway. The chance a partner like yours has HIV is under one in a thousand; and even with unprotected vaginal sex to completion, when the female partners HIV, there is one chance in 2,500 the male will catch it. With barely successful penetration, your risk was a lot lower than that. The other aspects of your exposure (such as mouth contact with breasts) is zero risk for STD.

As for other STDs, the risk was a bit higher, but still quite low, and your negative urethral swab tests assure you didn't have gonorrhea or chlamydia, and the doxycycline prevented them as well as syphilis. Finally, I'll repeat that neither HIV nor any STD causes the large majority of the symptoms you describe. Many of them sound like anxiety magnifying minor symptoms or even normal body sensations that otherwise you would not worry about and perhaps not even notice.

So all is well. If you have ongoing symptoms that concern you, keep working with whichever doctor seemed most competent and sensitive to your issue, then follow her advice. But you can be 100% certain you not have HIV or any other STD from the sexual exposure described. If you have a regular partner, you should continue your normal sex life with that person without worry.

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

HHH, MD

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28 months ago

Thank you Dr. Handsfield for your valuable insight, it really helped me to understand my condition. Because as you said, many of my sympathies resembles HIV symptoms that are mentioned on many medical websites, and that build up a huge stress and anxiety inside me, but the test results and my doctors opinion and support made me avoid the breaking point.

I would like to add that I had HIV RNA test on the day 55 after exposure and the result was undetected, but I couldn’t add it for the words limit.

I feel much better these days, however, I booked an appointment with infectious disease doctor and I will see him after two days to address my symptoms and recheck in case something went unnoticed.

I hope will through all of that behind my back it was the worst two months of my life, and thank you Dr. Handsfield for your support.

H. Hunter Handsfield, MD

28 months ago

Thanks for the follow-up information, and thanks for your thanks. I'm glad to have been of help.

Your negative RNA test really wasn't necessary, but it confirms you don't have HIV. You can expect your ID consultant to confirm all you've been told already, both here and by your doctors. But if you believe you will benefit from another reassuring opinion, follow through as planned. Threads are closed after 28 days or two follow-up comments with replies, so you have one more coming. Perhaps you'd like to hold off until you've seen the ID doc; I would be interested to hear how that shakes out. In the meantime, stay mellow. You're fine.

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28 months ago

The day after meeting with my ID doctor I got covid. He ordered full std panel. I was really hit hard by covid, put after a while I got better and my old symptoms also have gotten better (I don’t know what is the correlation here but that is weird). My follow up appointment was on the phone due to my condition and the doctor told me that all test results came back negative and that his job is done. I really like to thank you Dr. Handsfield for your support and expert opinion, it really helped me and as you said, it might be due to stress and feeling of guilt. Being in quarantine let me take a break from life and feel less stressed and be focus on recovery.

Thank you again,

Warm regards,

H. Hunter Handsfield, MD

28 months ago

Sorry to hear about your covid! But glad to hear you're through the worst of it, and you found a silver lining from being quarantined. And to know that you've been happy with our services. If you're so inclined, consider going to the home page of the forum sponsor (www.ashasexualhealth.org) and consider a donation!

I'm glad to have helped. Best wishes and stay safe.

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