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Hi doctors

I'll apologise in advance for the length of this message, but I'm a total mess over this whole episode....

I'm a 32 year old heterosexual male, and suffer from type 1 diabetes. Basically 8 weeks ago I was really drunk - I met a woman (unknown status) in a nightclub and ended up kissing and I also fingered her briefly. Once I left the nightclub, I realised that the skin on some of my fingers was broken/cut (it was a cold night and my knuckles were dry and broken). A couple of days later I started thinking about putting myself at risk.

I came to your clinic to see Dr Tryer who gave me some excellent robust advice that there was no practical risk, but if I experienced any symtoms I could come back and do the 28 HIV DUO test.

Things just went down hill from there:

Day 9-10: developed white tongue, felt like I had thrush
Day 10-11: started getting sore throat and felt achey, really lightheaded
Day 12: went to see my GP and he advised same as Dr Tryer (little/no risk) and gave me some antibiotics to clear up the throat - this did clear up within about a week
Day 17: noticed I'd lost quite a bit of weight (I don't regularly weigh myself but think I myabe lost half a stone within a couple of weeks - I'd willingly put this down to the anxiety though...) - also been bruising easily on injection sites (I take 4 times daily insulin)

On day 27/28, I came back to your clinic and saw Dr Tryer again. I did a HIV DUO test which came back as negative, and thought I'd finally get on with my life...

But I've been consistently getting (since probably the time I got the sore throat) a pain in the lymph nodes in my groin. This is like a dull aching, and the nodes look swollen to me. I accept that I have been prodding them, which I'd trying to stop doing, but it also feels like the other nodes in my body have come up again in the last week (including my armpits, my chest, behind my ears, even behind my knees sometimes aches). It's quite painful, especially in the groin. This has actually gotten worse recently and is really wearing me down.

I've been to see my GP again last week, and he ran some blood tests on me (no HIV test as he felt too early for the NHS test). He advised that if I had HIV, he should see a definite "footprint" in the blood results, and he felt it was virtually impossible I had it. He had a look at the swollen nodes but basically couldn't find a reason for them swelling - he suggested waiting a 3 months and doing the HIV antibody test, or otherwise having a biopsy of the nodes.

I've not had a fever or any rash (at least that I have noticed) throughout the episode.

This is stressing me out so badly, and I'm a natural worrier as it is... Here are my questions:

(1) Based on what I've said above, is fingering like this any real risk of HIV? Have you ever encountered anyone developing HIV from this?
(2) Is the 28 day HIV DUO test conclusive for me? Based on the achey lymph nodes, should I consider re-testing now (week 8) or at week 12 for a definitive result?
(3) If the sore throat symptoms etc were ARS symptoms, then surely the p24/antibody DUO test would have been positive wouldn't it?
(4) Are there any other STDs I could have caught from this which would cause these sort of symptoms - in particular the lymph nodes? Are swollen lymph nodes from ARS usually this persistent - now been going on for weeks it seems
(5) Is being diabetic any increased risk or variation on what you'd expect from a normal person exposed to HIV?

Thanks so much for your time, your're prpoviding a great service on this forum - I'm just so terrified of the consequences of what was a really silly mistake...

[Dr Jose]

Hello,
Thank you very much for your post.
Let me reply to each of your questions one by one here below:

(1) Based on what I've said above, is fingering like this any real risk of HIV? Have you ever encountered anyone developing HIV from this?
Fingering does not involve any HIV risk at all whatosever. In many years working in this field, I have never come accross anybody becoming infected this way!
(2) Is the 28 day HIV DUO test conclusive for me? Based on the achey lymph nodes, should I consider re-testing now (week 8) or at week 12 for a definitive result?
Your negative HIV Duo test performed at 28 days is final and fully conclusive without the need of requiring any further test. I can assure you that you DO NOT have HIV and that the lymph nodes have absolutely nothing to do with HIV
(3) If the sore throat symptoms etc were ARS symptoms, then surely the p24/antibody DUO test would have been positive wouldn't it?
Exactely. That is by definition. If they had anything to do with HIV sero-conversion, then the test had to be positive, and it was not.
(4) Are there any other STDs I could have caught from this which would cause these sort of symptoms - in particular the lymph nodes? Are swollen lymph nodes from ARS usually this persistent - now been going on for weeks it seems
Your symptoms are NOT typical of ARS. Swollen lymph nodes can be a symptom of hundreds of conditions. I do not beleive that they can be related to any STD or STI becuase your penis was not used in this incident. Therefore they cannot be related to it.
(5) Is being diabetic any increased risk or variation on what you'd expect from a normal person exposed to HIV?
Not at all.

Best wishes,

José