I had an encounter with a high risk couple (male and female, met them online), I know very stupid and regret it. They both performed oral on me and I performed briefly oral on the male (did not take it in my mouth) and there was no ejaculation. There was also penis to anus contact (frottage?) no penetration, I do suffer from an anal fissure though on and off. The next morning I started panicking and enquired about PEP but was told that it is not recommended.
First 7 days,felt very tired and tingling on legs (very worried I am infected) (started antidepressants and Beta Blockers anxiety/panick attacks)
Day 19 I woke up and my mouth was full of painless mouth ulcers (convinced I am infected with HIV)
Around day 22-23 a rash started appearing on my arms. Been checking my body for rash and signs, noticed some brown spots and 2 tiny bright red spots. Body temperature never went above 36.8C, checked it constantly during week 3 when mouth ulcers appeared. But had chills and felt nauseous at times and tingling throat. Checking lymphnodes during this period not sure I could locate the nodes on groin.
I tested in local GUM clinic on day 30 for HIV (doctor and health adviser told me that the test looks for antibodies and p24antigen) -doctor looked at rash on arms and checked lymphnodes. I was convinced that the test will come back positive. Had to wait for a week and kept checking for symptoms and reading about HIV etc. Rash appeared around the side of belly as well -been checking 4-5 times every day.
Day 35 noticed one lymph node as swollen (could see it on mirror).
Day 36 got the results back, clear for all STDs and HIV result negative, a different doctor I saw on that day told me that this covers 3+months so I would need to re-test, I asked her about the HIV test and was referred to the health advisor. The health advisor confirmed that the test looks for AB and p24AG. I asked whether I should test again after 6 weeks and was told I should wait 3 months 'to tick the box' and that it is unlikely that the HIV result will change.
2 days later saw GP and prescribed 'fluoxetine' instead for anxiety/OCD -he said mouth ulcers could be because of dry mouth.
Started calming down but at week 6 the rash is still visible, at times it not very visible, but then becomes very visible (happens throughout the day) and the mouth ulcers still persist. Anxiety creeps up again and even after I got my results I thought that it might not have been detected, because I have thalasemia B trait and it may take longer to produce antibodies or as the people I met visited Cape Verde recently it might be HIV2 that would not show positive with p24antigen test.
Given the description of the symptoms and the encounter could you please advise about the risk and whether my worries are justified? Should I just forget about it and move on, is another test warranted?
Hello,
Thank you very much for your post and welcome to our forum.
First of all I would like to reassure you about your sexual encounter. This did not involve any risk of HIV infection at all whatsoever. You need to have had unprotected penetration and this did not happen. That is the reason why you were not offered PEP in the first place, and in fact you did not have to ahve a HIV test in the first place regardless of the symptoms. I am convinced that most of your symptoms are related to anxiety.
Anyhow, most of the symptoms and the timing do not correlate with acute HIV seroconversion. If any of the symptoms had anything to do with HIV sero-conversion, by definition, the tests that you have had should have been positive (regardless of thalassaemia trait or HIV2) as the antibodies would have been detected. In any case, HIV2 is very rare and much more difficult to be transmitted than HIV1 (therefore that can be totally excluded from your 'no HIV risk at all' sexual encounter).
Your negative test results (HIV Duo) at 30 and 36 days are final and totally conclusive. I can assure you that you are definitely HIV negative and that you do not need any further tests.
Best wishes,
José
Thank you doctor, please allow me a follow up question.
I only had one test though 30 days after exposure and thought that I would calm down afterwards but the doctor at the clinic told me I would need to retest as it only covers up to 3 months -although she was not sure about the test that was used.
The health advisor explained that the test loks for antibodies and antigens (therefore I assume it is termed 4th generation) but she said to retest at three months.
Guilt/anxiety make things worse as I was convinced that the test would turn out positive. Although oral sex is low risk, I thought that the presence of chronic anal fissure would allow an entrance for the virus to the bloodstream from body fluids (pre-cum) -as it forms 'sentinel pile' (mucous membrane??).
Can one test at 30 days be seen as conclusive, there is so much Info on the Internet around this issue althoug I realise I do not do myself any favours by checking for every possible risk and symptom.
Risk and test after 30 days
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