Believe my results or bad symptoms?

[lostone43]

Greetings.  I am a male age 40. On October 18th I fingered a girl.  I used my left hand(my right hand had a three day old cut). I also used a vibrator on her vagina.  I did insert the toy using BOTH hands.  When I pulled the toy out it had blood on it.  I checked my hands and saw no blood.  The girl agreed to be tested.  She tested negative.  Her last partner was 6 weeks prior to the test.  

On November 15th I got Dr confirmed thrush.  

On November 18th (31 days post exposure) I had a duo test conducted.  The result was NEGATIVE.  The hospital counselor advised this was conclusive and I really didn't need the test.  

Well I thought I was safe but on October 21st I got minor angular chelitis on one side of mouth(I have had this before).  My Dr said it was minor and very common just let it be.

I also had a rapid antibody test today.  It was NEGATIVE.

My questions:

1. Can I sleep safely with my wife?

2. Can I move on?

3. Did I have a true risk(no anal no oral or no vaginal sex took place)?

4. Was my duo at 31 days proof something else is causing my health problems.

Thanks and happy turkey day.

[H. Hunter Handsfield, M.D.]

I'm sorry to hear about your perianal abscess; I'm sure it was quite uncomfortable.  But this has nothing to do with HIV and your previous tests remain valid.  Indeed it is "just bad luck" and you don't need any more testing.

That's definitely all for this thread.  Do your best to move on without worry.

[lostone43]

I am sorry for adding to my case.  I woke up today with a lump by my anus.  I immediately went to the ER.  They said I had an abscess.  They immediately drained it.  They also gave me antibiotics.  Unfortunately I spent the day in the ER.

Do I need more hiv testing? (Or am I just having bad luck)

[H. Hunter Handsfield, M.D.]

Of course you're the only one surprised by your test result.  But thanks for the thanks; you're welcome.

[lostone43]

I was excited and shocked to report my negative duo that I forgot to thank you.

[lostone43]

I like many suffer from hiv terror.  I went back and had a final duo test today (Abbott architect).  SHOCKINGLY it was negative!!!!!!! Can you believe it.

I'll return to dermatologist if the sore on arm remains.

[H. Hunter Handsfield, M.D.]

Since it is not possible you caught HIV, any and all symptoms you have now or may develop in the future cannot be due to HIV.  Stop worrying about it.

That's all for this thread.  Do your best to move on.

[lostone43]

Dermatologist said he thought it was bruise or scrape but not fungal.  My concern is what if it WAS fungal?  Do I need more tests?

[lostone43]

Yesterday's test was 53 days past exposure.

[lostone43]

Since my last post I noticed one brown sore on my elbow.(8 days ago) I went to a dermatologist he advised that it did not appear to be fungal.  He thought it was a bruise.  

My question is if this WAS fungal would you advise further hiv testing?  I did have one additional antibody test yesterday it was negative.

Thanks

[H. Hunter Handsfield, M.D.]

See my reply to question 1 above.  I haven't changed my mind!

Thanks for the thanks and the holiday wishes.  Same to you.

[lostone43]

Thanks so much for your detailed response.  I will discuss the info you provided with my primary care physician.

Considering all of the oral conditions I described in my post can I still move on and sleep with my wife safely?


Thanks and happy holidays!!!

Ps- I won't ask anything further, I know your time is limited.

[H. Hunter Handsfield, M.D.]

Sorry -- I would have recommended an ID specialist if you hadn't seen one.

One idea you might discuss with him or her:  In recent years, we have learned that some people have very specific minor immune system defects that leave them susceptible to particular infectious organisms.  It might be some strains of staph in one person, strep in another, certain mycobacteria (TB-like bacteria), or certain yeasts in another.  Unfortunately, there are no specific diagnsostic tests for many of these, but perhaps you such a defect in relation to Candida albicans or other yeasts.

For the most part, most people with such problems have no serious health outcomes.  Probably you do not have any broad kind of immune deficiency that will ever harm you.

This is only an idea -- but as I said, maybe consider running it past your ID consultant.  If s/he agrees something like this might be going on, conceivably referral to a particular specialist doing research in this area might be helpful.

But we're getting well beyond HIV, which is the main topic for this forum.  That will have to end this thread.  Best wishes.

[lostone43]

One final question:

Considering my recent oral symptoms and that I also had thrush in the past is their a certain speciality in medicine who might have success figuring out the cause of  my problems?

(The ID Dr I saw several months ago found nothing after many tests)

Thanks for your time and advice.

[lostone43]

Thanks for your professional advice! Unfortunately I am not a very healthy person.  I have had thrush and chelitis before.  I was refered to ID doctor in the past.  He did every test in the book and found no underlying cause.  Such is life.  Thanks!

[H. Hunter Handsfield, M.D.]

Welcom to the forum.

I can answer this one easily based entirely on the title of your question, before reading anything else.  if testing is done sufficiently long after the last possible exposure (4-8 weeks, depending on the specific test or combination of tests), then definitely rely on the test result, not symptoms.  No matter how typical the symptoms may seem to be, the test result rules.  There are no exceptions.

Now I have read the question.  I agree exactly with your doctor, including his comment about the cheilitis.  Oral thrush is rarely a sign of new HIV infection and occurs commonly in healthy people.  I had it myself once.  Angular cheilitis can often be due to the same yeast infection as the thrush -- and also doesn't generally signify significant immune deficiency.  Your negative duo test at 4.5 weeks is conclusive.  (And in any case, you had a zero risk exposure.  HIV has never been known to be transmitted by fingering or hand contact with genital secretions.  And your partner's negative HIV test also proves she wasn't infected anyway.)

Those comments answer all your speccific questions, but to be sure there is no misunderstanding:

1) Yes.  2) Yes.  3) No risk.  4) Yes.

You can move on without worry. Don't confuse anxiety or shame over a sexual choice you regret with HIV risk.  They aren't the same.  Deal with the former as you need to, but forget the latter.

Best regards--  HHH, MD

[H. Hunter Handsfield, M.D.]

Noted.  See above.

[lostone43]

I had one typo the angular chelitis started on NOVEMBER 21.

Sorry for the typo.

[lostone43]

Please note the finger with the cut was not bleeding or oozing.  It also never was inserted inside the gal. I did use the injured hand to use the toy.  I am worried vaginal fluids while holding the sex toy came in contact with my wound.