hiv exposure and length of ARS symptoms

[anxiety65]

35 days ago I had protected vaginal sex with a sex worker.  She provided the condom  I also lubricated her clit with my tongue, but did not insert my tongue into her vagina.  18 days later I developed slight fever and swollen gum.  I also felt some discomfort in my arm pits.  This came and went during the day.  My normal temperature is about 97.7 and it went to 98.5 only at night.  It is back to normal when I wake up.  30 days later I had nausea and dry heaves once each day. At this 30 day period I had facial flushing and did not feel well for about 3-4 days.  Now 34 days after exposure I have developed an ball like swelling behind my left ear.  I have also developed candida in my groin.  I know this because I have had it before.  I have had night sweats once at about 20 days.  

So my question is, it seems that symptoms have progressed since the 18th day after my incident.  I have read everyone is different but is it possible for my symptoms to be changing with each passing day.  I have had unprotected sex with my wife twice, but have stopped because of my concerns.  

I called the CDC hotline and they said protected sex is only 95% effective.  And that unprotected oral sex, although low exposure is an exposure and they recommend not having unprotected sex until I am tested at 90 days.

Anxiety is a horrible thing but my swollen gland and arm pit discomfort are not caused by stress.

I have had previous great responses from your doctors and hope to have that again.  I am thinking that the Oraquick test may be a help.

thank you for your response.

[Edward W Hook, MD]

Welcome back to the Forum.  I think you are associating coincidental occurrences with your exposure to a CSW over two months ago. Most commercial sex workers do not have HIV, even unprotected genital sex between and infected and uninfected person transmits HIV only once in about 1000 sex acts and the risk for oral sex, even when asking the most conservative sources (like the CDC, is far, far lower.  Mathematically, I would gauge your risk for HIV as being less than 1 in 100,000 (i.e. more than 10 times the likelihood you will be struck by lightning)and probably far lower than that.

The information you received from the CDC is overly conservative, as you would expect to be the case with information as you might expect from a governmental agency which feels that if "cannot afford" to be wrong.  Further the symptoms that are concerning you do not resemble any description of the ARS which typically has its onset abruptly between 2 and 6 weeks after an exposure, which all occur at about the same time, and which resolve in a week or less.  Swollen glands, in any location, are non-specific findings.

I would not worry at all about this exposure or that your symptoms were due to the ARS.  If you feel you must, you could get an standard HIV antibody test at this time.  If any of your symptoms were due to HIV, the test would be positive at this time.  

Please don't worry. EWH

[Edward W Hook, MD]

Glad we could help.  Take care.  EWH

[anxiety65]

Dr. Hook,
i just wanted to let you know that i took a HIV Elisa test at 8 weeks and the results came back negative, as you predicted.  i have regular follow-up visits for another condition with a blood oncologists.  they also agreed that my exposure was extremely low risk.  they said i could take another test at 6 months, if i was still anxious about it.  

Thanks for all you do.  My advise is to pay heed to your advise. it will save weeks of agony.

thanks again

[anxiety65]

Thank you

[Edward W Hook, MD]

As i said in my original post, your risk form the exposure you described was minsicule to start with.  You are correct, this further information is strong evidence that you are not at risk from HIV from the exposure you describe.
I will have nothing more to say.  You need to relax and move on. EWH

[anxiety65]

my last post had a warning 'report" with three options.  i inadvertently hit abuse not knowing what the report "report" meant.  i was just trying to tell Dr. Hook that that sex worker took an Oraquick test and it was negative.  i really appreciate the work Medhelp does and would not abuse it.  just felt the Oraquick comment might have supported Dr. Hook's original comments.  i apologize if I did something wrong

[anxiety65]

the sex worker took a Oraquick test today and it was negative.  today was 36 days after my encounter with  her.  Certainly not definitive but comforting, until i take my test

[anxiety65]

I hope your anticipation is correct.  you have a very nice way of saying that i need to accept those results, which you anticipate will be negative and then quick worrying about an go about my life.

you are so kind and thoughtful.

thanks

[Edward W Hook, MD]

An OraQuick test will be fine.  Before you take it however, please commit to believe the test result when you get it (I anticipate it will be negative).  EWH

[anxiety65]

True, they come on an off, although it seems that since the 30th day, my neck has remained stiff, my armpits have discomfort and I have a swollen node behind my left ear.  I began to think that maybe symptoms started the 30th day and not the 18th day which I thought.

anyway thinking is stressful. will an oraquick test work just as good or should I just get a regular HIV test?

thanks again for all your help.

[Edward W Hook, MD]

Among other things, it is that your symptoms are occurring every few days that makes me confident that your symptoms are not due to HIV.  I see no need for your to abstain from sex with your wife because of concern that your symptoms are due to HIV. EWH

[anxiety65]

As always your words are comforting.  My curiosity was because it seemed that every few days I had some new symptoms.  I will test, if you think I should and until that time will not have unprotected sex with my wife.  

thanks