Risk Assesment Needed

[user1605]

Dr H's - Here is my story:

Myself:
Age: 26 -Uncircumcised- No prior STDs - Heterosexual

Possible Exposure:
1st Sexual experience (virgin prior) w/ CSW
Location: Tijuana, Mexico – Legal Brothel
Oral + Vaginal = Protected – Durex Pleasuremax – Exp 2014 – Approx 7 minutes  
Alcohol was involved; however, I am sure of the following:
Condom was:
-Placed on by CSW – She demanded she place the condom on me
-Stayed on through intercourse – Adjusted slightly by hand of CSW while delivering HJ to make me more erect
-Did not break- Pulled out before ejaculating and saw semen gather in reservoir  with no leak
-Removed with a towel
Her response after asked about STDs after sex “this is my job” and I have nothing to worry about.  

Possible Symptom:
(every anxiety symptom)  - Fear of HIV-  Consuming my life
Nausea, vomiting, lack of appetite, short. of breath:( only in the mornings and when I think of my life with HIV) – Started @ 5-6 Days(rough to tell due to hangover symptoms after incident) – Lasted 2-3 weeks
No fever, headache or sore throat - 98.8 (highest-oral)

Trouble sleeping and nightmares – I have nightmares about HIV and wake up a bit sweaty – I wake up roughly 2 hours early and use the restroom as well. (normal stool not diarrhea)  

Went my doctor (@ 4 weeks) and he said my symptoms were anxiety related –cried during appointment – He told me a normal blood test was what I needed – He said NO HIV testing required
Result – slightly high: calcium+ wbc count– but 100% healthy

I went to Europe @ week 5 and felt fine there (I believe it was due to a mental distraction)
Pain in neck – I am sure it was due to wrestling on the beach and whiplash (not swollen lymph nodes – no fever) - but not 100%
Rash after scratching bug bites on shoulder and back – (don’t know if ARS rashes start as a bite and spread after itched)

Questions:
1. HIV Risk?
2. Analysis of sypotoms and timeframe?
3. Any further testing required?

[H. Hunter Handsfield, M.D.]

That's supposed to say "any further discussion".  Sorry for the typo.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.

You very clearly describe the main problem here.  I agree exactly with your doctor about anxiety as the only important health issue.  You had a very low risk exposure:  your partner probably did not have HIV, you had completely safe sex, you describe no symptoms that suggest HIV, and the improvement when you were traveling (and your mind not on the sexual exposure) further supports a psychological origin for your symptoms.

That said, I disagree with your doctor about HIV testing and think you should do it.  For sure no testing is needed from a medical or risk assessment perspective, and this does not mean that I really believe HIV is possible.  I do not.  But most people with anxieties like yours are not satisfied merely by verbal reassurance.  Knowing you have had a negative test probably will help convince you that you were not infected and will help you move on without worry.

Feel free to report your HIV test result.  But let's not have any hoer discussion.  There is nothing you can that is likely to change my opinion or advice.

Best wishes--  HHH, MD