Horrified

[Horrified87]

A little more than 4 weeks ago I got quite drunk and slept with a sex worker in a brothel in Spain.  I used protection, and it appeared that it is standard practice there to use protection, but did finger her.  Just three days later I had vomiting and diarrhea along with a rash on my thighs.  Those symptoms lasted approximately two days or so.  After returning to the states I developed jock itch and folliculitus.  At exactly two weeks I had a fever of 101 only for a day, and honestly only for a few hours that day.  I am horribly anxious doctor.  To the point at which I cannot sleep.  I got tested at 10 days, and then again at 4 weeks.  Both tests were negative for HIV.  What horrifies me is that my hands seem quite dried out, often sort of stinging with minor internal pain.  After washing several times, they had little red dots on them (on the outside), which appeared to be in the hair follicles.  Those dots don't last more than 20 minutes and only happened two or three times.  I've also had a very minor sore throat, and some what running nose.  Please doctor, I would appreciate some advice.  I'm horrified to the point that I can't even hold my hands straight.  Does this sound like it is HIV infection?  And also, how accurate would my 4 week results be?  And does this sound like it could be some other STD?  I've also had pains in what I think may be my lymph nodes (arm near armpit, and neck), but I don't know if thats from me pressing on my lymph nodes every five minutes to check if they're swollen.  I've also broken out in an unusual number of pimples on my shoulders.

[Edward W Hook, MD]

Welcome to our Forum:

Even before we discuss your test results let me assure you that your risk of HIV from the exposures you describe is essentially zero.  Here are the reasons that I say this:

1. It is unlikely that your partner had HIV.  Most commercial sex workers do not have HIV.
2.  As you point out, condom protection appears to be the norm for this woman.  The reason for condom use in this setting of for her to protect herself, not to protect you.  This too makes it unlikely that she had HIV.
3.  Even if she had HIV, this is of infection if intercourse is unprotected is only about 1 infection per 1000 exposures.  You used a condom, making the exposure virtually zero risk.  There is no risk for HIV transmission from your masturbation of your partner.  
4.  Your symptoms are non-specific and not suggestive of HIV.

Putting the facts above together, your risk from this exposure is essentially zero.  Your blood test at this time further supports this statement.  At 4 weeks about 90% of persons who had acquired HIV 4 weeks earlier would have positive tests.

Bottom line, you really are not at risk for HIV from this exposure.  You really have nothing to worry about and do not need further testing.  I hope that my comments are helpful to you and will you to put your anxiety behind you.  EWH

[Horrified87]

Good news doctor, the test results were negative!  Just as you had predicted.  This has given me good hope that I am truly negative.  The symptoms still worry me quite a bit.  But I'm seeking mental health professional to try to work over my fears.  I've gotten both the rash on the chest (pimples) and the spots on my hands, now coupled with this severe sore throat.  However, the high fever hasn't appeared.  I truly hope I am negative and as you have quoted, an antibody test at 6 weeks would catch about 95% of those who would be positive, correct?  Thank you again Doctor, it's a wonderful service you provide here.  I'm soon to be married, would've proposed on my return from Spain, but this whole ordeal set me off the edge!  I'll never make the same mistake again.  Thank you again doctor!

[Edward W Hook, MD]

It is time for this thread to stop. Four questions ago you had "one last question".  Since that time it appears that you have spent you time examining and re-examining yourself for signs of HIV infection.  As I said, this is a waste of time.  Your test result from today will be negative. When it is, I urge you to believe it - it will  verify what I told you almost two weeks ago. You are not at risk for HIV from the exposure you inquiired about.  The thread is now over until you have some test results to report.  Take care.  EWH

[Horrified87]

Doctor, today I took the 6 week test (one day early) waiting on results.  In the mean time, a small red patch appeared on the shaft of my penis right about in the middle.  It's about 2-3cm in diameter, and has three lines raised up from it.  It does sting a bit.  As I haven't had any encounters outside of the one protected encounter I described, what on earth could be causing all of this?  The dry hands and armpits are gone, but my sore throat has gotten much worse.  I do not believe I have a fever.  I'm still going crazy thinking this could be HIV and the patch means maybe the condom failed, although I don't recall it breaking or slipping.  I'm horrified doctor.

[Edward W Hook, MD]

You can test as much as you like- the answers will be the same.  You did not get HIV from the exposure that you are concerned about.  Until you accept that, you will delay assessing what is really troubling you.  The rash and your other symptoms could well be a community acquired viral infection, perhaps withthe symtoms worsened by your anxiety and your internet searches.  If your symptoms are really troubling you, I would suggest you see a trained health care provider for evaluation.  You do not hawever have HIV.  I say this only in an effort to help.  EWH

[Horrified87]

I failed to mention that the test next friday will be exactly 6 weeks.  It's just so confusing with so many different opinions on the matter.  I trust your opinion on the matter Doctor Hook.  It's just I am anxious and I do know that my anxiety is getting the best of me.  And I do apologize for the multiple questions.

[Horrified87]

Doctor, while I don't want to be one of those users who repeatedly posts pointless questions, which I'm sure can get tiring, I had tiny red pin-point dots on my hands this morning when I awoke.  The dots were the same as the ones I had about a week ago.  In a cluster on the back of my hand in a group of about 10.  My sore throat persists, and my joints feel a little stiff, especially my neck and my shoulders.

I unfortunately continue to search online and have finding symptoms and it is absolutely horrifying.  I intend to get a DNA test by PCR next Friday, April 16th, along with another DUO antigen/antibody test.  If these symptoms are caused by HIV, would these tests show the presence of the disease given the symptoms were present?  And can I rest assured with those results?

What could suddenly be causing these red dots?

[Edward W Hook, MD]

Neither dry armpits nor hand pain are signs of syphilis, HIV or any other STD.  That you notice them and are worried suggests that your anxiety is getting the best of you.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to various sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  I suspect this is a contributor to your situation.  Try to relax.  EWH

[Horrified87]

One last question Dr Hook, while you've rested many of my fears concerning HIV, I did not mention that my armpits seem dried out as well, and a little bit in pain occasionally.  Along with the pains in my hands, does this sound like Syphilis possibly?  Or is it still too general to be able to determine?  Again, I appreciate the help.  I know my level of anxiety is not normal.  In fact, it is driving me insane.  I think I may be driving the symptoms myself.  Especially my sore throat, which to be honest isn't exactly sore just dry.

[Edward W Hook, MD]

Glad to help.  Take care.  EWH

[Horrified87]

Thank you Dr. Hook.  I cannot express my gratitude for your answer.  I have thought my many of my symptoms may have been stress induced.  While I'm still going to get a test at 6 weeks and once again at around 3 months just to be 100% sure, your answer has allowed me to relax, and breath easy again.  The use of this forum is a wonderful way to get answers from experts such as yourself.  Again, I appreciate it so very much Dr Hooks,  you're an enormous help.  

[Horrified87]

One last thing I left out, was her insistence on using protection (which is fine by me, as I wouldn't have done otherwise).  But what struck me as odd was when she even wanted me to put a condom on my finger when I began to finger her.