I still can not shake this feeling...Please Help

[crazykid111]

Dear Dr.,
I am a 22 year old straight male and about a year ago i had a long sexual encounter with a prostitute.  I put a condom on before and hopefully it stayed on the whole time (I was very drunk, it could of possibly broke or fell off without me noticing).  Ever since then i have had these very weird symptoms that can not shake me of the feeling that i might of got HIV.  Since then I have had painful/difficulty swallowing (i constantly feel the urge to swallow and its painful, but has been getting a little less painful over time, but still never goes back to normal) and get oral sores more frequently.  Also i have greatly lost a lot of muscle mass and my face has been looking very sucked out (to the point where people i know keep telling me i look terrible and think i do cocaine, which i do not).  Also my cuts do not heal as quick as they used to.  Another symptom of mine that is very weird is ever since the exposure, my ejaculate has become very seperated (half is thick and half is very very watery...this is not how it used to look before this exposure).  I have gotten a blood test a month after and an oral swab 6 months after, both which came back negative.
My Quesions are:
1.  Would painful swallowing start a week after my exposure or that is not a sign of early HIV infection?
2.  Do my symptoms sound like wasting, or would wasting not occur till later?  (i can blame muscle mass loss on i do not work out 5x a week like i used to, but my face looking sucked out scares me)
3.  Would impaired wound healing happen this early if i was infected?
4.  Should i consider the 6 month oral test a definitive negative or should I get tested again to ease my mind?
5.  Do men with HIV have different looking ejaculate or is this problem caused by something else most likely?

Thanks

[Edward W Hook, MD]

Welcome to the Forum.  There is nothing in the symptoms you describe to suggest in the least that you have HIV.  In addition, your HIV tests absolutely prove that you did not get HIV from your encounter of concern a year ago.  It is time for you to forget about HIV.  On the other hand, both the difficulty swallowing and the unexplained weight loss/wasting warrant evaluation if you have not already done so.  I recommend you see your regular doctor or, if you don't have one, that you get one to have these problems evaluated.

As far as your specific questions are concerned:
1.  No.  In persons with HIV, painful swallowing is a problem that occurs late in infection, after people have been infected for years.
2.  Se above, weight loss can be caused by lots of things including calorie deficiencies from excessive workouts.  See my advice above.
3.  No
4.  Your 6 moth test IS definitive evidence that you did not get HIV.
5.  There is no reason to think that HIV would alter the appearance of your ejaculate.  

Hope this helps.  Take care.  EWH

[crazykid111]

Thank you doctor for your response.  I already went to my PCP and he said these problems can be caused by the stress i have caused myself by the encounter.  I think my next step is to get over possible HIV infection and go see an ENT specialist.

Thanks again for your reassuring response