Mono or HIV?

[timerunit213]

Hi Doctor, Late January 2010 I had a "no-risk" exposure for HIV: French kissing, hickies, fingering someone else. I tested positive for strep throat after 2 days (sore throat/tonsils but symptoms went away after treatment) and at about 2 to 2.5 weeks later mono-like symptoms (lymph nodes in face and neck (nowhere else), night sweats, neck pain, swollen tonsils, (NO RASH). I thought it was mono but I tested negative for it. These symptoms lasted a month. I panicked and since I tested negative for mono I thought I might have HIV. I kissed two girls and fear one of them infected me.I have been told time and time again that HIV simply is not transmitted through the ways I describe but over the past couple months I have had some inexplicable symptoms such as back rash and a pimple right on my perineal area (March 25); white tongue, armpit pain (June-July); and redder, more wrinkly palms (June). I took many antibiotics during February and March to deal with my Strep throat and back rash (penic/amox/bactrim) I also took a steroid (prednisone) to reduce swelling.I showed my white tongue to my doctor and he told me to not worry. I'm afraid I'll get a false-positive or that I actually have HIV. My anxiety is so great that I play "what-if" game and think I may have been pricked by a needle that night and contracted HIV that way even though I did not feel any sort of sting and did not see a needle or see any blood or anything like that. I also had a random bruise and that also made me panic. I am a virgin and have never used needles.  I have not tested yet, and I need to ask some questions:
a) Is it possible for mono to test falsely negative at 18 days after exposure? If not what could it be?
b) Was I at risk for HIV?
c) Is there a chance all the antibiotics and prednisone caused my white tongue (which came 2 to 3 months after getting off the meds)?
d) Will I be the first person in history to contract HIV from kissing?

Please tell me I don't have HIV. Thanks.

[Edward W Hook, MD]

Welcome to our Forum.  I considered answering your question based on the title of your question and, after reading the entire question, could have.  The activities you describe are completely and entirely no risk and not a reason for concern.  Mononucleosis is a common problem and in about 25% of people with mono the mono test is negative.  What you describe sounds very typical of mono.  With this as background, let's deal with your specific questions:

1.  Yes, as I said above, this could still be mono and probably was.  
2.  No, no risk what so ever.
3.  White tongues are most often caused when the papillae (microscopic bumps) which cover the tongue grow longer than normal.  this can occur for many reasons. White tongues (which are not thrush) are not a manifestation of HIV infection.  Your antibiotics may have played a role.
4.  Nope.  there is no reason for you to be concerned about HIV and no medical reason for testing.

I hope this is helpful.  EWH

[Edward W Hook, MD]

This is a new question.  One answer and then there will be no more.

Condom protected sex is safe sex.  While there are a few infections which can be spread by direct contact with skin not covered by a condom (herpes, syphilis, HPV) condoms greatly reduce the risk for them too.  Since most persons do not have STDs and since most exposures do not lead to transmission of infection and since condoms work so well, you really have little to worry about.

thread is over.  EWH

[timerunit213]

One quick question Doctor. I had protected vaginal sex last night with a woman of unknown status. I checked the condom and there were no holes or tears. Are there any STDs i should worry about from this "exposure"?

[timerunit213]

I would like you to know that I took a rapid finger prick test for HIV and came back negative. My anxiety of over 6 months has finally left me. Thank you so much for your help. :)

[Edward W Hook, MD]

The questions you are asking are anxiety-driven, "what if"s and "could this be" questions which do more than identify you as a person who "needs an explanation for everything". It suggests you are a bit paranoid and having trouble moving forward.  I will briefly address or comment on each of these questions, then you really need to move forward, not to get caught up in a series of "but what if's" and "could this be"s.  

1.  I have no idea what is causing you sore throat and this question is beyond the scope of this site which is dedicated to questions relating to HIV.  Whatever it is however, it is unlikely to represent an infectious disease. Infectious diseases just don't cause persistent sore throat of the sort you describe.  Perhaps you snore or are mouth breather.

2.  OHL does not affect the surface of the tongue and is not a sign of early HIV.  

3.  This strikes me as being a bit paranoid.  There are NO infectious diseases which cause disease with an infection of 2 hours.  I can't tell you why you had the experience you describe but it was not an infectious disease.

4.  All rapid tests perform similarly as they are all evaluated in the same fashion by the FDA.  Any approved tet, rapid or otherwise will provide reliable results.

It is now time for this thread to end.  EWH

[timerunit213]

Oh Okay. Thank you for the reassurance. I had no clue 25% of people test negative for mono even after doing internet research. Also, I am glad you answered that white tongues are not thrush. There seems to be A LOT of confusion on what oral thrush is on MedHelp and it was one of the factors that led me to asking this question. That makes me feel a lot better.. I have a couple more questions though:

1. I have had a very mild, constant sore throat for the past 2 months. Its sore when I wake up in the morning but once I drink a glass of water it goes away.Could this be allergies, recurrence of mono, something else? Its symptoms coincided with the beginning of white tongue...
2. My white tongue has a hairy appearance and I can brush of the white at the front of my tongue most of the time but sometimes I can't. The reason I'm concerned is because someone on MedHelp mentioned that if you cannot brush off the white that it is OHL, which is often a sign of HIV. This person was not a doctor and I felt like this was faulty information but it just frightened me a little (What if I can't brush the white off one morning?). With my added description do you feel like it's a harmless white tongue? And is the statement of the random MedHelp user false? (I wish the internet had never been invented....)
3. Over the summer I also feel like a Denny's waiter spit in (or did something to) my food because we had not tipped him the last time we came and he was our waiter again. 2 hours after eating at Denny's my throat started swelling and I had trouble breathing. The next morning the white tongue/mild sore throat started and has persisted since. Could this explain the white tongue?
4. If I were to test, which rapid test would give me the least chance of false-positive?

Thanks again and sorry for the questions. I'm one of those people that's needs an explanation for every little thing that happens to me. The unknown leaves room for fear.