potential hiv exposure - strange symptoms

[paul65K]

Dr HHH or Dr Hook,

I posted this question in the community forum but would like your insight as well. I'll give you the quickest version I can. On September 11th I had a sexual encounter with a transexual prostitute. It was completely protected oral and anal and I was the insertive partner. The same condom was used for the oral and the anal. It appeared that the condom did not fail but I've been doubting that for the following reasons:

- 2 days after the encounter I had bumps in my pubic region. Went to the doctor and she said I had folliculitis and gace me doxy. The bumps went away in about a day and a half and I only took the doxy for 5 days as it had appeared to do its job.
- about 5 days after stopping the doxy the back of my tongue was white. Several days later, about 12 days after the sexual encounter my tongue was now white and I had a cold. Runny nose, coughs/ sneezes, my neck felt swollen but the doctor said my glands weren't. Throat mildy sore, only really in the AM.Some chills I guess? No fever and no rash. took a full std test at this time- all negative.
- the cold lasted 5 days.was given nystatin for my tongue, at first made it worse then seemed to help. I was also taking OTC pribiotics/ eating a lot of yogurt to try and help what I assumed what thrush.
-a week after my tongue turned white I started getting blotches under the head of my penis and rash on my inner thighs. Dr said it was yeast, gave me cream. The cream helped.
- my tongue was almost better but then my mouth turned completely dry and my tongue turned white again. My skin is also very dry/ flaky.
I've losted about ten lbs in the passed 6 weeks and I haven't really had an erection since. I have a family and have been avoiding sex with my wife. I plan on getting tested this week but I feel like I will be positive because I've never had any of these issues and they all came right after this encounter. Your opinion is much appreciated.

[Edward W Hook, MD]

Your testing was done more than 5 weeks after your encounter of concern. At that time the antibody test would have detected over 90% of recent infections, strong evidence that you were not infected at the encounter you described.  EWH

[paul65K]

Dr. I went to a Duane Reade walk-in clinic and had a Hiv AB blood test done. The results came back (in less than a full business day which I found surprising) and were negative. I want to feel relieved but also don't want to get my hopes up. Judging from your advice though this should be a promising result shouldn't it?

[Edward W Hook, MD]

I'm pleased I could help. Please don't worry. EWH

[paul65K]

Thank you very much Dr. Your response is much appreciated. I will get tested this week and again at 3 months. I was most nervous because the cold and worst of the thrush happened at 2 weeks post exposure. Right after the encounter I remember having no concern of condom failure until I started having symptoms. I'm hoping this is all anxiety related. Thank you again for your time.

[Edward W Hook, MD]

Welcome to our Forum. I'll be pleased to comment and expand a bit on what you've already heard from the HIV Prevention Community site.  First, it is unlikely that your partner had HIV, most people, even most transsexual commercial sex workers do not have HIV.  Further, even with unprotected penetrative anal intercourse, your risk for infection if no protection was used would be less than 1%.  With condom use, the exposure you describe was very low and probably no risk for HIV.  Condom protected sex is safe sex as long as the condom is worn throughout the encounter and does not break.  If your condom appeared intact at the end of sex, it almost certainly was- when condoms fail they break wide open leaving no doubt that they have failed.  

Your folliculitis began too soon to be a manifestation of recently acquired HIV.  The symptoms of recently acquired HIV, the ARS typically occur between 2 and 6 weeks following exposure, not at two days.  None of your other symptoms are particularly suggestive of HIV either.

There is a very good explanation for your thrush- this is a common problem following taking antibiotics such as tetracycline and certainly does not suggest HIV related to the exposure you describe.  

I urge you not to worry.  Get tested.  If any of your symptoms were due to HIV, the tests would be positive at this time and a standard HIV antibody test performed at 6 weeks detects over 95% of recent HIV infections.

I hope these comments are helpful to you. EWH