Strange case

[learned]

Hello.. I'll make this breif.  I am worried that I may have contracted an std in africa that we don't screen for here in the us.  I had an encounter with a girl from botswana africa 7 years ago.  Since then every 6 months or so I get sick..(bad taste in mouth tired spells) Finally I went and got tested for hiv and Chlymidia (spelling?) The hiv test (ora-quick advance oral) came back positive (there was a faint line).  They did a follow up test -standard elisa - negative.  Then I went to my doc who ran an Rna pcr just to be sure about the hiv..negative... I also had a third elisa (hiv1/o/2) that came back negative.. so I think hiv is out.  Heres the thing.. what else should I test for?? If the first test showed positive are there any other stds out there that I should be looking for.  I'm trying to enjoy the good news about not having hiv.. but dont want to put my health in jeapordy by overlooking other causes.  Thanks for any help.  Also, if you don't mind.. I've gotten some mixed research on false positive ora-quicks.. cdc says you should follow them up with  a western blot.. but the clinic and my doc thought that should only be done if the blood draw elisa was positive..and that a western blot adds nothing to a negative elisa.. who should I believe? Thanks sooo much for your time...

[learned]

thanks doc.. your wisdom is very helpfull.  I trust my doctor and the clinic.. I was just a litttle worried about going against the "CDC" and thier "mighty" reccomandations.. although I know they have to be as conservative as possible.  I am "pretty much" over the hiv thing.. I figured that a western blot was pointless because if the elisa test was negative after so long it means there are no antibodies.. thus a positve western blot would eith be wrong or my body does not make anti-bodies (and I'd probably be a sick dude) As for the other std's I just wanted to be sure I was covering all the grounds.. you can imagine how scary that positive oqa-quick was and it made me aware of the unfortunate consequences of not always being safe.. I guess the scare was hard to let go and I tsarted filling the gap left behind by worrying about other stds.. I really respect your judgement and promise to listen to you.. I am so thankful for you... you ROCK!!!!!!!!!!!!!!!!!!!!

[H. Hunter Handsfield, M.D.]

I'll try to help, but based on the opening lines I am doubtful.  There are no STDs in Africa that are not well known and easily tested for in industrialized countries.  Now having read the rest of your message, you can be sure no STD is responsible for your symptoms.  There simply is no STD that causes such things as bad taste in the mouth, periodic fatigue, and so on.  I very much doubt your symptoms have anything at all to do with your sexual encounter in Botswana, except perhaps anxiety over that event.

That includes HIV, and your test results prove unequivocally you don't have HIV.  Your comments about false positive HIV tests (e.g., with OraQuick or any other test) are irrelevant. You have not had a false positive result, you had only negative results.  Your doc is right, there is no point in a western blot after a negative ELISA.  You definintely do not have HIV; let it go.

Good luck---- HHH, MD