Still worried

[sicksarf]

I had sex with a gay masseuse/escort about a month ago. He was the third one I had ever been with, and I had stupidly assumed that he would use a condom like the others before. To my utter horror, he flipped me over right after the massage, all lubed up and proceeded to top me bareback right after the massage. I resisted as I could not take the pain and wasn't at all comfortable with him doing it without a condom and told him to stop. He withdrew but attempted to penetrate me again after further foreplay, stopping only after my repeated protests due to the pain. We  eventually did some anal frottage and we both climaxed through c2c frottage. My anus felt raw after the encounter but there was no further pain nor any blood.

The symptoms I went through in the following weeks did not seem too reminiscent of ARS; constipation (no bleeding) for the first week, extreme fatigue for two whole days during the third week, on-and-off diarrhea, and a persistent cough. This still did not put my mind at ease because according to what I gathered on the net, not every person infected with HIV goes through ARS. What made me panic even more was the fact that I am undergoing biologic treatment for my psoriasis. What if the biologic suppressed the ARS symptoms but my body had already gone through seroconversion?

I finally gave in to my fears and took the test this morning, more than six weeks after exposure. The test came out negative after a long and agonizing wait. I am obviously extremely relieved but that nagging worry about my psoriasis treatments giving a false negative still keeps going off in my head. Should I still be worrying so much?

[Andy Velez]

The average time to seroconversion is 22 days. So a negative at 6 weeks is very meaningful. You should still re-test at 3 months for a conclusive negative result. With that negative already in hand now, it is likely you will continue to test negative again at 3 months.

When you are with anyone in the future whether escort or not, you need to make clear you only want to have protected intercourse if it goes that. Bring your own condoms to the event just to be sure they are handy.

I expect you to come out of this ok.

[jkinatl2]

Wow, what you describe sounds right next door to sexual assault. You have the right - actually the obligation - to set your sexual boundaries and have them respected. At the very least, I would give this masseur a scathing Yelp! review.

If he is a professional masseuse, is there a licensing body in your area to whom you could report him?

On the topic of HIV, your six week test results are HIGHLY encouraging. It is a rare event when someone tests positive between week six and twelve. Not that it never happens, but I honestly can't remember the last time I saw it happen to someone on these forums.

I agree with Andy, as always, and expect you to come out of this OK.

[sicksarf]

Hi Andy and JK, thank you so much for your kind and hopeful words. The emotional roller coaster I've been on for the past few weeks still hasn't come to a complete stop even after the results today. I know I'm probably being irrational but it just feels like something inside is still telling me no, you can't expect this result to be accurate because your immune system is already messed up (my psoriasis) and complicated by steroids and immunosuppressants.

Not to mention the extreme guilt and betrayal I feel towards myself and my loved ones that still lingers constantly in my mind. The thought of having to endure the same level of torturous anxiety for the next two months feels like pure hell to me.

The escort was not a licensed one operating on a site which is probably illegal in most places anyway. I do feel that I need to seek help regarding my porn and sex addiction. Finding escorts online was the escalation of that plus a lot of self-loathing I guess.

[sicksarf]

I have been asking around on other HIV/AIDS forums and people are telling me that prolonged immune suppression may prevent the development of antibodies to HIV (and thus lead to a false negative test result) due to systemic illness affecting the immune system or some potent systemic immunosuppressant.

My anxiety spiral has come back because I am actually on ustekinumab, a biologic which targets certain interleukins which cause psoriasis. Does this mean that I could very well land right in the "rare" percentage where testing negative for a 6 week or even 12 week ELISA rapid test might still turn out inconclusive? Do I have to keep testing until 6 months? Or should I be going for a PCR test to find out my viral load instead?

The only "comforting" thought I can give myself is that one of the adverse side effects of ustekinumab is an increased risk of infection. In fact I had to test thoroughly for infectious diseases like tuberculosis before I could even start. But this uncertainty is wrecking me internally every single day. I know I shouldn't keep googling and asking around on forums but nobody wants to be a statistic, I guess.

[Ann]

sarf,

The drug you are on to help control your psoriasis is not one that will affect your hiv antibody test results.

The only people who might need to test out further than three months are those who are on chemotherapy for cancer, anti-rejection drugs following organ transplant, or those who have been injecting street drugs, every day, for years. Even these people will normally test positive on today's tests by three months, if not six weeks.

Like Andy and JK, I also do not expect your six week negative result to change when you confirm at the three month point.

Ann